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There are hundreds of drugs routinely prescribed
against a variety of disorders that apparently can cause all kinds
of lung diseases and damage, according to a recent report.
This damage can happen within a very short
time or after several years. The effects are mostly unpredictable
and some are irreversible, leaving damaging after-effects, according
to the warning.
Drugs used to treat
the following problems are just some of the culprits:
- high blood pressure
- allergies
- rheumatism
- certain cancers
- common non-respiratory inflammations
According to a French researcher, so far
310 therapeutic substances have been identified as having such effects,
and each year 20 to 30 new substances are
being added to the list.
"This means the number is really much
greater if you consider that each active principle in a preparation
is usually marketed in several different forms," said French
lung expert Philippe Camus of the University Medical Centre of Dijon.
There are no less 50 different lung diseases
and syndromes (ranging from simple coughs and breathlessness to
pleurisies and even acute respiratory failures) that seem to be
either caused or aggravated by drugs.
Researchers collected 4200 bibliographical
references to investigate the effect of various drugs on the lungs.
They note that the information provided
with the drug's packaging hardly ever warns patients that the medicine
could potentially cause a lung disorder, and there are still not
many doctors who give the matter due thought when they prescribe
a treatment.
Researchers note that in
about 70% of cases the early withdrawal of the medicine would increase
the patient's chances of avoiding the damaging sequelae, and very
often the medicine concerned could simply be replaced with another.
The researchers have put together an informative,
comprehensive, and regularly updated Internet site which makes
all this information available free of charge (http://www.pneumotox.com).
The site is currently visited by 6000-7000 people per month. On
the site, scientists have classified the incriminated substances
into three categories, according to the number of reports published
on their iatrogenic effects.
At the head of this list are a number of antihypertensive
beta-blockers, angiotensin-converting enzyme (ACE) inhibitors
used to treat congestive heart failure or hypertension, and Cordarone
amiodarone administered in the treatment of ventricular arryhthmias.
But some antibiotics are well up the
list, as are antirheumatics (including methotrexate and several
nonsteroidal anti-inflammatories), or ergot derivatives used
to improve the brain functions of elderly patients or to treat Parkinson's
disease.
A recent British study even showed that a
commonly used analgesic, acetaminophen (paracetamol), was
not entirely free of blame either. Conducted on more than 1,500
patients, the study concluded that people who take acetaminophen
(e.g., Tylenol) every week have an 80% greater risk of suffering
from asthma than people who never take any, while those who consume
it daily are over twice as likely to have asthma.
New Evidence
An Oslo University team presented a recent
study linking the use of busulphan
and cyclophosphamide with a
temporary reduction in the pulmonary function. A Spanish team reported
similar results concerning the same medicines, prescribed during
the preparation of a bone marrow transplant and against breast cancer.
A team from Cairo University announced results
in showing that pneumonitis due to methotrexate
is not unusual (over 8%) among Egyptians treated for rheumatoid
arthritis.
Professor Camus and colleagues reported new
cases of serious pulmonary complications found in patients suffering
from bladder cancer, who had been given injections
of BCG and mitomycin directly in the bladder. One patient
even died of it, after an attack of accelerated interstitial pneumonia.
Professor Camus drew a simple conclusion from
all of this research. "These accidents could largely be avoided,
or at least reduced," he declared, "but only if certain
conditions are satisfied."
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"First, the practitioner who has
been consulted (whatever his specialty) must be aware of what
has happened.
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Second, the patient has to consult as
soon as he notices the slightest abnormal or lasting pulmonary
symptom.
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Third and last, the patient must immediately
stop taking the suspect product, which is absolutely essential
if sequelae are to be kept to a minimum."
"In addition to all those measures, there
are many changes needed in epidemiology, if such cases are to be
properly dealt with, instead of being treated merely as therapeutic
accidents".
First World Congress
on Lung Health and Respiratory Diseases Florence, Italy, August-September
2000
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