In: Bleomycin19 Apr 2013
In the preoperative evaluation of patients who have received bleomycin, the clinician should look carefully for a history of dyspnea, tachypnea, or dry cough. Rales heard when examining the lungs may indicate early toxicity. Baseline arterial blood gas analysis and chest x-ray films are recommended. The presence of interstitial disease on the chest x-ray film is significant, but changes on physical examination may occur earlier in the course of the disease than changes on the chest x-ray film. Pulmonary function tests may be helpful in determining the extent of damage in known pulmonary fibrosis, but they are not predictive to subclin-ical disease. They may be useful when a patient exhibits physical signs or has a chest x-ray film indicative of pulmonary toxicity. Buy Advair Diskus Online
Other important factors which may indicate that the patient is at increased risk for bleomycin-induced pulmonary toxicity and postoperative pulmonary complications include a history of smoking, previous irradiation to the chest, age over 70 years, a total dose of bleomycin exceeding 500 mg, and treatment with other chemotherapeutic agents. Cyclophosphamide has been implicated in the potentiation of bleomycin toxicity. Cisplatin is often used in combination with bleomycin, and associated renal toxicity may be present.
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