Pneumotox » Drug » Aspirin (Salicylate-ASA) - Aspirin containing drugs

Aspirin (Salicylate-ASA) - Aspirin containing drugs

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Aspirin-exacerbated respiratory disease (AERD; PMID 24961377) is a naturally-occurring state where aspirin and NSAIDs can produce acute exacerbations and asthma attacks. Tests to document AERD at PMID 17521312. For induction of AS tolerance see PMID 12532116, 23861151, 24369807, 24468245.

Chronic or excessive intake of aspirin can produce pulmonary edema and ARDS (PMID 9743184, 21297545 , 27531848)

Last update : 24/01/2019

I.a Pneumonitis (ILD), acute and/or severe (may cause ARDS)

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I.c Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

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I.l Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf)

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II.a Pulmonary edema, noncardiogenic (NCPE)

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II.b ARDS - Acute lung injury

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III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

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III.c Hemoptysis

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III.m Coagulopathy

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IV.a Bronchospasm - Wheezing - Asthma

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IV.f Severe or catastrophic bronchospasm or asthma attack (can be fatal)

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V.e Hemothorax - Serosanguineous pleural effusion

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VII.b Lymphadenopathy with reactive changes

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VIII.a Angioedema (may cause UAO, asphyxia and death)

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VIII.y Sinonasal discharge, -blockage, -obstruction

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X.a DRES syndrome - DRESS-like reaction

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X.f Anaphylaxis-Anaphylactoid reaction (can be fatal)

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X.h Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

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X.m Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative)

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X.q Systemic inflammatory response

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X.u Multiple organ dysfunction/failure (MODS/MOF)

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XI.b Chest pain (acute or subacute), lone or prominent

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XI.d Metabolic acidosis (incl. lactic acidosis/-gap). May cause hyperpnea/dyspnea

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XI.as Pharmacobezoar

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XI.az Sneezing (may cause pulmonary barotrauma)

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XII.n Cardiovascular collapse - Cardiogenic shock - Hypotension

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XII.s Heart block (bundle branch- or AV-)

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XII.af Coronary vasospasm - Vasospastic angina

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XV.a Path: NSIP-cellular pattern (see also Ia, Ib)

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XV.f Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

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XV.w Path: Pulmonary edema (see also II/IIa)

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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