Tag: Platinum Compounds

Platinum Compounds

PLATINUM COMPOUNDS

Q. 1

Which of the following is a common side-effect of Cisplatin –

 A

Diarrhea

 B

Vomiting

 C

Pulmonary fibrosis

 D

Alopecia

Q. 1

Which of the following is a common side-effect of Cisplatin –

 A

Diarrhea

 B

Vomiting

 C

Pulmonary fibrosis

 D

Alopecia

Ans. B

Explanation:

Ans. is ‘b’ i.e., Vomiting

  • Most common side-effect of Cisplatin is : Vomiting
  • The most important dose dependent toxicity is renal impairment.

o Amifostine is labelled for reduction of cisplatin induced nephrotoxicity.


Q. 2

All the following are examples of cardiotoxic drugs except-

 A

Cyclophosphamide

 B

5-FU

 C

Adriamycin

 D

Cisplatin

Q. 2

All the following are examples of cardiotoxic drugs except-

 A

Cyclophosphamide

 B

5-FU

 C

Adriamycin

 D

Cisplatin

Ans. D

Explanation:

Ans. is ‘d’ i.e., Cisplatin

Cisplatin is not cardiotoxic

Cardiotoxicity of Adriamydn: –

I ) ECG changes, arrythmias               2) Congestive heart failure 3) Cardiomyopathy
Doxorubicin is also known as adriamycin.

Other anticancer drugs causing cardiotoxicity:

I)Daunorubicin                                 2) Cyclophosphamide               3) Mitoxantrone           4)5 – FU


Q. 3

Most emetogenic drug is –

 A

Cisplatin

 B

Carboplatin

 C

High dose cyclophosphamide

 D

a and c

Q. 3

Most emetogenic drug is –

 A

Cisplatin

 B

Carboplatin

 C

High dose cyclophosphamide

 D

a and c

Ans. D

Explanation:

Ans. is ‘a’ i.e., Cisplatin; ‘c’ i.e., High dose cyclophosphamide

Quiz In Between


Q. 4

Which of the following Anti neoplastic drugs SHOULD NOT be given by rapid IV infusion‑

 A

Cyclophosphamide

 B

Cisplatin

 C

Bleomycin

 D

Cytosine arabinoside

Q. 4

Which of the following Anti neoplastic drugs SHOULD NOT be given by rapid IV infusion‑

 A

Cyclophosphamide

 B

Cisplatin

 C

Bleomycin

 D

Cytosine arabinoside

Ans. B

Explanation:

Ans. is `b ‘ i.e., Cisplatin

o Cisplatin is the most common culprit causing chemotherapy induced nausea and vomiting, therefore cisplatin is given as slow i.v. infusion(never bolus) to prevent vomiting.


Q. 5

Which of the following chemotherapeutic agents is associated with secondary leukemia-

 A

Vinblastine

 B

Etoposide

 C

Cisplatin

 D

Bleomycin

Q. 5

Which of the following chemotherapeutic agents is associated with secondary leukemia-

 A

Vinblastine

 B

Etoposide

 C

Cisplatin

 D

Bleomycin

Ans. C

Explanation:

Ans. is ‘c’ i.e. Cisplatin

“Cisplatin is mutagenic, teratogenic and carcinogenic. Secondary leukemias are reported with the use of cisplatin and the use of cisplatin or carbolatin based chemotherapy for women with ovarian cancer is associated with a fourfold increased risk of developing secondary leukemia.”

Remember

All alkylating agents can also cause leukemia. Melphalan, nitrosoureas and procarbazine have the greatest propensity, while it is less common with cyclophosphomide.


