Pharmacology-Prostate Rx Flashcards
What drugs reduce the risk of developing prostate cancer?
Statins and finasteride (5alpha-reductase inhibitor for BPH)
Pure anti-androgen drug that targets DHT binding to AR taken orally 3x a day. Why is this better than orchiectomy?
Flutamide. It also inhibits binding of androgens from the adrenal.
Initial therapy for metastatic prostate cancer
Leuprolide (GnRH agonist) and flutamide (AR antagonist)
Adverse reactions from flutamide
Diarrhea, gynecomastia and rare hepatotoxicity
Newer anti-androgen (AR antagonist) that has no hepatotoxicity and less diarrhea.
Bicalutamide
Best anti-androgen drug that is the most effective antagonist.
Enzalutamide. Note that this drug is great because it does not promote AR translocation to the nucleus like bicalutamide and flutamide do.
What anti-androgen drug should you use if prostate cancer has metastasized to the brain? What side effect does this result in?
Enzalutamide, it can penetrate the BBB. Note however that this can sensitize patients to seizures.
Medical orchiectomy
GnRH analogues: leuprolide and goserelin. They overrun the GnRH receptors on the anterior pituitary and the anterior pituitary becomes desensitized so that it no longer releases LH and FSH.
Why use bicalutamide w/leuprolide?
Bicalutamide will make sure adrenal androgens don’t promote tumor growth
GnRH-R antagonist
Abarelix
This frog blocks synthesis of androgens in the testes and adrenal cortex by inhibiting 17alpha-hydroxylase
Abiraterone acetate. The most effective way to treat prostate cancer is with abiraterone acetate and enzalutamide.
Therapy that involves exposing the patient’s dendritic cells to prostatic acid phosphatase. Then you stimulate them with G-CSF and infuse them. Then the immune system attacks the prostate.
Provenge
