Fitzy Specifics

Question 1

Goserelin and Leuprolide MOA and use?

Answer 1

GnRH agonist for lowering T and Estrogen

Question 2

Major SE of GnRH agonists?

Answer 2

Flare

• Bone Pain
• Prostatic Hypertrophy – Urethral obstruction
• FATAL spinal cord compressiomn

Question 3

Delayed SE of GnRH agonists?

Answer 3

Low T/E
Impotence
Osteoporosis
Hot Flashes (E)

Question 4

Degralix MOA and use?

Answer 4

GnRH antagonist for Prostate Cancer

Question 5

Problem with Degralix duration?

Answer 5

Short duration with cost and compliance issues

Question 6

Degralix SE?

Answer 6

HISTAMINE (Rash, anaphylaxis, hypotnesion)

Question 7

Dutasteride and Finasteride MOA?

Answer 7

5-a-reductase inhibitors

Question 8

Major Toxicity of 5-a-reductase inhibitors?

Answer 8

TERATOGENIC even if wife handles the pill

Question 9

Abraterone Acetate MOA and use?

Answer 9

CYP17 inhibitor for Castration-resistant prostate cancer

Question 10

Aminoglutethimide MOA?

Answer 10

NON-STEROIDAL
Inhibits Aromatase
Inhibits conversion of cholesterol –> Pregnenolone

Question 11

Aminoglutethimide SE?

Answer 11

Acute = Nausea, fever, fatigue
Chronic = Adrenal insufficiency, Myelosuppresion

Question 12

3rd gen aromatase inhibitors?

Answer 12

Exematide (Steroidal)
Anastrozole (Non-steroidal)
Letrozole

Question 13

1st line TX for ER+ breast cancer?

Answer 13

Aromatase inhibitors

Question 14

SE of aromatase inhibitors?

Good effect?

Answer 14

Acute = headache, nausea
Polyarthralgia, osteoporosis

Lowers LDL and raises HDL

Question 15

Aromatase main effect in Pre-menopausal women?

Answer 15

T –> Estradiol in OVARIES

Question 16

Aromatase main effect in Post=menopausal women?

Answer 16

Androstene –> Estrone in ADIPOSE

Question 17

Bicalutamide and Flutamide MOA?

Answer 17

Inhibit Androgen receptor translocation to cell surface

Question 18

Use of biclutamide/flutamide?

Answer 18

Prevent flare during GnRH analog administration

Question 19

Delayed tox of biclutamide/flutamide?

Answer 19

LIVER TOX
gynecomastia
Decreased T

Question 20

Hydroxyprogesterone
Medroxyprogesterone
Megestrol
MOA?

Answer 20

Progesterone R antagonists

Question 21

Uses of Progesterone R antagonists?

Answer 21

2nd line for ER+ breast cancer

Endometrial cancer

Question 22

SERMs (3)?

Answer 22

Tamoxifen
Toremifine
Raloxifene

Question 23

SERD?

Answer 23

Fulvistrant

Question 24

SERM agonist in bone and uterus?

Answer 24

Tamoxifen

Question 25

SERM agonist in uterus, no bone effect?

Answer 25

Toremifene

Question 26

SERM agonist in bone, antagonist in uterus?

Answer 26

Raloxifene

Question 27

SERD antagonist in uterus and bone?

Answer 27

Raloxifene

Question 28

Which SERM increases risk of endometrial cancer?

Answer 28

Tamoxifen

Question 29

Which SERM is used as a 2nd line ER+ breast cancer tx?

Answer 29

Tamoxifen

Question 30

Which SERM is used for prevention if DCIS?

Answer 30

Tamoxifen

Question 31

Which estrogen modulators are administered orall?

Answer 31

Tamoxifen Toremifene Raloxifene

Question 32

Which estrogen modulator is administered IM injection?

Answer 32

Fulvestrant

Question 33

SE of all estrogen modulators?

Answer 33

``` Hot flashes nausea vomiting dysmennorhea Vaginal Bleed Dermatitis ```

Question 34

Specific fulvestrant SE?

Answer 34

GI symptoms Headache Back Pain Pharyngitis

Question 35

Peak conc of SERMs?

Answer 35

4-7 hrs (Faster)

Question 36

PEak conc of SERD?

Answer 36

7 days (Slower)