Sweatman Prostate Cancer Flashcards Preview

Reproductive > Sweatman Prostate Cancer > Flashcards

Flashcards in Sweatman Prostate Cancer Deck (42):
1

first line tx for prostate cancer

combined androgen blockade-medical or surgical castration plus pure anti-androgen

2

converson of DHEA to DHT

3 beta- dehydroepiandrostenedione

3

theory behin GnRH treatment

GnRH normally release is pulsatile, tx with GnRH agonist is constant--> result sin downregulation of GnRHReceptors on pituitary-->decreased FSh and LH in 2-4 weeks

4

Initial outcome of GnRH agonists

transient increase in FSH and LH can cause disease flare
*give AR blocker coinsidingly

5

Name the GnRH agonist

Gosorelin
Histrelin
Leuprolide
Triptorelin

6

side effects of the GnRH agonists

reduced lipido, elevated trigs, weight gain, DM, DECREASED BONE MINERAL DENSITY, SEIZURES (HISTRELIN, SUICIDE (HISTRELIN), CV EFFECTS EDEMA HTN MI AND HF (LEURPROLIDE)

7

SEIZURES AND SUICIDAL IDEATION

HISTRELIN

8

MI AND HEART FAILURE

LEUPROLIDE

9

reversible GnRH antagonist

Degarelix (SC)
*reduces FSH and LH secretion
*castrate T levels in 3 days

10

will bring T levels down quicker and avid disease flar en route to castration

Degerelin

11

Severe AE's with degerelin

Prolong QT
less severe others** elevated LFTS, sweats HTN, arthralgia, impotence

12

Drug for Prostate CA with comparable effects to estradiol

Estramustine

13

MOA for Estramustine

inhibits microtubules, promoting dis-assembly and G2/M arrest
*causes DNA strand breakage

14

AE's of Estramustine

gynecomastia. mastalgia, impotence, GI upset

15

When estramustime works too well what can happen (AE's of another molecule)

Same side effects of Estradiol
-thromboembolic Dz (PE and DVT), MI, CVA, Edema

16

name the Androgen Receptor blockers

Bicalutamide
Enzalutamide
Flutamide
Nilutamide

17

all Androgen receptor blockers end in

-lutamide

18

do AR blockers affect circulating androgen levels

no-but the adverse effects are from apparent decreases androgen levels

19

only AR blocker indicated for women's health issue--> Hirsutism and PCOS

flutamide

20

male teratogenicity

enzalutamide

21

prostate > central
-antagonist + agonist activity

biclutamide

22

prostate and central
-antagonist

Enzalutamide (T)
Nilutamide

23

Prostate only
-antagonist

flutamide

24

BBW for flutamide

interstitial pneumonitis

25

respiratory insufficiency and increased time to accomodate to light from dark with

nilutamide

26

URTI with

enzalutamide

27

3/4 AR are teratogenic except

nilutamide

28

drug that stimulates T cells against Prostatic Acid Phosphatase

Sipuleucel-T

29

the cell that carrie out the action for Sipucel is

CD8 t cells-->intracelluar/cancer cell lysis

30

Name the 17 alpha hydroxylase inhibitor (CYP17)

Abiraterone

31

difference between ketoconazole and abaterone

Abaterone increases mineralocorticoids, ketoconazole decreases mineralocorticoids and cortisol production

32

CYP17
CYP17 inhibitor

17 alpha hydroxylase
abaterone

33

SE of Aabaterone

hyper-mineralocoricoid state
HTN,
HYPOKALEMIA, HYPERNATREMIA
*CAUTING WITH PREVIOUS CV ISSUE

34

pregnancy category for abaterone

category X-->woman precautions too

35

Give abaterone with

glucocorticoids to inhibit ACTH overdirve

36

abrupt stoppage of abaterone

adrenal crisis

37

high total PSA seen with

Prostatic Cancer

Free: total ratio is decreased in cancer than with BPH

38

high free PSA seen in

BPH

free: total ratio is increased more in BPH than in prostatic CA

39

5 alpha reductase inhibitors are recommended

NO

40

5 alpha reductase inihibitors
thought to be chemopreventative

finasteride
dutasteride

41

which ER is protective

ERB-> tumor supressive effect
ERa--> proliferative, pro-malignant, inflammatory

42

convential agents in prostate cancer (advanced)

Docetaxel and
Carbazitaxel-taxane
(usedful in MDr tumorsa because a poor substrate for pgP pump)
.Mitoxantrone