Which drug requires hydration and mannitol to prevent nephrotoxicity?

Cyclophosphamide is the drug that requires hydration and mannitol to prevent nephrotoxicity. This requirement arises because cyclophosphamide is metabolized into active metabolites that can be toxic to the bladder and kidneys. The hydration helps to dilute the toxic metabolites and increase urine output, thereby reducing the concentration of these substances in the renal tubules. Additionally, mannitol, which is an osmotic diuretic, promotes diuresis and helps to protect the kidneys from damage by maintaining high urine flow. This is especially crucial when using higher doses of cyclophosphamide, as it can lead to complications such as hemorrhagic cystitis and potential nephrotoxicity if not managed appropriately.

The other drugs listed do not typically have the same nephrotoxicity profile that mandates such precautionary measures. For instance, carboplatin is known for causing myelosuppression rather than direct renal injury, while docetaxel and paclitaxel primarily exhibit side effects related to neutropenia and peripheral neuropathy, respectively. Thus, hydration and mannitol are specifically important in the context of cyclophosphamide treatment.