Q. 6

Which of the following drugs is associated with untoward side effect of renal tubular damage-

 A

Cisplatin

 B

Steptozotocin

 C

Methysergide

 D

Cyclophosphamide

Q. 6

Which of the following drugs is associated with untoward side effect of renal tubular damage-

 A

Cisplatin

 B

Steptozotocin

 C

Methysergide

 D

Cyclophosphamide

Ans. A

Explanation:

Ans. is ‘a’ i.e. Cisplatin

Some nephrotoxic agents which cause tubular necrosis.

o Aminoglycosides           o Colistin                                      o Methoxyfluranes               o Sulfonamides

o Amphotericin B             o Cyclosporine                               o Polymyxin                        o Tetracyclines

o Cephaloridine              o Intravenous immune globulin       o Radioiodinated contrast      o Acetaminophenmedium

o Cisplatin                                                                

Quiz In Between


Q. 7

In oesophageal ca which Neoadjuvant chemotherapy is used –

 A

Cisplatin

 B

Cyclophosphamide

 C

Doxorubicin

 D

Methotrexate

Q. 7

In oesophageal ca which Neoadjuvant chemotherapy is used –

 A

Cisplatin

 B

Cyclophosphamide

 C

Doxorubicin

 D

Methotrexate

Ans. A

Explanation:

Ans is ‘a’ ie Cisplatin 

Sabiston writes-“Since its introduction in 1980, cisplatin has emerged as the cornerstone of combination therapy in esophageal cancer. As a single agent, it has a response rate of 25% to 30%. Given in combination with 5-fluorouracil, a response rate of 50% may be achieved, and this is an established chemotherapeutic regimen for esophageal cancer.”


Q. 8

Cytotoxic agent with maximum emetogenic potential:

March 2012, March 2013

 A

Cisplatin

 B

Daunorubicin

 C

Bleomycin

 D

Methotrexate

Q. 8

Cytotoxic agent with maximum emetogenic potential:

March 2012, March 2013

 A

Cisplatin

 B

Daunorubicin

 C

Bleomycin

 D

Methotrexate

Ans. A

Explanation:

Ans: A i.e. Cisplatin

Emetogenic potential of drugs

  • Emetogenic potential of cisplatin is high (other drugs are cyclophosphamide, actinomycin-D)
  • Daunorubicin has moderate emetogenic potential
  • Bleomycin and Methorexate has mild emetogenic potential

Q. 9

Anti cancer drug causing nephrotoxicity ‑

 A

Cyclophosphamide

 B

Busulfan

 C

Cisplatin

 D

Procarbazine

Q. 9

Anti cancer drug causing nephrotoxicity ‑

 A

Cyclophosphamide

 B

Busulfan

 C

Cisplatin

 D

Procarbazine

Ans. C

Explanation:

Ans. is ‘c’ i.e., Cisplatin 

Platinum compound

  • These are alkylating agents and act by similar mechanism. 
  • Drugs are –

First generation -9      →      Cisplatin

Second generation      →      Carboplatin

Third generation         →      Oxaliplatin

Side effects of Cisplatin

Vomiting           Ototoxicity     Hyperuricemia

Nephrotoxicity   Neuropathy

Note ‑

  • Cisplatin is most nephrotoxic where as carboplatin is more hematotoxic (bone marrow suppression). 
  • Carboplatin has less nephrotoxic, neurotoxic and ototoxic effects.
  • Dose limiting toxicity of oxaliplatin is neurotoxicity (Peripheral neuropathy).
 

Drugs causing nephrotoxicity:

Chemotherapy and Immunosuppressants drugs causing nephrotoxicity:

– Cisplatin

–  Methotrexate

– Mitomycin

– Cyclosporine

– Ifosphamide (Causes Fanconi’s Syndrome)

Antibiotics:

– Aminoglycoside

– Sulfonamides Amphotericin B

– Foscarnet

Quinolones (e.g. Ciprofloxacin, Levofloxacin)

–                Rifampin

–                Tetracycline

–                Acyclovir (only nephrotoxic in intravenous form)

–                Pentamidine

–                Vancomycin

Heavy Metals:

