Prostatitis/Prostate Cancer/Psoriasis/Pulmonary Hypertension

Question 1

What medications are used to treat prostate cancer?

Answer 1

1.) Lutenizing hormone-releasing hormone (LHRH) agonists: Lutron (Leuprolide), Zoladex (goserelin), Trelstar (triptorelin), Supprelin (histrelin).
2.) Anti-androgen: Casodex (bicalutamide), Eulexin (flutamide), Nilandron (nilutamide)

 Reduce testosterone production which may be feeding the cancer
*SE: erectile dysfunction, hot flashes, reduced bone mineral density, weight gain

3.) Chemo agents for metastatic disease: docetaxel, cabaxitaxel, mitoxantrone, estramustine

Question 2

How do you treat prostatitis?

Answer 2

If due to bacterial infection, primary options include:
1. Bactrim, cipro, doxycycline, gentamicin
2. Length of therapy usually 6 weeks

Symptomatic treatment
1. Alpha blockers to help with flow (doxazosin, terazosin, tamsulosin, alfuzosin)
2. Pain management (NSAIDS, APAP)

Question 3

What drive the therapy for psoriasis?

Answer 3

The severity of disease

Question 4

How do you treat mild to moderate, small areas of psoriasis?

Answer 4

With topical corticosteroids is treatment of choice but can also be treated with Vitamin D analogs: Calcipotriene, calcitriol or combo of both

Topical calcineurin inhibitors are also options but can increase risk for skin cancer, so not used long-term

Methotrexate, cyclosporine

Biologics: Enbrel (Etanercept), Remicade (infliximab) for severe cases (risk for malignancy)

Question 5

What type of heart failure could PAH cause?

Answer 5

right sided heart failure, overtime the right ventricle may have to pump harder to which can place the heart at risk

Question 6

What classification is used for PAH?

Answer 6

WHO functional classifications (1-4)
1. no limitations on physical acitivity
2. comfy at rest, light limitation on physical activity
3. significant limitation of activity, overall comfy at rest
4. Severe limitation of activity and symptoms even at rest

Question 7

What therapy is used to treat WHO class 1 and 2 for PAH?

Answer 7

WHO 1: treat causes, removing of offending agents, treat other disease states

WHO 2: Letairis (ambrisentan) plus tadalafil

Question 8

What therapy is used to treat WHO class 3 and 4 in PAH?

Answer 8

WHO 3: ambrisentan plus tadalafil
WHO 4: Veletri, Flolan (epopostenol IV) *Flolan older med not stable at room temp

Question 9

T/F: medications for PAH such as ambrisentan, bosentan are in REMS program? what are some side effects?

Answer 9

True. HA, edema, flushing and reduced hemoglobin, must monitor

Question 10

What is the diff between eporopstenal and iloprost?

Answer 10

epoprosternal is IV. and side effect for iloprost include flushing, low BP, and headache