Literature Case Analysis on Toxicities and Management of Cisplatin Overdose
DENG Jian-hao1, ZHANG Qing-xia2*
1. Department of Pharmacy, Longyan Second Hospital, Longyan 364000, China; 2. Department of Pharmacy, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
Abstract：OBJECTIVE To explore the clinical characteristics and management of cisplatin overdose. METHODS Relevant databases at home and abroad updated to December 31, 2021 were searched to find the case reports of cisplatin overdose.The basic information of patients, indications of cisplatin, usage and dosage of cisplatin, toxicity, duration of hospitalization, and treatment and outcome of cisplatin overdose was descriptively analyzed. RESULTS A total of 21 patients were included in the analysis, aged from 1 to 67 years, involving in 12 kinds of primary tumors, dosage from 180-800 mg·m-2.Medication errors included prescription error(18 cases), dispensing errors(2 cases) and transcription errors(1 case). The most common toxicities of cisplatin overdose were nephrotoxicity (95%), ototoxicity (86%), myelosuppression (86%), hepatotoxicity (48%), acute pancreatitis (19%), vision loss (19%) and respiratory failure (19%) . The length of hospital stay for drug overdoses was 7-49 days, with a median of 26 days. Of the 21 patients, 4 died and 17 survived. CONCLUSION The key management points for cisplatin overdose are adequate hydration, prompt clearance of the overdose with plasmapheresis, avoidance of nephrotoxicity and consideration of chemoprotective agents such as amifostine and sodium thiosulfate. In order to prevent the recurrence of such accidents, it is suggested that the evaluation should be carried out at multiple levels to ensure the safety of patients.
邓健浩, 张青霞. 顺铂过量致毒性反应的临床救治的文献分析[J]. 中国药学杂志, 2022, 57(14): 1209-1213.
DENG Jian-hao, ZHANG Qing-xia. Literature Case Analysis on Toxicities and Management of Cisplatin Overdose. Chinese Pharmaceutical Journal, 2022, 57(14): 1209-1213.
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