II. Indications (Part of combination protocols)

III. Mechanism

  1. Second-generation platinum based Antineoplastic Agent
    1. More stable and less toxic than its parent drug Cisplatin
  2. Components
    1. Platinum atom
    2. 1,2-diaminocyclohexane (DACH)
      1. Decreases Alkylating Agent resistance
    3. Oxalate Ligand (displaced, "leaving group")
  3. Activated (on displacement of the oxalate leaving group) as reactive platinum complexes
    1. Binds DNA (e.g. GC rich regions)
    2. Results in DNA cross-links
    3. Results in cell growth inhibition, apoptosis and cell death

IV. Dosing

  1. See other references for disease specific dosing protocols

V. Adverse Effects

  1. Anaphylaxis
    1. May occur within minutes of infusion
    2. Acute Laryngospasm may also occur
  2. Bronchiolitis Obliterans Organizing Pneumonia (rare)
  3. Cardiovascular Toxicity
  4. Impaired future fertility
  5. Myelosuppression (Bone Marrow suppression)
  6. Neuropathy
    1. Exposure to cold after infusion may worsen acute neurotoxicity
  7. Neutropenia (severe)
  8. Posterior Reversible Encephalopathy Syndrome (Rare)
  9. Pulmonary Fibrosis
  10. Rhabdomyolysis
  11. Transient Vision Loss

VI. Safety

  1. Avoid in Lactation
  2. Pregnancy Category D
    1. Avoid in Pregnancy (all trimesters)
    2. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Renal Function tests

VII. Efficacy

  1. More effective than Cisplatin in advanced Colorectal Cancer

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