Pulmonary Changes Associated with Hexamethonium Therapy

Abstract

Since 1953 several reports of pulmonary lesions developing concurrently with hexamethonium therapy for hypertension have been recorded. The lesions have been described as similar but not always identical to acute diffuse interstitial pulmonary fibrosis as described by Hamman and Rich.¹ In 1953, Morrison ² reported 39 cases of hypertension treated with parenteral hexamethonium, with the development of dyspnea and bilateral symmetrical opacities on chest roentgenograms in three patients treated for 7, 9, and 15 months, respectively. One of these patients died, and autopsy revealed extensive central carnification of both lungs. A subsequent report by Doniach, Morrison, and Steiner,³ apparently on the same three patients, showed both an intra-alveolar and an interstitial pulmonary fibrosis in the two patients who died. One atient recovered, with improvement as observed in the chest x-ray. Morrow, Schroeder, and Perry⁴ mention five cases of hypertension treated with hexamethonium and hydralazine in which interstitial