The Drug-Induced Respiratory Disease Website

Beta-2 agonists, B2 mimetics (parenteral)

Takotsubo (stress) cardiomyopathy

Cases have also been described following drug overdose (PMID 25172356) or withdrawal (24170890)

Publications

Salahuddin FF, Sloane P, Buescher P, Agarunov L, Sreeramoju D

A case of apical ballooning syndrome in a male with status asthmaticus; highlighting the role of B2 agonists in the pathophysiology of a reversible cardiomyopathy.

Journal of community hospital internal medicine perspectives 2013;3; — 2013

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

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

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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