hormonal therapy and cancer tx
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16 terms
English | Photos |
|---|---|
 Control of female hormones-pic |  |
| control of androgen secretions -pic |  |
| Leuprolide -mechanism -use -toxicity | Mechanism: GnRH analog w/ antagonist properties Special: 1)Agonist properties when used pulsatile 2)Antagonist properties when used continuous Use: 1)Infertility (pulsatile) 2)Prostate cancer(continuous) 3)Uterine fibroids Toxicity: -Anti-androgen -nausea -vomiting |
| Testosterone (methyltestosterone) -mechanism -use -toxicity | Mechanism: Androgen receptor agonist Use: 1)hypogonadism 2)stimulate anabolism to promote burn recovery 3)treat ER-positive breast cancer Toxicity: Females--> masculinization Males-->Gonadal atrophy *inhibiting release of LH which results in reduced intra-testicular testosterone |
| Antiandrogens | 1)Finasteride 2)Flutamide 3)Ketoconazole 4)Spironalactone |
| Finastaride | 5α-reductase inhibitor (↓ conversion of testosterone to dihydrotestosterone) Use: BPH, male pattern baldness Toxicity: promotes female breast growth |
| Flutamide | nonsteroidal competitive inhibitor of androgens at the testosterone receptor Use: prostate carcinoma |
| Ketoconazole and Spironolactone -mech -use -toxicity | Ketoconazole: inhibits steroid synthesis (desmolase) Spironolactone: inhibits steroid binding Use: used in polycystic ovarian syndrome to prevent hirsutism Toxicity: -Gynecomastia -Amenorrhea |
| Estrogens -drugs -mechanism -clinical use -toxicity -contraindications | Drugs: ethinyl estradiol, diethylstilbestrol (DES), mestranol Mechanism: bind estrogen receptors Use: 1)Hypogonadism or ovary failure 2)menstrual abnormality 3)HRT in postmenopausal women MEN: men with androgen dependent prostate cancer Toxicity: 1)increase risk of endometrial cancer 2)bleeding in postmenopausal women 3)increased risk of thrombi Contra: 1)ER-positive breast cancer 2)history of DVTs |
| Selective estrogen receptor modulators -what -who | What: estrogen partial agonists Who: 1)Clomiphene 2)Tamoxifen 3)Raloxifene |
| Clomiphene -what -use -toxicity | What: partial agonist at estrogen receptors in hypothalamus Use: prevents normal feedback inhibitions and ↑ release of LH and FSH from pituitary which stimulates ovulation **used for infertility and PCOS Toxicity: -hot flashes -ovarian enlargement -multiple pregnancies -visual disturbances |
| Tamoxifen -what -use | What: Antagonist on breast tissue Use: treat and prevent recurrence of ER-positive breast cancer |
| Raloxifene -what -use | What: Agonist on bone Use: tx osteoporosis by ↓ bone resorption |
| Hormone Replacement Therapy -use -dangers | Use: to relive or prevent menopausal symptoms and osteoporosis (↑estrogen = ↓osteoclast activity) Danger: unopposed estrogen replacement ↑ risk of endometrial cancer |
| Anastrozole/exemestane | Aromatase inhibitors used in postmenopausal women with breast cancer |
| Progestins -mechanism -use | Mechanism: bind progesterone receptors -reduces growth and ↑ vascularization of endometrium Use: 1)oral contraceptive 2)tx of endometrial cancer 3)tx for abnormal uterine bleeding |
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