Perioperative Considerations for Patients Treated with Bleomycin (12)

In: Bleomycin

14 Apr 2013

The macrophages collected from smokers spontaneously released hydrogen peroxide, with significant increases in hydrogen peroxide secretion after bleomycin. There was no concomitant increase in lactic dehydrogenase, ruling out cell death as the cause of the increase in hydrogen peroxide. buy flovent inhaler
A history of smoking in a patient who has received bleomycin should alert the practitioner to the possibility of significant pulmonary damage. None of the previously cited studies conclusively implicated smoking as a potentiator of bleomycin toxicity, but it is conceivable that bleomycin-induced pulmonary damage superimposed on that caused by smoking could significantly impair respiratory function.
Hyperoxia
Numerous studies in animals have shown hyperoxic potentiation of bleomycin-induced pulmonary lung damage.’ The applicability of these studies to human disease is unclear for several reasons. Drug doses higher than those used in clinical practice or drug administration via the intratracheal route may have resulted in higher drug concentrations in the lung than those seen in humans. In addition, the hyperoxic exposure used in some studies was either much longer or at a much higher FIo2 than would be used during routine anesthesia.


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