Medications causing shortness of breath
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Medications Causing Shortness of Breath: A Review
Prednisone and Dyspnea
Prednisone-Induced Shortness of Breath
Prednisone, a corticosteroid commonly used to treat inflammatory conditions, has been reported to cause episodes of shortness of breath. Although systematic evidence is limited, case studies have confirmed that prednisone can induce dyspnea. The exact mechanisms remain unclear, but potential explanations include fluid retention and changes in respiratory muscle function1.
Clopidogrel and Respiratory Symptoms
Clopidogrel-Related Dyspnea
Clopidogrel, an antiplatelet agent, has been associated with reversible episodes of shortness of breath. This side effect is particularly noted in patients following radiologic interventions. Prompt recognition and management are crucial to prevent systemic complications2.
Cyproterone Acetate and Respiratory Issues
Cyproterone Acetate-Induced Dyspnea
Cyproterone acetate, used for treating conditions like androgenetic alopecia, has been reported to cause shortness of breath, although this is rare. This side effect has been observed in both high-dose treatments for prostatic carcinoma and lower doses for other conditions, such as in a case involving a 66-year-old woman8.
Opioids and Breathlessness Management
Opioids for Breathlessness Relief
Opioids, including short-acting formulations, are commonly used to manage breathlessness in palliative care settings. Evidence supports their efficacy in reducing dyspnea and improving activity levels when administered before exertion. However, their use as a scheduled medication for overall breathlessness relief is less well-supported3 5 7.
Diagnostic Practices and Misdiagnosis
Misdiagnosis and Inhaler Use
A significant number of patients treated with inhalers for presumed obstructive airway disorders may not have undergone proper diagnostic testing, such as pulmonary function tests. This can lead to misdiagnosis and inappropriate treatment, highlighting the need for confirmatory testing before prescribing inhalers4.
Conclusion
Several medications, including prednisone, clopidogrel, and cyproterone acetate, have been associated with episodes of shortness of breath. While opioids are effective in managing dyspnea in palliative care, proper diagnostic practices are essential to avoid misdiagnosis and ensure appropriate treatment. Recognizing these potential side effects and ensuring accurate diagnosis can significantly improve patient outcomes.
Sources and full results
Most relevant research papers on this topic
Episodes of shortness of breath induced by prednisone.
Prednisone use may cause episodes of shortness of breath, with potential explanations including increased muscle strength and skeletal muscle sensitivity.
Case ReportReversible shortness of breath caused by the antiplatelet agent, clopidogrel.
Clopidogrel can cause reversible shortness of breath after radiologic intervention, requiring prompt recognition and appropriate management to prevent systemic complications.
Shortness of breath and cough in patients in palliative care.
In most patients, shortness of breath and cough can be relieved by a series of therapeutic measures, including reassurance, emergency plans, physical activity, and relaxation exercises.
Systematic ReviewDiagnostic practices for patients with shortness of breath and presumed obstructive airway disorders: a cross-sectional analysis.
Less than half of community-based patients with shortness of breath treated with inhalers had pulmonary function tests, highlighting the need for confirmatory testing before prescribing inhalers for presumed obstructive airway disorders.
Observational StudyGaps in the evidence base of opioids for refractory breathlessness. A future work plan?
Opioids show promise in treating refractory breathlessness, but more research is needed to fill knowledge gaps and design effective trials for palliative care.
How to recognise an LV thrombus when you see one: a review of cardiac point-of-care ultrasound
Cardiac point-of-care ultrasound can effectively identify LV thrombus in patients with shortness of breath and chest pain, aiding in early diagnosis and treatment.
Case ReportUse of short-acting opioids in the management of breathlessness: an evidence-based review.
Short-acting opioids can reduce breathlessness and improve activity level when given before exertion, but more research is needed to optimize their prescription for overall relief and quality of life.
Systematic ReviewShortness of breath: an uncommon side‐effect of cyproterone acetate in the treatment of androgenetic alopecia
Cyproterone acetate treatment for androgenetic alopecia in women may cause shortness of breath, an uncommon side-effect not previously reported in women.
Case ReportShortness of Breath, a ‘Wearing-Off’ Symptom in Parkinson’s Disease
Shortness of breath in Parkinson's disease patients can be a wearing-off symptom caused by prolonged levodopa use, and can be improved with the addition of entacapone.
Case Report
Rigorous JournalPerceived effect on shortness of breath of an acute inhalation of saline or terbutaline: variability and sensitivity of a visual analogue scale in patients with asthma or COPD.
The sensitivity of the visual analogue scale to bronchodilation is better in asthmatics than in COPD subjects, but COPD subjects can be divided into high and low perception subgroups.
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