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Reproductive > Sweatman Prostate Cancer > Flashcards

Sweatman Prostate Cancer Flashcards

1
Q

first line tx for prostate cancer

A

combined androgen blockade-medical or surgical castration plus pure anti-androgen

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2
Q

converson of DHEA to DHT

A

3 beta- dehydroepiandrostenedione

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3
Q

theory behin GnRH treatment

A

GnRH normally release is pulsatile, tx with GnRH agonist is constant–> result sin downregulation of GnRHReceptors on pituitary–>decreased FSh and LH in 2-4 weeks

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4
Q

Initial outcome of GnRH agonists

A

transient increase in FSH and LH can cause disease flare

*give AR blocker coinsidingly

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5
Q

Name the GnRH agonist

A

Gosorelin
Histrelin
Leuprolide
Triptorelin

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6
Q

side effects of the GnRH agonists

A

reduced lipido, elevated trigs, weight gain, DM, DECREASED BONE MINERAL DENSITY, SEIZURES (HISTRELIN, SUICIDE (HISTRELIN), CV EFFECTS EDEMA HTN MI AND HF (LEURPROLIDE)

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7
Q

SEIZURES AND SUICIDAL IDEATION

A

HISTRELIN

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8
Q

MI AND HEART FAILURE

A

LEUPROLIDE

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9
Q

reversible GnRH antagonist

A

Degarelix (SC)

  • reduces FSH and LH secretion
  • castrate T levels in 3 days
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10
Q

will bring T levels down quicker and avid disease flar en route to castration

A

Degerelin

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11
Q

Severe AE’s with degerelin

A

Prolong QT

less severe others** elevated LFTS, sweats HTN, arthralgia, impotence

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12
Q

Drug for Prostate CA with comparable effects to estradiol

A

Estramustine

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13
Q

MOA for Estramustine

A

inhibits microtubules, promoting dis-assembly and G2/M arrest
*causes DNA strand breakage

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14
Q

AE’s of Estramustine

A

gynecomastia. mastalgia, impotence, GI upset

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15
Q

When estramustime works too well what can happen (AE’s of another molecule)

A

Same side effects of Estradiol

-thromboembolic Dz (PE and DVT), MI, CVA, Edema

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16
Q

name the Androgen Receptor blockers

A

Bicalutamide
Enzalutamide
Flutamide
Nilutamide

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17
Q

all Androgen receptor blockers end in

A

-lutamide

18
Q

do AR blockers affect circulating androgen levels

A

no-but the adverse effects are from apparent decreases androgen levels

19
Q

only AR blocker indicated for women’s health issue–> Hirsutism and PCOS

A

flutamide

20
Q

male teratogenicity

A

enzalutamide

21
Q

prostate > central

-antagonist + agonist activity

A

biclutamide

22
Q

prostate and central

-antagonist

A

Enzalutamide (T)

Nilutamide

23
Q

Prostate only

-antagonist

A

flutamide

24
Q

BBW for flutamide

A

interstitial pneumonitis

25
Q

respiratory insufficiency and increased time to accomodate to light from dark with

A

nilutamide

26
Q

URTI with

A

enzalutamide

27
Q

3/4 AR are teratogenic except

A

nilutamide

28
Q

drug that stimulates T cells against Prostatic Acid Phosphatase

A

Sipuleucel-T

29
Q

the cell that carrie out the action for Sipucel is

A

CD8 t cells–>intracelluar/cancer cell lysis

30
Q

Name the 17 alpha hydroxylase inhibitor (CYP17)

A

Abiraterone

31
Q

difference between ketoconazole and abaterone

A

Abaterone increases mineralocorticoids, ketoconazole decreases mineralocorticoids and cortisol production

32
Q

CYP17

CYP17 inhibitor

A

17 alpha hydroxylase

abaterone

33
Q

SE of Aabaterone

A

hyper-mineralocoricoid state
HTN,
HYPOKALEMIA, HYPERNATREMIA
*CAUTING WITH PREVIOUS CV ISSUE

34
Q

pregnancy category for abaterone

A

category X–>woman precautions too

35
Q

Give abaterone with

A

glucocorticoids to inhibit ACTH overdirve

36
Q

abrupt stoppage of abaterone

A

adrenal crisis

37
Q

high total PSA seen with

A

Prostatic Cancer

Free: total ratio is decreased in cancer than with BPH

38
Q

high free PSA seen in

A

BPH

free: total ratio is increased more in BPH than in prostatic CA

39
Q

5 alpha reductase inhibitors are recommended

A

NO

40
Q

5 alpha reductase inihibitors

thought to be chemopreventative

A

finasteride

dutasteride

41
Q

which ER is protective

A

ERB-> tumor supressive effect

ERa–> proliferative, pro-malignant, inflammatory

42
Q

convential agents in prostate cancer (advanced)

A

Docetaxel and
Carbazitaxel-taxane
(usedful in MDr tumorsa because a poor substrate for pgP pump)
.Mitoxantrone

Reproductive (9 decks)

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