Nursing Research on the Green
Dena L. Navoichick RN/BSN
Viterbo University Graduate Student in Nursing
- Background: Carboplatin is a platinum-derived chemotherapy used for a variety of malignancies. Low toxicity rate and ease of administration make carboplatin a preferred agent for treating cancer. Carboplatin hypersensitivity is an oncologic emergency, which can be life threatening.
- Significance: To assist the professionals who are responsible for administering carboplatin to cancer patients in being prepared to both predict patients at risk and manage therapy following this oncologic emergency.
- Purpose/objective: The purpose of this integrative literature review was to synthesize the evidence on the most effective ways to predict which patients are at greater risk for carboplatin hypersensitivity reactions. Methods for continuation of platinum therapy following a carboplatin hypersensitivity reaction also were explored.
- Methods/project:Relevant databases were searched for medium to high-quality evidence on the topic of prediction and management of carboplatin hypersensitivity reactions. Desensitization and substitution of therapy were evaluated for safety and effectiveness as a means to continue platinum therapy after a carboplatin hypersensitivity reaction.
- Results: Findings indicated having received more than six cycles of carboplatin is an established method of predicting those at increased risk. Carboplatin skin testing, history of allergies, and administration of carboplatin following progression or recurrence are important factors to consider, but were less strongly supported as predicting patients at risk. Desensitization and substitution of therapy are both viable methods of continuing platinum therapy in those who have experienced a carboplatin hypersensitivity.A tool to assist providers in identifying patients who may be at increased risk for nurses was developed using the evidence from this review.
- Clinical Implications: Carboplatin hypersensitivity is a risk for any patient receiving this common chemotherapy. Predicting those at risk prior to a hypersensitivity reaction and responding after a reaction are critical elements in their management.
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