What occurs when the lifetime dose of bleomycin exceeds 400 units?

When the lifetime dose of bleomycin exceeds 400 units, pulmonary fibrosis is a significant risk. Bleomycin is an antineoplastic agent that is particularly associated with lung toxicity, which manifests as pulmonary fibrosis. This condition results from damage to the lung tissue and can lead to symptoms such as cough, dyspnea, and decreased lung function.

The risk of pulmonary toxicity increases with cumulative doses, particularly beyond the threshold of 400 units. Clinicians monitor patients closely for signs of pulmonary complications when administering bleomycin, particularly in those who may have additional risk factors such as prior lung disease, smoking history, or concurrent lung radiotherapy.

The other options listed are not directly related to the specific dose of bleomycin. While nausea can occur with various chemotherapeutic agents, it is not specifically linked to bleomycin overdose. Cardiotoxicity is more commonly associated with drugs like anthracyclines, and hepatic injury is typically connected to agents that affect liver function. Thus, pulmonary fibrosis is the primary concern at elevated doses of bleomycin.