Carboplatin, a chemotherapy agent. Its MOA, uses, contraindications,precautions, Nursing intervention, family/ patient teaching.

1. Presentation
on
Carboplatin
Prepared by :
Kalpana Kawan
Roll no. 06
BNS 3rd year

2. Introduction
• Functional class : Antineoplastic alkylating
agent
• Chemical class :Platinum coordination
compound
• Pregnancy category D

3. ACTION
Carboplatin interferes with the development of
the genetic material in a cell, the DNA. This
stops it from dividing into 2 new cells and kills
it.

4. USES
• Mainly ovarian cancer.
• Other types of cancer, including lung, head and
neck, endometrial, esophageal, bladder, breast,
and cervical; central nervous system or germ
cell tumors; osteogenic sarcoma; and as
preparation for a stem cell or bone marrow
transplant.

5. Contraindications
• Pregnancy
• Hypersensitivity to platinum compound
• Breastfeeding
• Significant bleeding
• Severe bone marrow depression

6. Precautions
• Geriatric patients
• Renal disease
• liver disease
• Anemia
• Infection

7. Available forms
• Lyophilized powder for inj 50, 150, 450 mg
vials
• Aqueous solution for inj 50 mg/5 ml vial, 150
mg/15 ml vial, 450 mg/45 mg vial, 600 mg/60
ml vial

8. Dosage and Routes
Advanced ovarian cancer
• Single agent: 360 mg/m² IV every 4Weeks
• Combination treatment: 300 mg/m² IV (plus
cyclophosphamide 600 mg/m² IV) every
4Weeks, 6 cycles
• Refractory tumors 360 mg/m2 single dose,
may repeat every 4 week as needed.

9. Dosage and Routes
• Renal dose
Adult: IV INF CCr 41-59 ml/min 250 mg/m2 ,
CCr 16-40 ml/min 200 mg/m2 ; do not use in
CCr ,15 ml/min
• The amount of carboplatin depends on many
factors, including height and weight, general
health or other health problems, and how the
body responds to it.

10. Adverse effects
• CNS: Seizures, central neurotoxicity,
peripheral neuropathy, dizziness, confusion
• CV: Cardiac abnormalities stroke
• EENT: Tinnitus, hearing loss, vestibular
toxicity, visual changes
• GI: Severe nausea, vomiting, diarrhea, weight
loss, mucositis, anorexia, constipation, taste
change

11. Adverse effects contd…
• HEMA: Thrombocytopenia, leukopenia,
pancytopenia, neutropenia, anemia, bleeding
• INTEG: Alopecia, dermatitis, rash, erythema,
pruritus, urticaria
• META: hyponatremia, hypokalemia,
Hypomagnesemia, hypocalcemia,

12. Adverse effects contd…
• SYST: Anaphylaxis
• RENAL: Serum creatitine elevations, Blood
Urea Nitrogen elevation
• HEPATIC: Bilirubin elevation, Alkaline
phosphatage elevations

13. Pharmacokinetics
Absorption Complete
Distribution Unknown
Metabolism Liver
Excretion Kidneys
Half-life Initial 1-2 hr;
postdistribution 2½-6 hr;
increased in renal disease

14. Pharmacodynamics
Onset ½ hr
Peak Unknown
Duration 4-6 hr

15. Interactions
• Amphotericin B: increased nephrotoxicity or
ototoxicity
• Aspirin, anticoagulants, platelet inhibitors:
increased risk of bleeding
• Radiation: increased toxicity, bone marrow
suppression

16. Nursing considerations
• Assess for anaphylaxis: pruritus, wheezing,
tachycardia; may occur within a few minutes
of use; notify physician after discontinuing
products; resuscitation equipment should be
available
• Peripheral neuropathy: may be increased in
geriatrics

17. Nursing considerations contd…
• Monitor renal function studies.
• Monitor liver function tests before, during
therapy as needed or monthly; note jaundice of
skin or sclera, dark urine, clay-colored stools,
itchy skin, abdominal pain, fever, diarrhea
• Monitor temperature every 4 hour (may
indicate beginning of infection)

18. Nursing considerations contd…
• Assess for bleeding: hematuria, bruising or
petechiae, inflammation of mucosa, breaks in
skin; avoid all IM injections if platelets
<50,000/mm3
• Identify effects of alopecia on body image;
discuss feelings about body changes

19. Nursing considerations contd…
• Bone marrow depression: Monitor CBC,
differential, platelet count weekly; withhold
product if neutrophil count is <2000/mm3 or
platelet count is <100,000/mm3
• Assess serum electrolyte value (sodium,
potassium, calcium, magnesium)

20. Nursing considerations contd…
Implementation
• Pre medication:
Inj. Aciloc 50mg
Inj. Dexona 8 mg in 100 ml N/S over 30
min
Inj. Ondem 8 mg
• Inj. Carboplatin 600 mg in 250ml 5% dextrose
over 2 hour
• Flush with 500ml/100ml NS

21. Nursing considerations contd…
• IV route - Do not use needles or IV
administration sets containing aluminum; may
cause precipitate or loss of potency
• Use cytotoxic handling procedures
• Store and protected from light at room
temperature; reconstituted solution is stable for
8 hours at room temperature

22. Patient/family education
• Teach patient to avoid use of products con-
taining aspirin or ibuprofen, NSAIDs, alcohol,
razors, since bleeding may occur.
• Advise patient to report ringing/roaring in
the ears, numbness, tingling in face,
extremities.
• Teach to report symptoms of bleeding
(hematuria, tarry stools).

23. Patient/family education contd..
• Instruct patient to report signs of anemia
• Instruct patient to report any changes in
breathing or coughing even several months
after treatment
• Instruct to avoid crowds and persons with
respiratory tract or other infections

24. Patient/family education contd..
• Report fever or any other signs of infection
immediately to health care provider.
• Advise patient that hair may be lost during
treatment; a wig or hairpiece may make patient
feel better.
• Caution patient not to have any vaccinations
without the advice of the prescriber.

25. Patient/family education contd….
• Teach patient that contraception is needed
during treatment and for several months after
the completion of therapy
• Not to breastfeed during treatment.
• To notify prescriber if pregnancy is planned or
suspected.

26. Patient/family education contd….
• Teach patient that impotence or amenorrhea
can occur.
• Drink at least 2- 3 liter of fluid every 24 hours.
• Wash your hands often.
• Use an electric razor and a soft toothbrush to
minimize bleeding.

27. Patient/family education contd….
• Avoid contact sports or activities that could cause
injury.
• Delay dental work until blood counts have
returned to normal
• To reduce nausea, take anti emetics drugs as
prescribed by doctor, and eat small, frequent
meals.
• Get plenty of rest.
• Maintain good nutrition.

28. References
Grover, JK. Monica, M. (2002) Textbook of
pharmacology for nurses (3rd ed).p.422 CBS
Publishers and Distributors Pvt Ltd
Tripathi, KD. (2019) Essentials of medical
pharmacology(8th ed). P. 918-920.Jaypee
Brothers Medical Publishers(P)Ltd
Skidmore, L.S.(2015).Mosby’s drug guide for
nursing students (11th ed).p. 168-170.Elsevier
Medscape(n.d.). Carboplatin. Accessed
https://reference.medscape.com/drug/paraplatin-
carboplatin-342107 on Dec 15, 2021