Question

4. (30 pts) The following passages were obtained from the clinical reference website, Oncology Dilution Database (http://www.globalrph.com/cisplatin.htm) for the drug, cisplatin/Platinol AQ. This formulation of the drug (Platinol AQ) is an aqueous solution of cis-[PtCl2(NH3)2] containing 3.3 mM drug and 154 mM Naci (normal saline solution) at a pH of 3.5-4.5. a. A passage on the website states, "Note: Needles or intravenous sets containing aluminum parts that may come in contact with cisplatin should not be used for preparation or administration. Aluminum reacts with cisplatin, causing precipitate formation and a loss of potency". What is the nature of the precipitate and briefly give a scientific explanation for why the precipitate forms. b. A male patient, who is 72 inches tall and weighs 180 pounds, will receive cisplatin chemotherapy. The attending oncologist determined that the appropriate dose of cisplatin for the patient is 60 mg/m². If the drug is in 500 ml of infusion solution and the infusion time is 1 h, calculate the concentration in moles per liter (M) of cisplatin in the infusion solution. Use the Mosteller formula to determine BSA c. One of the cautionary statements on the above website is, "Do not dilute cisplatin in just 5% Dextrose Injection". Briefly explain the chemical/pharmacological consequences if this directive is not followed, i.e. the clinician inadvertently dilutes the Platinol AQ in water containing 5% dextrose without added chloride ion.

Answer 1

According to the given question

a) It forms black precipitate of platinum.

Cisplatin reacts with aluminums causing to make a black color precipitate .

B)

BSA by mosteller method= square root of (height(cm)*weight (kg)/3600)

= Square root of ( 180* 81.72)=2.02 is the desired BSA

C) cisplatin must be diluted in sodium chloride not 5 percent dextrose because it shows interaction and leads to toxicity. It binds well sodium chloride.