Cisplatin
A platinum drug that cross-links DNA, used for testicular, ovarian, bladder and lung cancer; it is toxic to the kidneys, nerves and ears.
Drug card
- Class
- Platinum compound
- How it works
- Binding DNA through platinum to form cross-links that block replication
- Used for
- Advanced testicular cancer
- Advanced ovarian cancer
- Advanced bladder cancer
- Non-small cell lung cancer, with paclitaxel
- Known for
- Kidney damage, cumulative with each course
- Severe nausea and vomiting, sometimes delayed
- Hearing loss, worst in children
- Its name
- -platin means a platinum anticancer drug
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does cisplatin work?
Binds DNA in the nucleus, forming intrastrand and interstrand cross-links that disrupt transcription and replication and lead to cell death. It is highly emetogenic, and its kidney, nerve and ear damage is dose-related and builds with each course.
Like other platinum compounds: Platinum compounds carry a platinum atom instead of alkyl groups, yet act much like alkylating agents. Inside the cell they form reactive platinum complexes that bind DNA, making adducts and cross-links within and between strands. The damaged DNA cannot be copied or read properly, so the cell stops dividing and dies by apoptosis.
Uses
What is cisplatin used for?
- Advanced testicular cancer
- Advanced ovarian cancer
- Advanced bladder cancer
- Non-small cell lung cancer, with paclitaxel
Side effects
Side effects of cisplatin
- Kidney damage, cumulative with each courseKnown forSerious
- Severe nausea and vomiting, sometimes delayedKnown for
- Hearing loss, worst in childrenKnown forSerious
- Ringing in the ears (tinnitus)
- Peripheral neuropathy, possibly permanentSerious
- Bone marrow suppressionSerious
- Low magnesium, often needing supplementsSerious
- Low potassiumSerious
- Low calcium, sometimes with tetanySerious
- Low sodium (SIADH)Serious
- Optic neuritis and other vision problemsSerious
- Blood clots in veins and arteriesSerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Hydrate before, during and after each dose; check creatinine and electrolytes, and reduce or avoid it in kidney impairment.
- Give highly effective antiemetic premedication; vomiting can return a day or more later.
- Check hearing, especially in children, and nerve function before and during treatment.
- Avoid other nephrotoxic and ototoxic drugs where possible.
Remember it
A way to remember it
NOVEL
- N
- Nephrotoxicity (kidney damage)
- O
- Ototoxicity (hearing loss, tinnitus)
- V
- Vomiting, severe with cisplatin
- E
- Electrolyte loss, especially magnesium
- L
- Limb nerve damage (peripheral neuropathy)
Five platinum toxicities, all worst with cisplatin; carboplatin causes fewer of them but more marrow suppression.
Written for biofideX
Its name
-platin means platinum anticancer drug
Cisplatin, carboplatin and oxaliplatin carry platinum and cross-link DNA. Cisplatin is known for kidney and nerve damage, carboplatin for bone marrow suppression and allergic reactions.
- Every drug name stem
Its class
Platinum compounds
Other platinum compounds with a card:
Easily mixed up with alkylating agents.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Cisplatin for injection: label (DailyMed)
- Cisplatin (NCI Thesaurus)
- Cisplatin (NCI)
- Paclitaxel injection: label (DailyMed)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Cancer chemotherapy
Cisplatin is one of 9 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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