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Cisplatin Toxicity

Cisplatin Toxicity

Description

A major obstacle to more widespread use of cisplatin is the persistence of severe toxic side effects. ¤ The major dose-limiting effect is nephrotoxicity. It is dose-dependent, apparently irreversible in some cases, and primarily affects the proximal tubules. Renal damage caused by cisplatin includes tubular degeneration, loss of brush border, necrosis and mineralisation of tubular epithelial cells, all of which are cumulative. Patients are therefore, put on regimes of regular hydration and diuresis, and are given blood tests before each treatment.The administration of a diuretic, such as D-mannitol, along with copius amounts of water before and after treatment, induces frequent passing of water. This reduces the nephrotoxicological effects and ensures that the kidneys are functioning properly. It also makes possible for the administration of larger and more effective doses of cisplatin. Although renal damage is the most serious effect of cisplatin, it actually displays few symptoms, those of which are relatively mild compared to the nausea and vomiting. The mechanism of platinum nephrotoxicity may be similar to that of mercury and may involve depletion of SH groups of the renal tubes. It is therefore, no surprise that nephrotoxicity may also be decreased by pretreatment with a thiol compound.

Use

Cisplatin is administered intravenously as short-term infusion in normal saline for treatment of solid malignancies. It is used to treat various types of cancers, including sarcomas, some carcinomas (e.g., small cell lung cancer, squamous cell carcinoma of the head and neck and ovarian cancer), lymphomas, bladder cancer, cervical cancer, and germ cell tumors.

Side Effect

There are many effects of cisplatin on epidermal and follicle cells, one of which is the commonly known side effect - hair loss. A few others include:

  • Angioedema
  • Erythema
  • Exfoliative Dermatitis
  • Facial Edema
  • Flushing
  • Hyperhidrosis
  • Rash
  • Alopecia
  • Hypomelanosis
  • Anaphylaxis
  • Gingival Discolouration
  • Injection-site cellulitis
  • Oral Mucosal Lesions

Precaution

Do not receive any kind of immunization or vaccination without your doctor's approval while taking cisplatin.Your fertility, meaning your ability to conceive or father a child, may be affected by cisplatin. Please discuss this issue with your health care provider.Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Cisplatin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking cisplatin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

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