Mercury Poisoning

– Lead Poisoning

– Arsenic Poisoning Bismuth

– Lithium related kidney disorders

AntiHyperlipidemics:

– Statin Drugs (Rhabdomyolysis)

Gemfibrozil-Associated with Acute Renal Failure due to Rhabdomyolysis

Miscellaneous Drugs:

– Chronic Stimulant Laxative use-Resulting in chronic volume depletion and Hypokalemia causes nephropathy

– Radiographic contrast

– ACE Inhibitor
–  NSA ID

– Aspirin

– Mesalamine

Quiz In Between



Platinum Compounds

PLATINUM COMPOUNDS


PLATINUM COMPOUNDS

Drugs: Cisplatin, carboplatin & oxaliplatin.

MOA:

  • Similar to alkylating agents.
  • Acts on both resting & dividing cells.
  • Platinum acts on nucleophilic groups on DNA bases –> Leading to cross-linking of bases, abnormal base-pairing  & DNA strand breakage.

Adverse effect:

  • Most common – Nausea & vomiting (maximum among all anti-cancer drugs).
  • Nephrotoxic, ototoxic & neurotoxic.
    • Cisplatin – Most nephrotoxic.
    • Carboplatin – More hematotoxicity.
  • Mild bone marrow suppression.

Individual drug details:

I) Cisplatin:

Adverse effect:

1. Most nephrotoxic.

  • Prior to cisplatin therapy – Establish chloride diuresis to prevent renal toxicity.
  • Chloride diuresis – No effect on ototoxicity.
  • Amifostine – Reduces cisplatin-induced nephrotoxicity.

2. Reduces all serum ions – Causes hypomagnesemia, hypokalemia, hypocalcemia & hypophosphatemia.

3. On long-term treatment (>4yrs) – AML development.

4. Bone marrow suppression (less incidence).

Note on Amifostine: Treats xerostomia during irradiation of head & neck (involving parotid).

Cisplatin administration instructions:

  • Always slow i.v. infusion (never bolus) – To prevent intense nausea & acute rise in serum creatinine.
  • Aluminum-containing equipment/needles should not be used with cisplatin – Aluminium inactivates cisplatin.

Carboplatin:

  • More hematotoxic (bone marrow suppressant).
  • Less nephrotoxic, ototoxic & neurotoxic potential than cisplatin.

Oxaliplatin:

  • Effective against cisplatin/carboplatin resistant cells.
  • Adverse effects:
    • Neurotoxicity (peripheral neuropathy) – Dose-limiting toxicity.

Exam Important

  • Cisplatin, carboplatin & oxaliplatin are platinum compounds.
  • Most common adverse effect of platinum compounds is Nausea & vomiting which is maximum among all anti-cancer drugs.
  • Nephrotoxic, ototoxic & neurotoxic are all caused by platinum compounds.
  • Cisplatin is the most nephrotoxic.
  • Carboplatin is the more hematotoxicity.
  • Prior to cisplatin therapy, it is essential to establish chloride diuresis, to prevent renal toxicity.
  • Amifostine reduces cisplatin-induced nephrotoxicity.
  • Cisplatin reduces all serum ions & causes hypomagnesemia, hypokalemia, hypocalcemia & hypophosphatemia.
  • On long-term treatment (>4yrs) cisplatin can cause AML development.
  • Amifostine is used to xerostomia during irradiation of head & neck (involving parotid).
  • Cisplatin administered as slow i.v. infusion (never bolus), to prevent intense nausea & acute rise in serum creatinine.
  • Carboplatin is more hematotoxic (bone marrow suppressant), but less nephrotoxic, ototoxic & neurotoxic than cisplatin.
  • Oxaliplatin is effective against cisplatin/carboplatin resistant cells but causes neurotoxicity (peripheral neuropathy), which is a dose-limiting toxicity.
Don’t Forget to Solve all the previous Year Question asked on PLATINUM COMPOUNDS

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