C.P. agrees to chemotherapy and is scheduled to receive cisplatin (Platinol) 60 mg in 100 mL
normal saline (NS) IV over 1 to 2 hours daily, and etoposide (VePesid) 200 mg in 250 mL NS
IV over 1 to 2 hours daily, both during the first 3 days of each
month. What is the nadir for
each drug, and what implications does the nadir have for C.P.?
The nadir is the lowest point reached in the peripheral blood cell count after chemotherapy is
administered.
• Cisplatin's nadir is 2 to 3 weeks, with recovery in 4 to 5 weeks.
• Etoposide's nadir is 7 to 14 days, with recovery in 20 to 22 days.
Because C.P. is receiving a dose of each drug on the first 3 days of each month, his blood counts
will never return to optimal levels between doses and he will be maximally immunosuppressed for
2 weeks out of every month. He is likely to be most susceptible to infection, bleeding, and fatigue
during that time.
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