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Cisplatin
💊 Cisplatin is a platinum-based chemotherapy agent. Always check the BNF entry here before prescribing.
⚙️ Mode of Action
- Platinum-containing anti-cancer drug, functioning as an alkylating agent.
- Forms DNA cross-links → disrupts DNA replication and transcription.
- Cell cycle non-specific but particularly effective in rapidly dividing cells.
🎯 Indications
- Testicular, ovarian, and bladder cancers.
- Head & neck, oesophageal, lung (small & non-small cell), breast, cervical, stomach, prostate cancers.
- Lymphomas (Hodgkin’s, non-Hodgkin’s), neuroblastoma, sarcomas, myeloma, melanoma, mesothelioma.
💉 Dose & Administration
- Given intravenously (IV infusion).
- Requires pre- and post-treatment hydration to protect kidneys.
🤝 Interactions
- Avoid live immunisations during treatment.
- Concomitant nephrotoxic or ototoxic drugs increase risk of toxicity.
⚠️ Cautions
- Ensure adequate hydration (urine output >100 ml/hr).
- Always prescribe antiemetics to counter severe nausea/vomiting.
- Educate patients: seek urgent help if fever ≥37.5°C or if feeling unwell (infection risk).
🚫 Contraindications
- Refer to BNF for full list.
❗ Side Effects
- 🎧 Ototoxicity: hearing loss, tinnitus.
- 🧪 Nephrotoxicity (acute tubular necrosis), electrolyte losses (Mg, Ca, K).
- 🩸 Myelosuppression: anaemia, neutropenia (2–3 weeks), thrombocytopenia.
- 🤢 Severe nausea and vomiting (highly emetogenic).
- 🔥 Local thrombophlebitis at infusion site.
- Metallic taste, peripheral neuropathy.
📚 References
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