cisplatin


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cisplatin

 [sis´plah-tin]
a platinum coordination compound whose main mode of action resembles that of alkylating agents with production of cross links between the two strands of DNA in the double helix so that DNA cannot be replicated and the cells cannot divide. It is used as an antineoplastic agent in the treatment of metastatic tumors of the testis, ovary, bladder, and head and neck. It can cause serious damage to the kidney, eighth cranial nerve, gastrointestinal tract, and bone marrow, can upset metabolic processes, and can produce hypocalcemia and hypomagnesemia. Called also DDP or cis-DDP.

cisplatin

Platinex (UK)

Pharmacologic class: Alkylating agent, platinum coordination complex

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• Give under supervision of physician experienced in cancer chemotherapy, in facility with adequate diagnostic and treatment resources.

• Drug may cause severe cumulative renal toxicity. Other major dose-related toxicities are myelosuppression, nausea, and vomiting.

• Drug may lead to significant ototoxicity (which may be more pronounced in children), high-frequency hearing loss, and deafness.

• Anaphylactic-like reactions may occur within minutes of administration.

• Use caution to prevent inadvertent overdose. Doses above 100 mg/m2/cycle once every 3 to 4 weeks are rarely used. Avoid inadvertent overdose stemming from confusion with Paraplatin (carboplatin) or failure to differentiate daily doses from total dose per cycle.

Action

Inhibits DNA synthesis by causing intrastrand and interstrand cross-linking of DNA

Availability

Injection: 1 mg/ml in 50-mg and 100-mg multidose vials

Indications and dosages

Metastatic testicular tumors

Adults: 20 mg/m2 I.V. daily for 5 days/cycle, repeated q 3 to 4 weeks

Metastatic ovarian cancer

Adults: 75 to 100 mg/m2 I.V., repeated q 4 weeks in combination with cyclophosphamide; or 100 mg/m2 q 4 weeks as a single agent

Advanced bladder cancer

Adults: 50 to 70 mg/m2 I.V. q 3 to 4 weeks as a single agent; dosage depends on whether patient has undergone radiation or chemotherapy.

Off-label uses

• Cervical cancer
• Squamous cell carcinoma

Contraindications

• Hypersensitivity to drug or other platinum-containing compounds
• Severe impairment of renal function
• Severe myelosuppression
• Hearing impairment
• Pregnancy or breastfeeding

Precautions

Use cautiously in:
• mild to moderate renal impairment, active infection, myelosuppression, chronic debilitating illness, heart failure, electrolyte abnormalities
• females of childbearing age.

Administration

• Prepare drug with equipment that doesn't contain aluminum.
• Give 2 L of I.V. fluids, as prescribed, 8 to 12 hours before drug infusion to help prevent toxicity.
• Dilute each dose in 2 L of dextrose 5% in 1/4 or 1/2 saline solution or 0.9% normal saline solution. Do not use dextrose 5% in water.
• Infuse each liter over 3 to 4 hours to minimize toxicity. In well-hydrated patients with good renal function, infusions of 100 to 500 ml may be given over 30 minutes.
• Follow facility policy for handling and disposal of antineoplastics.

If solution contacts skin, wash immediately and thoroughly with soap and water. If solution contacts mucosa, flush with water immediately.
• Protect drug from light.

Adverse reactions

CNS: malaise, weakness, seizures

EENT: ototoxicity, tinnitus

GI: severe nausea, vomiting, diarrhea

GU: sterility, nephrotoxicity

Hematologic: anemia, leukopenia, thrombocytopenia

Hepatic: hepatotoxicity

Metabolic: hypocalcemia, hypokalemia, hypomagnesemia, hyperuricemia

Skin: alopecia

Other: phlebitis at I.V. site, anaphylaxis

Interactions

Drug-drug.Amphotericin B, loop diuretics: increased risk of hypokalemia and hypomagnesemia

Antineoplastics: additive bone marrow depression

Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions

Nephrotoxic drugs (such as aminoglycosides): additive nephrotoxicity

Ototoxic drugs (such as loop diuretics): additive ototoxicity

Phenytoin: reduced phenytoin blood level

Drug-diagnostic tests.Aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, uric acid: increased levels

Calcium, magnesium, phosphate, potassium, sodium: decreased levels
Coombs' test: positive result

Patient monitoring

• Before starting therapy and before each subsequent dose, assess renal function test results and CBC with white cell differential.
• Monitor neurologic status, hepatic enzyme and uric acid levels, and audiogram results.
• Monitor urine output closely.

Patient teaching

• Instruct patient to drink 8 oz of water every hour while awake.

