PARTNERS WITH
Nedaplatin
Platinum based Alkylating agents
MECHANISM OF ACTION
Inhibits DNA duplication resulting in cell death/Excreted in urine
MECHANISM OF KIDNEY INJURY
ATN (Acute tubular necrosis), Water/electrolyte disturbances
CLINICAL KIDNEY SYNDROME
AKI, causes proximal and distal tubulopathy, electrolyte abnormalities can be seen
CARDIOVASCULAR ADVERSE EFFECTS
a case series of 3 cases reported: sinus tachycardia and atrial premature beats, complete left bundle branch block, and bigeminy ventricular premature contraction -- PMID: 29056132
LYTE ABNORMALITIES
Elevated BUN, Hypokalemia, Hypocalcemia, Hypomagnesemia
RISK FACTORS
Pre existing renal injury, old age, concomitant other nephrotoxic agents use
MITIGATION STRATEGIES
Maintain euvolemia, correct dosing, avoid other nephrotoxic agents
SUGGESTIONS
Hold offending drug and rechallenge after AKI/proteinuria resolves, Volume expansion, Check urine analysis for cyrstals, WBC, RBC, etc, Check urine protein creatinine ratio, Check TMA work up (send haptoglobin, peripheral smear, LDH)
NOTES/COMMENTS
50%
PHARMACOKINETICS
Molecular Weight
303.17 g/mol
Volume of Distribution
12 L
Plasma Protein Binding
Metabolism
Not available
Bioavailability
---
Half-life elimination
1.1 to 4.4 hours
Time to peak
Not available
Excretion
Urine (59.6%)
Dialyzable?
Unknown
REF:
PATHOLOGY SLIDES:
ENTRY UPDATES:
Tanazul Pariswala, MD
United States
Sep 25, 2022