University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

418

Pages:

1
Author:

Maverick Martin

2.2 – “Breakfa “Breakfast st at Cisplatin’s”: Ci Cisplatin, splatin, carboplatin, aamifostine mifostine • Platinum-containing cancer chemo drugs include cisplatin, carboplatin, and oxaliplatin. All act by cross-linking DNA, similar to alkylating agents (double-helix chains with crossed links). Used to treat a variety of cancers, including solid tumors and hematologic malignancies (crumpled bag with a crab on it). • Toxicities: • Ototoxicity (gong-shaped earrings) results from targeting of outer hair cells in the Organ of Corti, causing a high frequency sensorineural hearing loss with tinnitus. Dose dependent. Cisplatin is notorious for this, although can also occur with high-dose carboplatin • Peripheral neuropathy in a stocking glove pattern (black arm gloves). Subacute neuropathy characterized by paresthesias and loss of sensation. Cisplatin > oxaliplatin >> carboplatin. • Nephrotoxicity & AKI, particularly with cisplatin (kidney shaped purse on Golightly’s flank). Can also cause acute tubular necrosis with muddy brown casts (muddy drainpipe). Two ways to prevent ATN o Amifostine, an organic thiophosphate, scavenges free radicals from cisplatin in the kidney (“Free Amethyst” sign over the visual of amethysts in a kidney-shaped purse) o Alternatively, IV saline diuresis (essentially induced polyuria) will flush toxic metabolites out of kidneys (cleaning the window with what appears to be a salt spray). • Myelosuppression, especially with cisplatin, and resulting immunosuppression (bone shaped box that has been depleted of its wares next to older woman with immunocompromised cane)