Advise patient to promptly report bleeding, bruising, hearing loss, yellowing of skin or eyes, decreased urine output, or suspected infection.
• Tell patient that drug may cause hair loss.
• Instruct female patient to use reliable contraception; drug can harm fetus.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

cisplatin

/cis·plat·in/ (sis´plat-in) DDP; a platinum coordination complex capable of producing inter- and intrastrand DNA crosslinks; used as an antineoplastic.

cisplatin

(sĭs-plăt′n, -plā′tn)
n.
A platinum-containing chemotherapeutic drug, Cl2H6N2Pt, used in the treatment of metastatic ovarian or testicular cancers and advanced bladder cancer. Also called cisplatinum.

cisplatin

[sisplat′in]
an antineoplastic.
indications It is prescribed in combination with vinblastine and bleomycin in the treatment of neoplasms such as metastatic testicular, prostatic, and ovarian tumors, and Hodgkin's lymphoma.
contraindications Preexisting renal dysfunction, myelosuppression, hearing impairment, or known hypersensitivity to this drug or other drugs containing platinum prohibits its use.
adverse effects Among the most serious adverse reactions are nephrotoxicity, ototoxicity, myelosuppression, severe nausea, anorexia, vomiting, and allergic reactions.

cisplatin

A chemotherapeutic that forms covalent bonds and crosslinks with DNA, which is used for head and neck, ovarian, testicular, and bladder cancers and lymphomas.

Adverse effects
Nephrotoxicity, nausea, sensory neuropathy.

Management for adverse effects
• Nephrotoxicity: adequate hydration to maintain renal flow and high chloride concentration.
• Nausea: ondansetron, a selective antagonist of serotonin S3 receptors.
• Neuropathy: amifostine, growth factors, glutathione, Org 2766, acetyl-L-carnitine, vitamin E have all been tried; per Cochrane review, none proved effective; more studies are needed.

cisplatin

Cis-platinum, diaminedichloride, Platinol A chemotherapeutic that forms covalent bonds and crosslinks with DNA, which is used for head & neck, ovarian, testicular, bladder CAs, lymphomas Adverse effects Nephrotoxicity, nausea, neurotoxicity

cisplatin

An anticancer drug. Like any drug that damages cells it has side effects. Cisplatin can cause progressive kidney impairment. The drug is on the WHO official list.

cisplatin (sis·plaˑ·tn),

n a potent anticancer agent used to treat ovarian, prostatic, testicular, and other tumors.

cisplatin (sisplat´in),

n an antineoplastic prescribed in the treatment of a wide variety of neoplasms such as metastatic testicular, prostatic, and ovarian tumors.

cisplatin, cis-platinum

a platinum-containing complex used as an antineoplastic agent whose main mode of action resembles that of alkylating agents—production of cross-links between the two strands of DNA in the double helix so that DNA cannot be replicated and the cells cannot divide.

Patient discussion about cisplatin

Q. Is pervasive developmental disorder (PDD) or autism is fatal……what exactly it is……?

A. Autism is not fatal in its symptom and progression but it can become fatal as it does impair normal physiological function it CAN BE a fatal condition. It’s a group of illness which involves delays in the development of basic skills. It happens to children below age 3. It affects the child`s ability to communicate and interact. Autism affected children are also found to be mentally retarded.

Q. I was at my colleague's home and one of his kids kept talking to herself he said that she has PDD. i later asked my wife about it and she said she thinks it's a type of autism. but other than talking to herself the girl seemed perfectly normal. so is PDD a light version of autism?

A. I didn't really understand everything in this web page, but I think I get the big picture. Thanx

Q. What resources are available in Seattle, Washington to help with an autistic child?

A. i miss Seattle... here is a link to "Autism Spectrum Treatment and Research (ASTAR) Center". a well know establishment:

http://www.astarcenter.org/

More discussions about cisplatin
References in periodicals archive ?
Cisplatin induces apoptosis in LLC-PK1 cells via activation of mitochondrial pathways.
The study noted that "the mechanisms of the two agents through different growth signaling pathways suggest potential for the clinical use of sub-therapeutic doses of Cisplatin in combination with curcumin, which will allow effective suppression of tumor growth while minimizing the toxic side effects.
The incidence, severity, and persistence of neurotoxicity was significantly worse, however, in the cisplatin group, the investigators found.
This is an important first step in being able to pinpoint patients who are at higher risk of developing cisplatin toxicity and to learn how to better manage that risk," said co-corresponding author Clinton Stewart, Pharm.
Portrazza (necitumumab), in combination with gemcitabine and cisplatin, is approved for the first-line treatment of people with metastatic squamous non-small cell lung cancer (NSCLC).
Apoptosis caused by cisplatin treatment was analyzed quantitatively by a FITC Annexin V Apoptosis Detection kit II (BD Biosciences, Franklin Lakes, NJ, USA) (Chang et al.
To demonstrate that imatinib protects oocytes against cisplatin, Kim and colleagues cultured ovaries (containing the immature eggs) from five-day-old mice with imatinib and cisplatin for 96 hours.
The nano drug delivery showed a significant reduction of tumour and almost negligible kidney toxicity compared to the direct use of cisplatin and carboplatin.
7%), and the respective figures in the cisplatin patients were 0, 4 (40.
Cisplatin contains platinum and works by affecting the DNA within cancer cells to kill them off.
Cisplatin contains the metal platinum and works by affecting the DNA within
One hundred eight cancer patients being treated with cisplatin chemotherapy were randomly assigned to receive, in double-blind fashion, 400 IU per day of vitamin E or placebo, beginning before chemotherapy and continuing for 3 months after the completion of chemotherapy.