|
|
|
|
 |
|
|
|
|||||||
|
Cisplatin is a platinum-containing chemotherapy drug. Although the mechanism of action is not completely understood, cisplatin behaves similarly to a bi-functional alkylating agent by producing crosslinks in DNA. Cisplatin is widely distributed into the liver, kidney and intestines, and poorly distributed into the central nervous system (CNS). Cisplatin is particularly nephrotoxic and approximately 50 percent of cisplatin is excreted by the kidneys in the first 24 to 48 hours. It is activated in the kidneys to produce a metabolite that is toxic to the proximal tubule cells.
Cisplatin is a mainstay chemotherapy drug in the treatment
of ovarian cancer in women. Although the majority of ovarian cancers respond
initially to cisplatin, it appears that over time the tumors become resistant
to platinum chemotherapy. There is research in human medicine attempting
to identify other chemotherapy agents to enhance the effectiveness of
cisplatin.
Cisplatin is used to treat a number of different tumors in dogs. The most common ones include osteosarcoma, squamous cell carcinoma, bladder tumors, ovarian carcinoma and mesotheliomas. It is frequently used in the treatment of non-resectable or widespread carcinomas and may be administered intravenously, intraperitoneally or intra-lesionally.
Cisplatin has been shown to improve survival in dogs with osteosarcoma. In one study, the one-year survival for dogs with osteosarcoma that had undergone both tumor resection and cisplatin chemotherapy was between 45 to 55 percent.
Cisplatin is used intra-lesionally to treat equine
skin tumors such as sarcoids, spindle-cell tumors, squamous-cell carcinoma
and melanoma. When used as an intra-lesional injection, cisplatin is either
mixed with sterile sesame oil or delivered in a biodegradable, slow-release
bead. In reports on intra-lesional use, systemic side effects were not
noted, and local side effects resolved quickly.
The most common side effect is vomiting within six hours of treatment. This may be managed by pre-treatment with antiemetics such as butorphanol, dexamethasone and metoclopramide. The degree of GI toxicity may be dose related.
Nephrotoxicity is frequently the treatment-limiting side effect. Monitoring renal-concentrating ability, azotemia and presence of abnormal numbers of granular casts in urinary sediment may be useful. The risk of nephrotoxicity and ototoxicity may be decreased by slowing the infusion rate.
Another side effect may be mild to moderate myelosuppression
with a bimodal nadir at 7 and 14 days. White blood cell (WBC) count should
be monitored regularly in animals undergoing treatment.
• Gloves and protective clothing should be worn
when handling cisplatin.
• Cisplatin is nephrotoxic. It should not be used, or used with extreme
caution, in dogs with decreased renal function. It should always be used
with pre- and post- treatment saline diuresis. Cisplatin should be used
with caution in dogs with urinary tumors. It should not be used if the
serum creatinine is above normal range. Small dogs may be at greater risk
to develop nephrotoxicity than larger breed dogs.
• Dogs with pre-existing heart disease that are unable to undergo
fluid diuresis pre-treatment are not good candidates for cisplatin.
• Cisplatin should not be used in cats due to potential severe pulmonary
toxicity.
• In laboratory animals, cisplatin was found to be embryo-toxic and
teratogenic. It should only be used in pregnant animals when the benefit
of treatment clearly outweighs the risks.
• Cisplatin should not come in contact with aluminum as it may cause
the platinum to precipitate. Aluminum needles should be avoided. Discard
any cisplatin with precipitate.
• Treatment with other potentially nephrotoxic drugs should be separated
by two weeks.
• Cisplatin may decrease serum levels of phenytoin.
• There is a very narrow range between the therapeutic dose and the minimum lethal dose. Dosage calculations need to be meticulously checked due to the toxicity of this drug.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
The information contained on this site
is general in nature and is intended for use as an informational aid. It does
not cover all possible uses, actions, precautions, side effects, or interactions
of the products shown, nor is the information intended as medical advice or
diagnosis for individual health problems or for making an evaluation as to the
risks and benefits of using a particular product. You should consult your doctor
about diagnosis and treatment of any health problems. Information and statements
have not been evaluated by the Food and Drug Administration ("FDA"),
nor has the FDA approved the products to diagnose, cure or prevent disease.
Wedgewood compounded veterinary preparations are not intended for use in food and food-producing animals.
Request a Brochure | Request a Formulation Consultation
Compound Medications |
Veterinary Medicine | Compounding
Pharmacy
Veterinary Medications | Information
on Expired Medications | Sitemap | Partners
Wedgewood
Pharmacy
405 Heron Drive Suite 200 • Swedesboro, NJ 08085-1749 • 888.678.1967
Copyright © 2004-2009 Wedgewood Village Pharmacy, Inc. All rights reserved.
