kar-boe-PLA-tin
High Alert
Absorption: IV administration results in complete bioavailability.
Distribution: Well distributed to tissues.
Protein Binding: Platinum is irreversibly bound to plasma proteins.
Half-Life: Carboplatin: 2.6–5.9 hr (↑ in renal impairment); platinum: 5 days.
Contraindicated in:
Use Cautiously in:
Derm: alopecia, rash
EENT: ototoxicity
F and E: hypocalcemia, hypokalemia, hypomagnesemia, hyponatremia
GI: abdominal pain, nausea, vomiting
GU: gonadal suppression, nephrotoxicity
Hemat: ANEMIA, LEUKOPENIA, THROMBOCYTOPENIA
Neuro: peripheral neuropathy, weakness
Drug-drug:
Renal Impairment
Assess for nausea and vomiting; often occur 6–12 hr after therapy and may persist for 24 hr. Prophylactic antiemetics may be used. Adjust diet as tolerated to maintain fluid and electrolyte balance and ensure adequate nutritional intake. May require discontinuation of therapy.
Monitor for bone marrow suppression. Assess for bleeding (bleeding gums; bruising; petechiae; guaiac stools, urine, and emesis), and avoid IM injections and rectal temperatures if platelet count is low. Apply pressure to venipuncture sites for 10 min. Assess for signs of infection during neutropenia. Anemia may occur and may be cumulative; transfusions are frequently required. Monitor for ↑ fatigue, dyspnea, and orthostatic hypotension.
Monitor for signs of anaphylaxis (rash, urticaria, pruritus, facial swelling, wheezing, tachycardia, hypotension). Discontinue medication immediately and notify physician if these occur. Epinephrine and resuscitation equipment should be readily available.
Lab Test Considerations:
Monitor CBC with differential before and weekly during therapy. The nadirs of thrombocytopenia and leukopenia occur after 21 days and recover by 30 days after a dose. Nadir of WBC counts usually occurs after 21–28 days and recovers by day 35. Withhold subsequent doses until neutrophil count >2000/mm3 and platelet count >100,000/mm3
.Carboplatin should be administered in a monitored setting under the supervision of a physician experienced in cancer chemotherapy.
IV Administration:
Instruct patient to notify health care provider promptly if fever; chills; sore throat; signs of infection; lower back or side pain; difficult or painful urination; bleeding gums; bruising; pinpoint red spots on skin; blood in stools, urine, or emesis; ↑ fatigue, dyspnea, or orthostatic hypotension occurs.