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Reproductive Pharmacology > Prostate Cancer > Flashcards

Flashcards in Prostate Cancer Deck (24)
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1
Q

What 2 sources of androgens does prostate cancer treatment take into account?

A

Testes

Adrenals

2
Q

What is first line tx for prostate cancer?

A

Medical or surgical castration: anti androgen drugs

3
Q

What type of brachytherapy is used in PC?

A

I 125

4
Q

What are the anterior pituitary drug targets for PC?

A

ACTH
LH
17-a hydroxylase (adrenals)
Androgen receptors

5
Q

What are the GnRH agonist drugs?

A
-relin and leupron
Goserelin
Histrelin
Leuprolide
Triptorelin
6
Q

What are the GnRH antagonist drugs?

A

Degarelix

7
Q

GnRH MOA/AE?

A

MOA:
GnRH agonist: continuous: down regulate

AE: 
   Decrease bone density (fracture)
   LDL increase, TG increase
   Cardiac: MI/DVT/etc... estrogen loss
   weight gain (low T)
   Diabetes mellitus
   sexual dysfunction
   gynecomastia
   decrease libido
   Edema
   HTN
   HA
   depression
   fatigue
   myalgia
8
Q

SC GnRH agonists?

A

Goserelin
Histrelin
Leurolide

9
Q

IM GnRH agonists?

A

Leuprolide

Triptorelin

10
Q

GnRH agonist with Seizure and Suicide risk?

A

Histrelin (hystreonic?)

11
Q

GnRH agonist with MI and CHF risk?

A

Leuprolide

12
Q

What is notable about FSH/LH and sex hormones early in GnRH agonist tx?

A

High early, low late

13
Q

What is difference in agonists and antagonist of GnRH in terms of sex hormones?

A

Agonist: high early
Antagonist: no spike

14
Q

What is the GnRH antagonist?

A

Degarelix

15
Q

How long does agonist take to castrate? Antagonist?

A

Agonist: 2-4 weeks
Antagonist: 3 days!… much faster, no flare. Worse AE: heart and liver

16
Q

GnRH antagonist administration?

A

SC (not IM)

17
Q

Degarelix MOA, AE?

A

MOA: GnRH antagonist

AE:
   Elevated liver enzymes
   Liver toxicity
   QT prolongation 
   HTN
   Hot flashes
   Impotence
   arthralgia
18
Q

What are the androgen receptor blockers?

A

-mide:
Bicalutamide
Flutamide

19
Q

Androgen receptor blocker MOA, AE?

A

MOA:
Directly block T and DHT effects on tumor

AE:
   GI toxicity
   Hot flashes
   Arthralgia, myalgia
    TERATOGENS!!!!
20
Q

Sipulence MOA/AE?

A

MOA:
take patients APCs and modify them to attack cancer and put back in: T cells stimulated
*T cells become immune to prostatic acid phosphatase, more effective

AE: 
    *Parasthesia
    *Citrate toxicity
    GI
    Flu like (immunomodulation)
    Dyspnea
21
Q

Abiraterone MOA/AE?

A

MOA:
Inhibit 17-a hydroxylase in adrenals
Prevent DHEA production
*Boosts ACTH and Aldo–>HTN

AE: 
    *HTN: Increased mineralocorticoid production! 
    Low K: arrhythmias
    Edema
    CV issues: caution
    Monitor LFTs
    CAT X: semen spreads it!
*
22
Q

What drug is spread by semen?

A

Abiraterone: 17 a OH inhibitor

23
Q

What drug has parasthesias?

A

Sipuleucel

24
Q

What should not be used in PC?

A

5a reductase inhibitors: increase risk Ca