Oxaliplatin
Alkylating Agent | Antineoplastic Agent
Oxaliplatin, a platinum-based chemotherapeutic agent, is frequently used in the treatment of colorectal cancer, often as part of combination regimens like FOLFOX.
- Cold Sensitivity: One of the most notable side effects of oxaliplatin is acute sensory neuropathy, which can be triggered or exacerbated by exposure to cold. Patients should be advised to avoid cold temperatures and cold objects, and to wear gloves when handling cold items.
- Peripheral Neuropathy: Chronic peripheral neuropathy is a dose-limiting toxicity of oxaliplatin. It's important to monitor patients for symptoms like numbness, tingling, and pain in their hands and feet. Dose adjustments may be necessary if these symptoms become severe.
- Infusion Reactions: Oxaliplatin can cause hypersensitivity reactions, which are more common beyond the initial doses. Pre-medication with steroids and antihistamines may be recommended in patients with prior reactions, and vigilant monitoring during infusion is crucial.
- Dosing Schedule: Oxaliplatin is typically administered in a biweekly cycle as part of combination chemotherapy regimens. Understanding the timing and sequence of drug administration within these regimens is important for optimal therapeutic outcomes and minimizing toxicity.
- Renal Impairment Consideration: Although oxaliplatin is less nephrotoxic compared to other platinum compounds, it should still be used with caution in patients with renal impairment, and renal function should be monitored throughout treatment.
- Myelosuppression: Like many chemotherapeutic agents, oxaliplatin can cause myelosuppression, primarily neutropenia. Regular monitoring of complete blood counts is essential, and growth factor support may be necessary.
- Nausea and Vomiting: Oxaliplatin can cause significant nausea and vomiting. Prophylactic antiemetic therapy with a serotonin antagonist, potentially supplemented by other agents like NK1 antagonists and steroids, should be considered to manage these symptoms.
- Drug Interactions: Oxaliplatin's effectiveness or toxicity can be influenced by interactions with other drugs, especially those affecting hepatic enzymes or those excreted through the kidneys. Detailed medication reconciliation is necessary to identify potential interactions.
- Handling and Preparation: Oxaliplatin should be handled with care to avoid exposure to the skin or mucous membranes. Appropriate protective equipment should be worn during preparation and administration.
- Use of Dexamethasone: Pre-treatment with dexamethasone may reduce the risk and severity of oxaliplatin-induced hypersensitivity reactions.
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