Nepoželjna djelovanja lijekova na pluća

Cilj istraživanja: Brojni lijekovi, biljni i dijetalni pripravci, te nedopušteni preparati mogu uzrokovati ozljedu pluća (dišnih putova, plućnog parenhima, pleure i/ili krvnih žila). Iako su nuspojave na plućima uzrokovane nekim lijekovima dobro definirani klinički sindromi, do dijagnoze se češće dolazi isključenjem drugih uzroka. Ne postoje pouzdane i konačne kliničke, laboratorijske, radiološke ili histopatološke dijagnostičke metode. Cilj ovog istraživanja je sažeti suvremene spoznaje o pojavnosti i mehanizmima nuspojava različitih lijekova, biljnih te nedopuštenih preparata u plućima. Analizirati će se mehanizmi pouzdano dokazanih i dobro istraženih učinaka kao i manifestacije nejasnog etiopatogenetskog mehanizma. Analizom dosadašnjih istraživanja i prezentiranjem slučajeva iz kliničke prakse prikazati će se širina spektra lijekova sa potencijalom plućnih nuspojava te iznimna raznolikost njihovih kliničkih manifestacija. Materijali i metode: Uvidom u stručnu i znanstvenu literaturu (udžbenici) istražene su temeljne spoznaje o nepoželjnom učinku lijekova na pluća, istraženi su lijekovi pojedinačno, njihove manifestacije, dijagnostički postupci kao i pretpostavljeni mehanizam nastanka. Podaci su prikupljeni pretraživanjem literaturnih podataka u sljedećim pretraživačkim bazama: Medline, BioMed Central, Google Scholar, Evidence-Based Medicine Reviews, Web of Science i ScienceDirect. Rezultati: Određeni su lijekovi, biljni pripravci te nedopuštene supstancije koje mogu uzrokovati neželjena djelovanja na pluća. Podatci su prikupljani, kako za lijekove koji takva djelovanja vrlo često izazivaju, tako i za ksenobiotike čiji učinak na pluća još uvijek nije dovoljno istražen. Predstavljen je pretpostavljeni mehanizam djelovanja, kliničke manifestacije toksičnog učinka na pluća te dijagnostičke metode i nalazi koji potencijalno mogu pomoći pri opravdavanju sumnje i postavljanju dijagnoze. Zaključci: Svakim danom raste broj lijekova koji mogu uzrokovati značajno, ponekad i fatalno, oštećenje različitih struktura dišnog sustava. Iako je u nekim slučajevima mehanizam ozljede poznat, često se radi o zapažanju bez jasne uzročno-posljedične veze. S obzirom da se radi o vrlo propulzivnom području farmakovigilancije koje karakterizira veliki broj novih saznanja nužna je detaljna informiranost kliničkog farmaceuta glede lijekova s potencijalom navedenih nuspojava kao i kliničkim manifestacijama tih nuspojava. Stečeno znanje pomoći će u pravovremenom prepoznavanju određene plućne nuspojave lijeka te omogućiti ispravan postupak usmjeren maksimalno sigurnom liječenju i zaštititi bolesnika.The aim of the research: Numerous medicines, both herbal and dietary supplements, as well as illegal supstances may cause lung damage (respiratory system, lung parechyma, pleural disease and/or blood vessels). There are no reliable and/or definite clinical, laboratory, radiological or hystopathological methods to prove what had caused the lung damage if it occurs. Although some medicines have well known side effects that affect the lungs, the precise diagnose can be given only by excluding all the other factors.The aim of this research is to sum up the modern knowledge about the side effects that taking various medicines, herbal medicines and illegal supstances may have on human lungs. The objects of the analysis will be the mechanisms of scientifically proved and effects researched in details as well as manifestations of the still unclear etiopathogenic mechanism. The exceptional diversity of clinical manifestations as well as the wide spectrum of medicines that damage the lungs will be presented by analysis of the researches that have been done by this day as well as by presenting the cases from clinical practice. Methods and materials: By studying the scientific and professional literature ( textbooks), the basic knowledge about the unwanted effects that some medicines have on lungs, the particular medicines itself, their side effects, diagnosis as well as the suspected mechanism of the side effect have been researched. The data has been collected by searching the literature data from following data basis: Medline, BioMed Central, Google Scholar, Evidence-Based Medicine Reviews, Web of Science i ScienceDirect. Results: Defining the medicines, herbal medicines and illegal supstances that can cause unwanted effects on lungs. The data has been collected for the medicines that are known to cause that kind of effects very often as well as for the xenobiotics whose effect on the lungs is still not researched enough. Here are being presented the suspected mechanism in which medicines intoxicate the lungs and the diagnostical methods and medical findings that can potentialy help to justify the suspicions and to diagnose the problem. Conclusions: Every day the amount of medicines that can cause significant, sometimes even fatal, damages to different structures of respiratory system, grows. Although in some cases the mechanism of the damage is known, it is often about the insight without the obvious cause and effect link. Regarding the fact that pharmacovigilancy is a very propulsive scientific area that has a large number of different discoveries, clinical pharmacist had to be informed in detail about the medicines with side effects potential as well as about the clinical manifestations of those side effects. Gained knowledge will help to promptly recognize a certain respitatory side effect of the medicine and to enable the right procedure aimed to safe treatment and patient protection