Apomorphine is a potent dopaminergic agonist widely used in the management of motor fluctuations in advanced Parkinson's disease. Although generally well tolerated, rare pulmonary adverse drug reactions (ADRs) may occur. We report a case of probable apomorphine-induced pneumonitis associated with subcutaneous administration. A 62-year-old Caucasian male with multiple comorbidities presented to the emergency department with headache, non-productive cough, central chest pain, fever, and dyspnea over the past 48 hours (3 weeks after initiation of subcutaneous apomorphin). Chest X-ray revealed bilateral hilar infiltrates and basal consolidation. CT scan showed organizing pneumonia (OP)-like pattern. Extensive microbiological evaluation of bronchoalveolar lavage and bronchial aspirate samples, including bacterial, fungal, mycobacterial, viral, and atypical pathogen testing, was negative. Lack of response to broad-spectrum antibiotics raised the suspicion of drug-induced pneumonitis due to subcutaneous apomorphine. Antibiotics were discontinued, and corticosteroid therapy (methylprednisolone 40 mg/day) was initiated with gradual tapering resulted in rapid clinical improvement and complete radiological resolution within one month. The temporal relationship between apomorphine initiation and symptom onset, compatible clinical and radiological findings, extensive microbiological exclusion of infectious causes, and favorable response after drug withdrawal and corticosteroid therapy supported the diagnosis of probable apomorphine-induced pneumonitis.

Introduction: Nicotine dependence assessment is essential in smoking cessation programs. The Fagerström Test for Nicotine Dependence (FTND) is widely used, but its subjective nature limits accuracy. Biomarkers such as cotinine, exhaled carbon monoxide (CO), and carboxyhemoglobin (COHb) provide objective measures of tobacco exposure and dependence. Methods: A prospective observational study was conducted at the Smoking Cessation Unit of Salamanca University Hospital from 2009 to 2022. A total of 3820 smokers were included. Demographic data, smoking history, and dependence level were recorded. Biomarkers, including serum cotinine, exhaled CO and COHb, were measured. The correlation between biomarkers and FTND scores was analyzed. Results: Cotinine levels showed the strongest correlation with FTND scores (r = 0.302, p < 0.001), followed by COHb (r = 0.234, p < 0.001) and exhaled CO (r = 0.219, p < 0.001). Conclusion: Biomarkers offer a reliable alternative to subjective nicotine dependence assessments. Cotinine proved to be the most accurate marker. Integrating biomarkers into clinical practice could improve cessation outcomes by enabling personalized treatment strategies.