Androgen deprivation therapy (ADT) Flashcards
1
Q
What is Orchiectomy?
A
- testes removed surgically
2. limit androgen production / chem interference of hormonal pathways
2
Q
How does LNRH / LH inhibtion work?
A
- decrease LH + LHRH (GNRP) by:
1. oestrogens
2. LHRH agonists
3. direct GnRH antagonists
4. progesterones
5. cyproterone acetate
= decrease secretion testosterone by testes
3
Q
How does oestrogen work as a LNRH/LH inhibtor ?
A
- decrease androgen by inhibtion LH release
- act directly prostate cell
- decrease free androgn
- increase steroid-binding globuline levels
4
Q
How does LHRH agonist work by inhibting LH / LHRH?
A
- mimic endogenous LH + FSH release
- high dose/ continous infusion
- inhibit GnRH via receptor downregulation
= decrease testosterone
5
Q
How is androgen synthesis inhibited?
A
- inhibited in testes/ adrenal glands by drugs
6
Q
How does Abiraterone work as a androgen synthesis inhibitor?
A
pregnelonone (precursor test) —-x—> inhibits cymp 17A1 dehydroepiandrosterone (DHEA)
precursor substrate of all adrenal derived sterois + GA, MA + androgens
7
Q
How does ketoconazole work as a androgen synthesis inhibitor ?
A
- imidazole
- antifungal
- dose-related decrease cortisol + testosterone
8
Q
How does antiandrogens work?
A
inhibit DHT-R complex
interfer androgen mediated action at cellular level
9
Q
How does 5-alpha reductase inhibtor work?
A
inhibits testosterone –x–> DHT
