cisplatin

Contraindicated in:

Hypersensitivity;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Hearing loss;
Renal impairment (dosage ↓ recommended);
HF;
Electrolyte abnormalities;
Active infections;
Bone marrow depression;
Rep: Women of reproductive potential;
Geri: ↑risk of nephrotoxicity and peripheral neuropathy in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: alopecia

EENT: ototoxicity, tinnitus

F and E: hypocalcemia, hypokalemia, hypomagnesemia

GI: nausea, vomiting, diarrhea, HEPATOTOXICITY

GU: nephrotoxicity, sterility

Hemat: anemia, LEUKOPENIA, THROMBOCYTOPENIA

Local: phlebitis at IV site

Metab: hyperuricemia

Neuro: malaise, peripheral neuropathy, REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME (RPLS), SEIZURES, weakness

Misc: anaphylactoid reactions

Interactions ⬆ ⬇

Drug-drug:

↑risk of nephrotoxicity and ototoxicity with other aminoglycosides and loop diuretics.
↑risk of hypokalemia and hypomagnesemia with loop diuretics and amphotericin B.
May ↓ phenytoin levels and effectiveness.
↑bone marrow depression with other antineoplastics or radiation therapy.
May ↓ antibody response to live-virus vaccines and ↑ adverse reactions.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 1 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): Metastatic testicular tumors: 20 mg/m² daily for 5 days repeated every 3–4 wk. Metastatic ovarian cancer: 75–100 mg/m², repeat every 4 wk in combination with cyclophosphamide or 100 mg/m² every 3 wk if used as a single agent. Advanced bladder cancer: 50–70 mg/m² every 3–4 wk as a single agent.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits DNA synthesis by producing cross-linking of parent DNA strands (cell-cycle phase–nonspecific).

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: alkylating agents

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed; accumulates for months.

Metabolism/Excretion: Excreted mainly by the kidneys.

Half-Life: 30–100 hr.

Time/Action Profile ⬆ ⬇

(effects on blood counts)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	18–23 days	39 days

Patient/Family Teaching ⬆ ⬇

Instruct patient to report pain at injection site immediately.
Instruct patient to notify health care professional promptly if fever; chills; cough; hoarseness; sore throat; signs of infection; lower back or side pain; painful or difficult urination; bleeding gums; bruising; petechiae; blood in stools, urine, or emesis; increased fatigue; dyspnea; or orthostatic hypotension occurs. Caution patient to avoid crowds and persons with known infections. Instruct patient to use soft toothbrush and electric razor and to avoid falls. Caution patient not to drink alcoholic beverages or take medication containing aspirin or NSAIDs; may precipitate gastric bleeding.
Instruct patient to report promptly any numbness or tingling in extremities or face, difficulty with hearing or tinnitus, unusual swelling, or joint pain.
Instruct patient not to receive any vaccinations without advice of health care professional.
Emphasize the need for periodic lab tests to monitor for side effects.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Advise patient of the need for contraception, although cisplatin may cause infertility.

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Indications ⬇

Contraind./Precautions ⬆ ⬇