Therapeutics - Prostate Cancer 1
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What drugs can falsely lower PSA levels by 50% with 6-12 months of use?
- Finasteride, dutasteride
- Androgen receptor blockers (bicalutamide, flutamide)
- Some herbs (Saw Palmetto)
What are the American Cancer Society’s guidelines for Prostate cancer screening?
- Discussed and Offered:
- Life expectance is > or = to 10 years
- After age 50
- