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Patient: 63-year-old woman.
Comorbidities: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus, fibromyalgia, high blood pressure, and osteoporosis. History of exposure to a wood stove for 12 years.
Life habits: abstainer and smoker.
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aminophylline 200 mg (1-1-1); amitriptyline 25 mg (0-0-1); amlodipine (25 mg, 1-0-1); azithromycin 500 mg (Monday, Wednesday, and Friday/0-0-1); clonazepam 2 mg (0-0-1); codeine 30 mg (1-1-1); formoterol and bude-sonide 12 mcg and 400 mcg (1-0-1); indacaterol 150 mcg/day; salbutamol 100 mcg (1-1-1-1-1-1); sertraline 150 mg/day; and tiotropium 2.5 mcg (2-0-2). |
Hospitalized for eight days due to an exacerbation of dyspnea and cough. |
Upon hospital admission, the use of azithromycin and codeine was discontinued, and the use of morphine and dexamethasone was initiated. An improvement in dyspnea was observed, which might be attributed to the suspension of codeine and the use of morphine and dexamethasone. |
ICD-10 Codes: J441, J448, R05, J80.
Drug (pharmacological class): clonazepam (benzodiazepine), amlodipine (calcium channel blocker), and codeine (opioid).
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Possible for codeine induced dyspnea (category F). |
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Patient: 68-year-old woman.
Comorbidities: chronic obstructive pulmonary disease, diabetes mellitus, high blood pressure, and lung neoplasm.
Life habits: abstainer and nonsmoker.
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captopril 25 mg (1-0-1); formoterol and bude-sonide 12 mcg and 400 mcg (1-0-1); and metformin 850 mg (1-1-1). |
Hospitalized for 10 days due for an investigation of lung neoplasm and chronic cough. |
The enalapril dosage was reduced and the cough improves. |
ICD-10 Codes: C493, R05, R042, R91.
Drug (pharmacological class): captopril (angiotensin converting enzyme inhibitor).
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Possible for enalapril induced cough (category E). |
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Patient: 61-year-old woman.
Comorbidities: anxiety disorder, chronic obstructive pulmonary disease, and high blood pressure.
Life habits: abstainer and smoker.
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atenolol 25 mg (2-0-2); clonazepam 2 mg (0-0-1); formoterol and budesonide 12 mcg and 400 mcg (1-0-1); hydrochlorothiazide 25 mg/day; losartan 50 mg (1-0-1); salbutamol 100 mcg (if necessary); sertraline 50 mg (2-0-0); atorvastatin 50 mg (0-0-1); and tramadol 50 mg (1-0-0). |
Hospitalized for two days due an exacerbation of chronic obstructive pulmonary disease, dyspnea and cough. |
Upon hospital admission, the use of clonazepam and atenolol was discontinued, and it was observed an improvement in respiratory symptoms. |
ICD-10 Codes: J441, J98, R05, R60.
Drug (pharmacological class): atenolol (beta-blocker), and clonazepam (benzo-diazepine)
Trigger from Global Trigger tool: Abrupt medication stop
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Possible for atenolol and clonazepam induced dyspnea (category F). |
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Patient: 80-year-old man.
Comorbidities: diabetes mellitus, dyslipidemia, and high blood pressure.
Drugs in use before the hospitalization:
Life habits: abstainer and nonsmoker.
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aspirin 100 mg (0-1-0); enalapril 10 mg (1-0-1); metformin 500 mg (1-1-1); phenobarbital 100 mg (0-0-1); quetiapine 25 mg (0-0-1); and simvastatin 40 mg (0-0-1). |
Hospitalized for 42 days due an exacerbation of cough and broncho-pneumonia. |
Upon hospital admission, captopril was discontinued, and amoxicillin was prescribed, with improvement in respiratory signs. |
ICD-10 Codes: J180, R05, R60.
Drug (pharmacological class): enalapril (angiotensin converting enzyme inhibitor),and phenobarbital (barbiturates).
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Possible for captopril induced cough. |
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Patient: 71-year-old man.
Comorbidities: atrial fibrillation, diabetes mellitus, and high blood pressure.
Life habits: abstainer and nonsmoker.
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amiodarone 200 mg/day; carvedilol 5 mg (1-0-1); furosemide 40 mg (1-0-0); losartan 50 mg (1-0-0);metformin500mg(1-1-1);omeprazole 20 mg (1-0-0); simvastatin 40 mg (0-0-1); andwarfarin2.5mg/day(Monday to Friday). |
Hospitalized for 13 days due to an exacerbation of cough and dyspnea. |
Upon hospital admission, carvedilol was discontinued and meropenem was prescribed, with improvement in respiratory signs. |
ICD-10 Codes: J189, R05, R60, J80.
Drug (pharmacological class): amiodarone (antiarrhythmic), and carvedilol (beta-blocker).
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Possible for carvedilol induced cough. |
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Patient: 84-year-old woman.
Comorbidities: atrial fibrillation, cardiomyopathy, depressive disorder, dyslipidemia, epilepsy, high blood pressure, and sleep apnea.
Life habits: abstainer and nonsmoker.
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baclofen 5 mg (1-0-1); dipyrone 1000 mg (1-1-1-1); scopolamine 20 mg (1-1-1); metoprolol 50 mg (2-0-2); thiamazole 15 mg/day; and trazodone 50 mg/day. |
Hospitalized for eight days for palliative care and management of bronchopneumonia and dyspnea. |
Upon hospital admission, the use of clonazepam and trazodone was discontinued. The patient showed improvement in respiratory signs, but the patient evolves to death. |
ICD-10 Codes: J180, J80, R60.
Drug (pharmacological class): metoprolol (beta-blocker).
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Possible for clonazepam and trazodone induced dyspnea. |
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