시스플라틴

항종양제 - 백금 화합물

**시스플라틴(Cisplatin)**은 수의 종양학에서 주로 개의 다양한 암종 및 육종 치료와 말의 피부 종양 병변 내 주사로 사용되는 중금속 백금계 항종양제입니다. **주요 임상 포인트:** * **강한 최토성:** 화학수용체 구토유발대(CTZ)를 직접 자극합니다. 투여 전 강력한 항구토제(예: 마로피탄트, 온단세트론, 부토르파놀)의 전처치가 표준입니다. * **신독성:** 신세뇨관 손상을 방지하기 위해 투여 전, 중, 후에 적극적인 정맥 수액 이뇨(주로 0.9% 생리식염수)가 필요합니다. * **종 특이성:** 치명적인 용량 의존성 원발성 폐독성을 유발하므로 **고양이에게는 절대 금기**입니다. * **취급 주의:** 위험한 항암제이므로 조제 및 투여 시 엄격한 안전 수칙(장갑, 보호복, 폐쇄형 약물 전달 시스템 사용)이 요구됩니다.

작용 기전: Cisplatin acts as a **bifunctional alkylating agent**. * The **platinum** compound enters the cell and loses its chloride atoms in the low-chloride intracellular environment. * It then binds covalently to the N7 reactive center on **purine residues (guanine and adenine)** on the DNA. * This binding produces **interstrand and intrastrand crosslinks** in the DNA → alters DNA structure → inhibits DNA replication and transcription → leads to cell cycle arrest and **apoptosis**. * It is considered **cell cycle nonspecific**, though cells are most vulnerable during the G1 and S phases.

동물 종별 용량

Horses

For intralesional injection of skin tumors · 1 mg per cm3 of tumor/tumor bed intralesionally · Intralesional · at 2-week intervals · for 4 total treatments · Add 10 mg powder to 1 mL water and 2 mL medical-grade sesame oil (3.3 mg/mL). Inject in multiple planes no further than 0.6 to 1 cm apart.

Dogs

For potentially susceptible carcinomas and sarcomas · 30-70 mg/m2 (NOT mg/kg) IV over 20 minutes to several hours every 3-5 weeks · IV · every 3-5 weeks · Warning: Do not confuse cisplatin and carboplatin dosages; cisplatin dosages are much lower. Dogs must undergo saline diuresis before and after cisplatin therapy.
Intracavitary administration for palliative control of neoplastic pulmonary effusions · 50 mg/m2 (NOT mg/kg) (diluted in normal saline to a total volume of 250 mL/m2) · Intracavitary · every 3-4 weeks as needed · Discontinue after 4th treatment if resolved completely · Give IV normal saline at 10 mL/kg/hr for 4 hours prior. Warm solution to body temp. Remove pleural fluid first, then slowly infuse.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IVIntracavitaryIntralesional

금기

Cats (causes fatal pulmonary edema and dyspnea)
Preexisting significant renal impairment
Preexisting myelosuppression
History of hypersensitivity to platinum-containing compounds
Caution in patients with congestive heart failure (due to required fluid loading)

이상반응

Severe vomiting (acute and delayed)
Nephrotoxicity (renal tubular damage)
Myelosuppression (thrombocytopenia, granulocytopenia)
Ototoxicity (high-frequency hearing loss, tinnitus)
Anorexia
Diarrhea (including hemorrhagic)
Seizures
Peripheral neuropathies
Electrolyte abnormalities
Hyperuricemia
Increased hepatic enzymes
Anaphylactoid reactions
Death

약물 상호작용

Aminoglycosides · Potential for increased risk for nephrotoxicity; if possible, delay aminoglycoside administration by at least two weeks after cisplatin.
Amphotericin B · Potential for increased risk for nephrotoxicity; if possible, delay amphotericin B administration by at least two weeks after cisplatin.
Furosemide (and other loop diuretics) · Potential for increased ototoxicity.
Phenytoin · Cisplatin may reduce serum levels of phenytoin.

모니터링

Urinalysis, BUN, and serum creatinine (baseline and before each dose)
Hemogram and platelet count (baseline and before each dose)
Serum electrolytes and acid-base status
Tumor measurement and radiography (at least monthly to assess efficacy)
Monitor for signs of vomiting, dehydration, or ototoxicity

과용량

The minimum lethal dose of cisplatin in dogs is reportedly **2.5 mg/kg (≈80 mg/m2)**. Because of the potential for serious toxicity (severe nephrotoxicity, myelosuppression, intractable vomiting, and death), dosage calculations must be checked thoroughly. Overdose management involves aggressive IV fluid diuresis, antiemetics, and supportive care for bone marrow suppression.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.