Hormonal Therapy

Question 1

List the GnRH agonists

Answer 1

Leuprolide (lupron)

goserelin

Question 2

GnRH agonists MOA

Answer 2

agonist of gonadotropin releasing hormone (GnRH) receptors; initially cause an increase in gonadotropin secretion that is followed 2–3 weeks later by marked inhibition

Question 3

GnRH agonists side effects

Answer 3

osteoporosis, hot flashes, gynecomastia, fatigue, weight gain, fluid retention, erectile dysfunction and decreased libido

Question 4

Renal/ hepatic adjustment of GnRH agonists

Answer 4

Leuprolide (no renal or hepatic adjustment)

goserelin (no renal or hepatic adjustment)

Question 5

List the SERM

Answer 5

tamoxifen

raloxifene

Question 6

SERM MOA

Answer 6

selective estrogen receptor modulator (SERM) that competitively binds to estrogen receptors

Question 7

SERM side effects

Answer 7

Common: menopause sx, fluid retention

Warnings:
teratogenic
Thrombotic events
endometrial cancer risk increased

Question 8

Renal/ hepatic adjustment of SERM

Answer 8

tamoxifen (no renal or hepatic adjustment)

raloxifene (no renal or hepatic adjustment)

Question 9

List the aromatase inhibitors

Answer 9

anastrozole (Arimidex)
exemestane
letrozole (Femara)

Question 10

aromatase inhibitors MOA

Answer 10

nonsteroidal aromatase inhibitor. By inhibiting aromatase, the conversion of androstenedione to estrone, and testosterone to estradiol, is prevented, thereby decreasing tumor mass or delaying progression in patients with tumors responsive to hormones

Question 11

aromatase inhibitors side effects

Answer 11

osteoporosis, CV risks, HLD, myalgias, arthralagias

Question 12

Renal/ hepatic adjustment of aromatase inhibitors

Answer 12

anastrozole - no renal or hepatic adjustment
exemestane- no renal or hepatic adjustment
letrozole- hepatic adjustment