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“Pills” and the Air Passages201CPills201D and the Air Passages

Elif Küpeli, MD; Danai Khemasuwan, MD, MBA; Pyng Lee, MD, FCCP; Atul C. Mehta, MD, FCCP
Author and Funding Information

From the Baskent University School of Medicine, Pulmonary Diseases Department (Dr Küpeli), Ankara, Turkey; Pulmonary & Critical Care Medicine (Dr Khemasuwan), Respiratory Institute, Cleveland Clinic, Cleveland, OH; Yong Loo Lin School of Medicine (Dr Lee), National University of Singapore, and Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore; and Lerner College of Medicine (Dr Mehta), Respiratory Institute, Cleveland Clinic, Cleveland, OH.

Correspondence to: Atul C. Mehta, MD, FCCP, Lerner College of Medicine, Respiratory Institute, 9500 Euclid Ave, A-90, Cleveland Clinic, Cleveland, OH 44195; e-mail: Mehtaa1@ccf.org


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(2):651-660. doi:10.1378/chest.13-0080
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Aspiration of a medication in the airways in any form produces a variety of adverse effects, both local and systemic. Furthermore, specific reaction of the airways to each type of pill strongly affects the outcome. It is crucial for pulmonologists and emergency medicine specialists to acknowledge this clinical entity. In addition, airways have been increasingly used to deliver medications such as insulin and prostacycline. These aerosolized medications can also cause local as well as systemic side effects. We review the local and systemic reactions of these “pills” accessing the airways either by incidental aspiration or iatrogenic administration. We address clinical presentation, mechanism of injury, diagnosis, and management of complications of these pills in the air passages.

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