GNRH Agonists

Question 1

What drugs are in the GNRH Agonists class?

Answer 1

Drugs in this class are:
- Triptorelin
- Goserelin
- Leuprolide
- Histrelin

Question 2

What is the brand name of Triptorelin?

Answer 2

The brand name of this generic drug is:
- Trelstar Mixject
- Triptodur

Question 3

What is the brand name of Goserelin?

Answer 3

The brand name of this generic drug is:
- Zoladex

Question 4

What is the brand name of Leuprolide?

Answer 4

The brand name of this generic drug is:
- Camcevi
- Eligard
- Fensolvi
- Lupron

Question 5

What is the brand name of Histrelin?

Answer 5

The brand name of this generic drug is:
- Vantas

Question 6

What is the generic of name of Trelstar Mixject?

Answer 6

The generic name of this brand name drug is:
- Triptorelin

Question 7

What is the generic of name of Triptodur?

Answer 7

The generic name of this brand name drug is:
- Triptorelin

Question 8

What is the generic of name of Zoladex?

Answer 8

The generic name of this brand name drug is:
- Goserelin

Question 9

What is the generic of name of Camcevi?

Answer 9

The generic name of this brand name drug is:
- Leuprolide

Question 10

What is the generic of name of Eligard?

Answer 10

The generic name of this brand name drug is:
- Leuprolide

Question 11

What is the generic of name of Fensolvi?

Answer 11

The generic name of this brand name drug is:
- Leuprolide

Question 12

What is the generic of name of Lupron?

Answer 12

The generic name of this brand name drug is:
- Leuprolide

Question 13

What is the generic of name of Vantas?

Answer 13

The generic name of this brand name drug is:
- Histrelin

Question 14

What are the main indications for use of Triptorelin?

Answer 14

The main indications of this drug are:
- Prostate Cancer
- Endometrial stromal sarcoma

Question 15

What are the main indications for use of Goserelin?

Answer 15

The main indications of this drug are:
- Prostate Cancer
- Breast Cancer
- Prevention of early menopause during chemotherapy

Question 16

What are the main indications for use of Leuprolide?

Answer 16

The main indications of this drug are:
- Prostate Cancer
- Breast Cancer
- Prevention of early menopause during chemotherapy

Question 17

What are the main/common indications of the GNRH Agonists class?

Answer 17

The main/common indications of this drug class are:
- Prostate Cancer (primary)
- Breast Cancer

Question 18

What is the class and MOA of Triptorelin?

Answer 18

This drug in the following class:
- GNRH Agonists

This drug’s MOA is as follows:
- Agonist analog of gonadotropin releasing hormone (GnRH) and causes suppression of ovarian and testicular steroidogenesis due to decreased levels of LH and FSH (after initial increase during initiation phase) with subsequent decrease in testosterone (male) and estrogen (female) levels.

Question 19

What is the class and MOA of Goserelin?

Answer 19

This drug in the following class:
- GNRH Agonists

This drug’s MOA is as follows:
- Agonist analog of gonadotropin releasing hormone (GnRH) and causes suppression of ovarian and testicular steroidogenesis due to decreased levels of LH and FSH (after initial increase during initiation phase) with subsequent decrease in testosterone (male) and estrogen (female) levels.

Question 20

What is the class and MOA of Leuprolide?

Answer 20

This drug in the following class:
- GNRH Agonists

This drug’s MOA is as follows:
- Agonist analog of gonadotropin releasing hormone (GnRH) and causes suppression of ovarian and testicular steroidogenesis due to decreased levels of LH and FSH (after initial increase during initiation phase) with subsequent decrease in testosterone (male) and estrogen (female) levels.

Question 21

What is the class and MOA of Histrelin?

Answer 21

This drug in the following class:
- GNRH Agonists

This drug’s MOA is as follows:
- Agonist analog of gonadotropin releasing hormone (GnRH) and causes suppression of ovarian and testicular steroidogenesis due to decreased levels of LH and FSH (after initial increase during initiation phase) with subsequent decrease in testosterone (male) and estrogen (female) levels.

Question 22

What are the notable/common monitoring parameters for the GNRH Agonists class?

Answer 22

The notable/common monitoring parameters for this drug class are:
- Serum testosterone levels
- Prostate-specific antigen to monitor response to therapy

Question 23

Describe the emetic potential of the GNRH Agonists class.

Answer 23

The emetic potential of this drug class is:
- None, N/A

Question 24

Describe the extravasation risk and management strategies for the GNRH Agonists class.

Answer 24

The extravasation risk and management strategies for this drug class are as follows:
- None, N/A

Question 25

Describe the administration of Triptorelin.

Answer 25

The administration of this drug is described as follows: - Given IM by a healthcare provider - Canadian product can be given SubQ

Question 26

Describe the administration of Goserelin.

Answer 26

The administration of this drug is described as follows: - This drug is an implant that is administered/implanted SubQ

Question 27

Describe the administration of Leuprolide.

Answer 27

The administration of this drug is described as follows: - Administered SubQ expect for depot formulations (IM)

Question 28

Describe the administration of Histrelin.

Answer 28

The administration of this drug is described as follows: - This drug is an implant that is surgically implanted SubQ

Question 29

What are the notable/common ADRs of the GNRH Agonists class?

Answer 29

The notable/common ADRs of this drug class are: - Long term use can cause ADRs related to decreased testosterone levels including osteoporosis, bone fractures. obesity, insulin resistance, hyperlipidemia, and increased risk of diabetes/cardiovascular events. - Disease flare - Gynecomastia - Hot flashes - Erectile dysfunction - Edema - Injection site reactions

Question 30

Describe the strategy and rationale for management of disease flare caused by GNRH Agonists.

Answer 30

The strategy and rationale for management of this condition caused by this drug are: - This is thought to be caused by initial induction of luteinizing hormone (LH) and follicte stimulating hormone (FSH) by the GNRH agonist. - This can manifest as increased bone pain or increased urinary symptoms. - Antiandrogen therapy should be started before beginning a GNRH agonist and be continued in combination for at least 7 days for patients with metastases to help reduce tumor flare. - This flare reaction usually resolves after 2 weeks and has a similar onset and duration pattern between the depot and regular acting GNRH agonists.

Question 31

Describe the onset of GNRH Agonists.

Answer 31

The onset of drugs in this class is described as follows: - Following a transient increase, testosterone suppression occurs at ~2 to 4 weeks of continued therapy

Question 32

What are the clinical pearls of the GNRH Agonists class?

Answer 32

The clinical pearls of this drug class are as follows: - Also referred to as luteinizing hormone-releasing hormone (LHRH) agonists - GnRH agonists are a reversible method of androgen ablation and are as effective as orchiectomy in treating prostate cancer - In the context of prostate cancer, goal is to induce castrate levels of testosterone. - This can be accomplished by surgical castration (orchiectomy) or medical/chemical castration (GNRH agonists or antagonists). - When using GNRH agonists, the goal serum testosterone level is <50 ngldl after 1 month of therapy. - Use in combination with antiandrogen to reduce disease flare