Early stage disease LHRH agonists - IDE

Question 1

LHRH agonists

Answer 1

• reversible method of ADT
• effective as orchiectomy treating PCa
• lower a/e than oestrogen

Question 2

Leuprorelin

effective advance PCa

Answer 2

• adm q 4, 12 , 16 / 24 w
• depot formulation
• leuprolide acetate coated in pellets
• IM
• coating dissolves at different rates to allow sustained level through out dosing interval

Question 3

Goserelin

effective advance PCa

Answer 3

• adm q 4/12w
• implant = goserelin acetate
• dispersed in plastic matrix D , L - lactic acid + glycolic acid copolymer
• SC
• hydrolysis copolymer material - provide continous release gosereline over dosing interval

Question 4

Approved in SA

Answer 4

• 2 as mentioned

- Triptorelin - adm 4, 12/ 24 w

Question 5

Common adverse effects

Answer 5

• vasomotor symptoms - hot flashes, ED, decreased libido

- injection site rxns

Question 6

LT adverse effects

Answer 6

• decreased bone mineral density
• metabolic syndrome
• advice Ca + Vit D supplementation

Question 7

Disease flare

Answer 7

• 1st week
• initial induction LH + FSH (increase testos)
• resolves after 2w
• add antiandrogen prior start LHRH agonist + continue 2-4 w

Question 8

caution

Answer 8

• potential ureteral obstruction

- spinal cord impingement - irreversible complications