Which is a common side effect of cisplatin based chemotherapy?

PGIMER Sangrur NO - 2023

Pharmacology

Easy

Appeared in: PGIMER Sangrur NO - 2023

Explanation

Cisplatin is classified as a highly emetogenic chemotherapy agent, with an incidence of nausea and vomiting exceeding 90% in patients who do not receive preventive antiemetic medication.
This severe side effect is caused by the drug's direct stimulation of the chemoreceptor trigger zone (CTZ) in the brain, which is responsible for inducing the vomiting reflex.
Due to this high and predictable risk, standard nursing practice includes administering aggressive prophylactic antiemetics, such as serotonin (5-HT₃) receptor antagonists (e.g., ondansetron), before cisplatin infusion.

Option A: While alopecia (hair loss) is a possible side effect of chemotherapy, it is generally less frequent and less severe with cisplatin compared to other agents like paclitaxel or doxorubicin.
Option C: Signs of infection are related to myelosuppression (a decrease in bone marrow activity, leading to low white blood cell counts). While cisplatin can cause myelosuppression, it is typically of moderate severity. The risk of nausea and vomiting is far more immediate and universal.
Option D: Altered nutrition is a secondary problem or a consequence of the severe nausea and vomiting caused by cisplatin, rather than a direct primary side effect of the drug itself.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Common side effects of cisplatin chemotherapy as background academic context rather than a clinical decision trigger.
A primary nursing responsibility during cisplatin administration is the aggressive management of chemotherapy-induced nausea and vomiting (CINV) through timely administration of prophylactic antiemetics.
Patient education is crucial. Nurses must teach patients and their families about the schedule for taking antiemetics at home to manage delayed CINV, which can occur 24 hours or more after treatment.
Vigilant monitoring for signs of dehydration (e.g., decreased urine output, dizziness, dry mouth) is essential, as uncontrolled vomiting can lead to serious fluid and electrolyte imbalances.

How to Approach the Question

This is a factual recall question testing your knowledge of pharmacology.
First, identify the specific drug mentioned in the question: cisplatin, a platinum-based chemotherapy agent.
Next, recall the characteristic side effect profile for this drug. Think about what makes it unique or what it is most known for.
Evaluate each option against your knowledge of cisplatin's toxicities.
Cisplatin is famously known for being one of the most highly emetogenic drugs. This makes 'Nausea & Vomiting' the most likely correct answer.
Consider the other options. While other effects like hair loss or infection risk can occur with chemotherapy, they are not the defining, most common side effect of cisplatin specifically.

Concept Tested & Keywords

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E6 Gynecology Williams p. 188-222

E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 198-200