Prostate Drugs

Question 1

Alfuzosin MOA

Answer 1

Short-acting selective Alpha-1 Blocker

Question 2

Alfuozosin Tox

Answer 2

GI-xerostomia, nausea; CNS- dizziness, somnolence, asthenia, h/a, insomnia

Question 3

Alfuozosin M&E

Answer 3

CYP3A4; fecal/renal elim

Question 4

Does alfuozosin need does titration?

Answer 4

No

Question 5

Tadalafil MOA

Answer 5

PDE-5 Inhibitor: decreases breakdown of cGMP; Relief of BPH occurs via smooth muscle relaxation

Question 6

Tadalafil Tox

Answer 6

Uncommon; h/a, nausea, indigestion, nasopharyngitis, URTI; more rare-NAION, retinal artery occlusion, hearing loss

Question 7

Tadalafil M&E

Answer 7

CYP3A4; fecal elim

Question 8

Tadalafil DDI

Answer 8

Nitrates-profound hypotension exacerbated by alcohol

Question 9

Saw Palmetto?

Answer 9

useless shit drug

Question 10

Androgen Receptor Blockers (3)

Answer 10

Bicalutamide, flutamide, nilutamide

Question 11

Bicalutamide MOA

Answer 11

Androgen Receptor Blocker; Prostate > Central; Antagonist + some agonist activity

Question 12

Bicalutamide Tox

Answer 12

GI tox, hot flashes, aches/pains

Question 13

Flutamide MOA

Answer 13

Androgen Receptor Blocker; Prostate; Antagonist

Question 14

Flutamide Tox

Answer 14

GI tox, hot flashes, aches/pains
AND
Blood Dyscrasia

Question 15

Flutamide BBW

Answer 15

Hepatotoxicity/Failure

Question 16

Nilutamide MOA

Answer 16

Androgen Receptor Blocker; prostate & central

Question 17

Nilutamide Tox

Answer 17

GI tox, hot flashes, aches/pains
AND
HF/ HTN, Blood Dyscrasia; Increased time to accommodate transition from light to dark

Question 18

Nilutamide BBW

Answer 18

Respiratory insufficiency

Question 19

Estramustine MOA

Answer 19

Targeted Alkylator; Estradiol w/ Alkylating Moiety which is a MT inhibitor: promotes dis-assembly and G2/M arrest and produces DNA strand breakage

Question 20

Estramustine Tox

Answer 20

Common: GI upset, gynecomastia, mastalgia, and impotence;
Testosterone levels decreased via negative feedback on HPA;
Due to Estradiol: edema, thromboembolism, MI, PE, stroke;
Elevated hepatic enzymes, hyperbilirubinemia

Question 21

Estramustine Administration

Answer 21

Oral

Question 22

GnRH agonists

Answer 22

Goserelin, Histrelin, Leuprolide, Triptorelin

Question 23

Histrelin Tox

Answer 23

Unique=Seizures & Suicidal Ideation;

Edema, HTN, h/a, fatigue, depression, dec bone mineral density, spinal compression, elevated TG, weight gain, DM, reduced libido, sexual dysfxn, gynecomastia, rarely hepatotox, aches/pains

Question 24

Goserelin Tox

Answer 24

Edema, HTN, h/a, fatigue, depression, dec bone mineral density, spinal compression, elevated TG, weight gain, DM, reduced libido, sexual dysfxn, gynecomastia, rarely hepatotox, aches/pains

Question 25

Leuprolide Tox

Answer 25

Unique=MI/HF Edema, HTN, h/a, fatigue, depression, dec bone mineral density, spinal compression, elevated TG, weight gain, DM, reduced libido, sexual dysfxn, gynecomastia, rarely hepatotox, aches/pains

Question 26

Triptorelin Tox

Answer 26

Edema, HTN, h/a, fatigue, depression, dec bone mineral density, spinal compression, elevated TG, weight gain, DM, reduced libido, sexual dysfxn, gynecomastia, rarely hepatotox, aches/pains

Question 27

Pregnancy Categories of GnRH agonists

Answer 27

Cat X

Question 28

Goserelin Admin

Answer 28

SC; Initial transient dz flare avoided by 2-4 wks of AR blockers

Question 29

Histrelin Admin

Answer 29

SC; Initial transient dz flare avoided by 2-4 wks of AR blockers

Question 30

Leuprolide Admin

Answer 30

IM/SC; Initial transient dz flare avoided by 2-4 wks of AR blockers

Question 31

Triptorelin Admin

Answer 31

IM; Initial transient dz flare avoided by 2-4 wks of AR blockers

Question 32

Degarelix MOA

Answer 32

GnRH Antagonist; Reduced LH & FSH secretion; castrate testosterone levels w/in 3 days (quicker than GnRH Agonists)

Question 33

Degarelix Tox

Answer 33

Hot sweats, injxn site rxns, weight gain, HTN, arthralgia, chills, fatigue, impotence, elevated hepatic enzyme levels (reversible), QT prolongation

Question 34

Degarelix Admin

Answer 34

SC; Avoids initial dz flare

Question 35

Abiraterone MOA

Answer 35

17-Alpha-Reductase Inhibitor

Question 36

Abiraterone Tox

Answer 36

Produce hypermineralocorticoid state: HTN, hypokalemia, and fluid retention, caution w/ pre-existing CV issues; elevated hepatic enzymes; routine LFT's required

Question 37

Abiraterone Pregnancy Cat

Answer 37

Cat X: women cannot handle drug, condom should be used if partner is pregnant

Question 38

Adjuvant tx with abiraterone

Answer 38

Tx in combo w/ corticosteroid to avoid hypermineralocorticoid state

Question 39

Sipuleucel-T MOA

Answer 39

Individualized immunotherapy to stimulate T cell immunity against Prostatic Acid Phosphatase (PAP)

Question 40

Sipuleucel-T Tox

Answer 40

Mild infusion rxns; fever/chills/dyspnea; N/V; paresthesias, citrate tox, fatigue