Question

Medication Template:

Please answer the following questions for:

Medication: Cisplatin

Category Class: Platinum compounds

Expected Pharmacological Action:

Therapeutic Use:

Complications:

Contraindications/Precautions:

Interactions:

Medication Administration:

Nursing Interventions:

Patient Education:

Evaluation of medication effectiveness:

Answer 1

CISPLATIN

It is a drug that belongs to the category of platinum compounds.

Cisplatin was the first member in platinum combination complex.

Expected pharmacological action:

​​​​​​Mechanjsm of action is similar to action of alkylating agents.

It produce a highly reactive moiety by hydrolysing intracellularly, which results in cross linking of DNA. It can also react with - SH groups of cytoplasmic and nuclear proteins. It binds to N⁷ of guanine in DNA. The resulting cytotoxic lesion inhibits both DNA replication and RNA synthesis.

Therapeutic use:

-Advanced bladder cancer.

-Metastatic ovarian and metastatic testicular cancer

-Small and non small cell lung cancer.

- Bladder carcinoma.

- Breast cancer.

- cervical cancer.

- Stomach cancer.

- Hodking's and Non hodking's lymphoma etc.

Complications:

The most important toxicity is renal impairment which is dependent on total dose administered.

Other problems such as

Tinnitus,deafness,sensory neuropathy and hyperurecaemia are also seen.

Sometimes during IV infusion, a shock like state occurs.

Contraindications/precautions:

• Before administering cisplatin ask for other drugs the patient taking.
• Don't administer aspirin unless doctor says.
• Don't give if there is any history of allergic reaction
• Don't recieve any immunisation with doctor's approval.
• Severe persistent vomitong occurs at least 1 hour after administration of cisplatin and may last for 5 days. So antiemetics are given as premedication.
• Cisplatin may be hazardous to fetus. So use contraceptives while taking it.

Interactions:

There are many drug interactions.

74 major drug interactions

265 moderate drug interactions

19 minor drug interactions

Some of the major interactions with cisplatin are;

Adalimumab

Adefovir

Aldesleukin

Amiodarone

Arsenic trioxide

BCG vaccine

Botulism immune globulin etc.

Medication administration:

It is administered by slow IV infusion,

50-100 mg/m² BSA every 3-4 weeks.

Nursing interventions:

• ​​​​​​Monitor side effects.
• Monitpr CBC, serum electrolytes.
• Periodic physical examination, because drug toxicity is seen as numbness and tingling of fingers and toes.
• Hearing tests are orderes with high dose therapy and monitor at times during therapy.

Patient education:

• Instruct to take anti nausea drugs to reduce nausea.
• Instruct to Maintain good fluid intake to avoid kidney damage.
• Instruct to avoid crowds or people with cold to prevent from getting infected.
• Instruct to report in case of fever.

Evaluation of medication effect:

Cisplatin alone is not an effective drug in treating the diseases.