From the Guidelines
Stimulants can have detrimental effects on lung conditions, particularly in individuals with pre-existing pulmonary hypertension, as they can increase heart rate and blood pressure, potentially worsening respiratory symptoms. According to the American Heart Association and American Thoracic Society guidelines 1, stimulant exposure, such as amphetamine-methamphetamine, should be considered in the history of all children with potential exposure, as it can induce pulmonary arterial hypertension (PAH). The guidelines also highlight the importance of removing the inciting drug or toxin as soon as the diagnosis is made.
In terms of specific stimulants, a study published in Pediatrics 1 notes that stimulants can increase heart rate and blood pressure to a mild and clinically insignificant degree, but can also be linked to more substantial increases in heart rate and blood pressure in a subset of individuals. This is particularly relevant for individuals with lung conditions, as increased heart rate and blood pressure can exacerbate respiratory symptoms.
Key considerations for individuals with lung disease include:
- Consulting healthcare providers before using stimulant medications, as dosage adjustments or alternative treatments may be necessary
- Monitoring for potential interactions with respiratory medications
- Being cautious with substances like caffeine, as excessive consumption can increase anxiety and potentially trigger respiratory symptoms
- Considering alternative treatments, such as non-stimulant medications, which may have a lower risk of cardiovascular events 1
Overall, it is crucial for individuals with lung disease to exercise caution when using stimulant medications and to consult their healthcare provider to determine the best course of treatment.
From the Research
Stimulant and Lung Interactions
- The use of stimulants can have various effects on the lungs, including acute and chronic injuries to different parts of the respiratory tract 2.
- Illicit stimulants, such as cocaine and amphetamine, can cause permanent morbidities and fatal consequences, including nasal septum perforation, pulmonary hypertension, pneumothorax, and interstitial lung disease 2.
- Adulterants coinhaled with these substances and the metabolites of these substances can also lead to specific forms of systemic and respiratory complications 2.
- Stimulants can alter the patient's systemic acid-base balance and central nervous system, leading to further respiratory compromise 2.
Asthma and COPD
- Asthma and chronic obstructive pulmonary disease (COPD) are two different disease entities with distinct etiologies, symptoms, and types of airway inflammation 3, 4.
- Although they have many similarities, they also have many differences, and their diagnosis and treatment require careful consideration of these differences 3, 4.
- The overlap between asthma and COPD, known as asthma-COPD overlap syndrome (ACOS), is a complex phenomenon that requires further research to understand its pathophysiology and develop effective treatment strategies 4.
Risk Factors for Adverse Events
- Individuals with atherosclerotic heart disease, hypertension, cocaine use, and anxiety are at higher risk of adverse cardiovascular events when prescribed stimulants 5.
- Age may be an effect modifier of these relationships, and additional research is needed to better inform clinical decisions regarding stimulant prescriptions 5.
- Stimulant use disorder is associated with a range of individual and public health issues, including overdose deaths, and requires effective treatment strategies 6.