Perioperative Considerations for Patients Treated with Bleomycin (2)

In: Bleomycin

4 Apr 2013

Many patients who receive bleomycin are young and may subsequently require surgery for conditions which may or may not be related to their malignancies. Anesthesiologists, surgeons, pulmonologists, intensive-care specialists, and indeed anyone caring for these patients in the perioperative period should be aware of factors identified as contributing to bleomycin-related pulmonary toxicity. These include total drug dose, route of administration, previous irradiation, age, smoking, treatment with other chemotherapeutic agents, and hyperoxia. Although animal studies, human studies, and case reports addressing these factors have proven inconclusive, they do suggest guidelines for the evaluation and management of bleomycin-treated patients. Buy Advair Diskus Online
Mechanism of Action—Pharmacology
Bleomycin is believed to cause DNA scission by intercalating between DNA base pairs, especially guanine and cytosine. Ferrous iron and oxygen are both required for bleomycin to form its active complex. The effects of bleomycin on DNA have been attributed to free radical generation, with production of oxygen-free radicals exceeding the scavenging capacity of antioxidant enzymes such as superoxide dismutase, catalase, and glutathione peroxidase.


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