Cisplatin

From Anvita Health Wiki

Contents 1 Indications 2 Monitor 3 Adverse-effects 4 Drug-interactions 5 More General Terms 6 Additional Terms 7 Internet Database 8 References

Indications

• metastatic testicular or ovarian cancer
• advanced bladder cancer
• osteosarcoma
• Hodgkin's disease
• non-Hodgkin's lymphoma
• head & neck cancer
• cervical cancer
• lung cancer
• esophageal cancer Administration:
• prehydration with 1-2 liters of fluid 8-12 hours prior to administration
• monitor for anaphylactoid reaction

• Powder for injection: 10 mg, 50 mg
• Aqueous vials: 50 mg, 100 mg
• Needles, syringes, catheters etc for adminstration of cisplatin should NOT contain aluminum

Monitor

• creatinine, CBC, hearing, neurologic function

Adverse-effects

• common (> 10%)

• gastrointestinal

• cisplatin is one of the most emetogenic agents used in cancer chemotherapy
• nausea/vomiting

• 76-100% of patients
• may persist for 1 week

• nephrotoxicity

• acute renal failure

• dose-dependent
• attenuated by hydration, & mannitol or furosemide
• occurs in 30% of patients receiving 50-75 mg/m2
• associated with hypomagnesemia & hypokalemia
• early nephrotoxicity presents as polyuria without reduction in GFR
• nephrogenic diabetes insipidus & reduction in GFR may occur 72-96 hours after cisplatin administration
• recovery generally occurs in 2-4 weeks

• chronic renal failure

• occurs in patient receiving multiple courses
• cisplatin accumulates in distal tubules

• ototoxicity manifested as high-frequency hearing loss
• myelosuppression

• onset 10 days
• nadir 14-23 days
• recovery 21-39 days

• less common (1-10%)

• anorexia, pain at site of injection

• uncommon (< 1%)

• optic neuritis, blurred vision, mouth sores, SIADH, bradycardia, arrhythmias, phlebitis, mild alopecia, hypomagnesemia, hypocalcemia, hypokalemia, hypophosphatemia, abnormal liver function tests, papilledema

• others [1, 2, 4]

• peripheral neuropathy

• dose & duration-dependent
• axonal degeneration with damage to sensory nerves

• neuritis
• mild alopecia
• hyperuricemia
• hypomagnesemia
• hypertension
• Raynaud's phenomenon
• hypercholesterolemia
• secondary malignancies

• acute myeloid leukemia ( AML)
• melanoma

• Poisoning: antidote is sodium thiosulfate
  

• drug adverse effects of alkylating agents

Drug-interactions

• aminoglycosides

• do not use within 3 days of cisplatin administration
• increases nephrotoxicity & ototoxicity of cisplatin

• vancomycin

• do not use within 3 days of cisplatin administration
• increases nephrotoxicity & ototoxicity of cisplatin

• amphotericin B
• loop diuretics increase ototoxicity of cisplatin
• phenytoin

More General Terms

• alkylating agent
• antineoplastic agent (chemotherapeutic agent)

Additional Terms

• platinum [Pt]

Internet Database

PubChem: 441203
PubChem: 84691
PubChem: 5311048
PubChem: 2770
PubChem: 2767

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
3. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 598
4. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
5. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 529
6. National Guideline Clearinghouse The role of neurokinin-1 receptor antagonists in the prevention of emesis due to high-dose cisplatin. (Program in Evidence-based Care) ngc-guideline: [1]

cisplatin (Platinol)