Pulmonary Fibrosis; Idosyncratic Reactions
- In the use of cancer chemotherapy/Equipped Facility
- Most severe toxicity. Frequently presents as pneumonitis occasionally progresses to pulmonary fibrosis. Risk increased in elderly and with total dose > 400 units, but pulmonary toxicity has been observed in young patients and those treated with low doses.
- Hypotension, confusion, fever, chills, and wheezing has been reported in approximately 1% of lymphoma patients treated with this drug.
MONITORING RECOMMENDATIONS RELATED TO BLACK BOX DATA
- The earliest symptom associated with bleomycin pulmonary toxicity is dyspnea. The earliest sign is rales.
- Idiosyncratic reaction may occur immediately or be delayed for several hours, and usually occurs after the first or second dose. Treatment is symptomatic, including volume expansion, pressor agents, antihistamines and corticosteroids.
Updated January 2018