Sketchy Pharm: Cisplatin, Carboplatin, Oxaliplatin, Amifostine

Question 1

How do the platin drugs work?

Answer 1

They, like the alkylating agents, crosslink DNA both within strands and across strands.

(Think of the double helix necklace that is crosslinked by the platinum rings.)

Question 2

For which kinds of cancer are the platinum drugs effective?

Answer 2

Solid tumors (like the lunch bag with the solid mass in it and the crab on the side): testicular, small cell lung cancer, bladder cancer, etc.)

Question 3

What are the side effects of platinum chemotherapies?

Answer 3

• Ototoxicity, except oxaliplatin (gong-shaped earrings)
• Glove and stocking sensory neuropathy (stylish gloves)
• Nephrotoxicity (kidney-shaped purse and gutter with “muddy casts” spewing into the street)

Question 4

What can be done to prevent the nephrotoxicity seen in cisplatin usage?

Answer 4

• Co-administer amifostine (“AMethyst Free with purchase” in a kidney-shaped purse)
• Give IV saline to stimulate GFR (custodian cleaning glass with saline next to kidney bag)
• Give a less toxic platin like carboplatin or oxaliplatin

Question 5

Although carboplatin has less nephrotoxicity and ototoxicity than cisplatin, it is more likely to cause _______________.

Answer 5

myelosuppression (represented by the open bone case)