Perioperative Considerations for Patients Treated with Bleomycin (6)

In: Bleomycin

8 Apr 2013

There are no pathognomonic signs or symptoms of bleomycin-related pulmonary damage. Patients usually present with dyspnea, tachypnea, and a nonproductive cough. Rales, initially at the bases and then throughout the lungs, may be present on physical examination. Signs and symptoms usually precede changes on the chest x-ray film. Although radiographic changes may not be specific for bleomycin-induced toxicity, their presence is significant. The initial change is the development of bibasilar reticular infiltrates which may proceed to frank consolidation. Significant pleural efiusions are usually not seen. buy birth control online
Pulmonary Function Tests
The utility of pulmonary function tests as an indicator of the extent of the pulmonary damage produced by bleomycin is controversial. Spirometry usually shows a restrictive pattern in the presence of cytotoxic drug-induced pulmonary damage; however, such changes may not always be present in patients with subclinical bleomycin-induced toxicity. It has been suggested that changes in FVC may correspond with progression or regression of bleomycin-induced pulmonary toxicity.2 Others have found no consistent correlation between FVC or FEV, and the extent of pulmonary damage. Still others suggest that a rapid rate of decline in FVC may herald the onset of pulmonary fibrosis.


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