Cytotoxic drug manipulation and its impact on occupational safety of hospital workers

In order to study environmental contamination by cytostatic drugs in a Portuguese hospital two wipe sampling campaigns were conducted in 2010 (12 samples) and 2015 (44 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm2 for platinum and 0.1 pg/cm2 for fluorouracil. The detected contamination on specific locations in the pharmacy and in the day hospital was higher in 2010. More detailed sampling in 2015 confirmed that optimization of working procedures and introduction of closed transfer system resulted in lower contamination by platinum drugs and fluorouracil. But there is still a need for continuing those processes

Dosing of carboplatin in a patient with amputated legs: A case report

Carboplatin is a platinum derivative that is commonly used in combination chemotherapy for treatment of several malignancies, including small-cell lung carcinoma (SCLC). Because the estimated glomerular filtration rate, and therefore the carboplatin dose, is based on the serum creatinine level, dosing of carboplatin for amputees is a challenge. This case report describes how serum carboplatin levels were used to determine the most suitable carboplatin dose for an amputee. The patient received four cycles of etoposide in combination with carboplatin area under the curve =5 mg·min/ml, with a dose reduction of 25% and concurrent radiotherapy. The measured area under the curve was found to be 3.41 mg·min/ml, while the target area under the curve was 3.75 mg·min/ml (75% of 5 mg·min/ml). Therefore, for the next cycles, the carboplatin dose was calculated using the Calvert formula. No recurrence of disease was seen within two years after completion of therapy. This case demonstrates that therapeutic drug monitoring can successfully be used to determine the carboplatin dose for an amputee. </jats:p