Cisplatin - this alkylating cytotoxic drug action. Antitumor Effect
Cisplatin formulation is based on its ability to cause alkylation method irreversible disturbances DNA stability, leading to suppression of the synthesis of nucleic acids for a long time, and cell death. Chemical DNA damage occurs during the formation of coordination bonds between the two bases of deoxyribonucleic acid (mainly guanine) and platinum atom. As a result, DNA and forming interstrand crosslinking vnutrinitevye.
The ability of the drug Cisplatin cause regression of both the primary tumor and metastases, and is connected with the influence of the drug on the immune system. Efficacy proven in many clinical studies, and a powerful anti-tumor effect of cisplatin say reviews by oncologists.
When taken orally Cisplatin is not effective. When administered intravenously, the drug quickly enough and in large quantities penetrate into the kidneys, gastrointestinal tract, ovaries, liver; it is also found in muscle, skin, bone tissue. The drug is not able to penetrate the blood-brain barrier. About 90% of the drug binds to plasma proteins. It reports the news for a long time: in the first hours after the application displays only a small amount of the drug for 5 days - 40%.
Indications for use of the drug Cisplatin
The instructions to cisplatin contain the following indications:
- separately or in combination therapy (along with other drugs) in malignant tumors of the ovaries and testicles, bladder cancer, cervical cancer, squamous cancer localized in the head and neck, osteogenic sarcoma;
- in treatment of Hodgkin's disease, lymphosarcoma;
- cancer of the renal pelvis and ureter, bladder, urethra, Ewing's sarcoma, retinoblastoma, neuroblastoma, medulloblastoma, horionkartsinoma uterus
- lung cancer, mesothelioma, malignant thymoma.
According to the instructions, Cisplatin is contraindicated in diseases of the liver and kidneys, infringement of processes of bone marrow hematopoiesis, ulcers of the stomach and duodenum, circulatory failure, pregnancy, individual intolerance.
You can not assign both Cisplatin and drugs that have ototoxic and nephrotoxic effects.
Side effects of the drug Cisplatin
It is able to exert significant side effects, which is the cause of the negative reviews of cisplatin by patients. You may experience these effects:
- Gastrointestinal: anorexia, stomatitis, nausea, vomiting;
- from the hematopoietic system: thrombocytopenia, anemia, leukopenia;
- CNS: peripheral neuropathy, convulsions, svetovospriyatiya, neuritis of the auditory nerve, ototoxic effect;
- the part of the reproductive system: azoospermia, amenorrhea;
- From the CCC: hypotension, tachycardia;
- Allergic reactions: hoarseness, angioedema, skin rash;
- Others: nephrotoxicity.
Pregnancy and lactation
The drug Cisplatin is contraindicated in pregnancy, as has a strong
embryotoxic and teratogenic effects. In this regard, the patient of childbearing age who take this drug must use reliable contraception. In cases where the drug Cisplatin should be used during lactation should decide to discontinue breastfeeding.
Dosage and Administration
According to the instructions, Cisplatin is used only intravenously.
When monotherapy dose of the drug is 20 mg per 1 m square. body surface area once daily for 5 days or 30 mg per 1 m square. within three days, or 100-150mg per 1 m square. once every three weeks.
The interval between courses of therapy is 3 weeks. The total number of required courses selects the physician with the nosological unit and stage of disease.
The drug Cisplatin is not recommended for use in patients with chickenpox (including post-exposure and has recently been ill), herpes zoster and other infectious diseases
. Caution should be used this drug in patients with gout and nephrolithiasis (history included), as well as in patients who received prior radiation therapy or cytotoxic chemotherapy
. Before and during therapy with cisplatin is necessary to monitor hematologic parameters, laboratory parameters functioning of the kidneys and liver, fluid and electrolyte balance, and uric acid levels, audiometric and neurological performance
. To reduce the nephrotoxic effect of the drug Cisplatin before treatment is recommended by intravenous infusion of physiological saline solution or glucose, to appoint additional mannitol
. During treatment with cisplatin to patients and their family members it is not recommended to vaccinate
Cisplatin interaction with other drugs
Cisplatin simultaneously with urikozuricheskimi protivopodagricakih drugs increases the risk of developing nephropathy. Co-administration of antihistamines, phenothiazines, thioxanthenes mask ototoxic effects of cisplatin.
Reviews of cisplatin
Cisplatin preparation has a pronounced antitumor effect, it is effective in many malignancies. Reviews of cisplatin by doctors talk about the high activity of this drug. Patients say heavy tolerability Cisplatin due to the large number of side effects.
Storage conditions of the drug
Cisplatin refers to the list A. Store this medication at a temperature not exceeding 10 ° C.