The Drug-Induced Respiratory Disease Website

Beta-blockers

Refractoriness to epineprine in case of anaphylaxis

Ingall M, Goldman G, Page LB

Beta-blockade in stinging insect anaphylaxis.

JAMA 1984 Mar 16;251;1432 — 1984 Mar 16 — 1432

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

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