How to determine when lung disease is drug-induced

Many classes of drugs have been implicated in drug-induced lung diseases. The agents most commonly associated with bronchospasm are aspirin, NSAIDs, and nonselective ß-blockers, while alveolar hemorrhage is most often a complication of drugs that interfere with clotting. Penicillins, sulfonamides, and tetracyclines have been associated with pulmonary eosinophilia. The diagnosis involves ruling out other lung diseases and identifying certain clinical, radiographic, and histopathologic patterns in a patient with a corresponding history of drug exposure. For example, the combination of new radiographic infiltrates, decreased lung volumes and carbon monoxide-diffusing capacity, and foamy macrophages in bronchoalveolar lavage fluid is consistent with amiodarone-induced chronic interstitial pneumonitis.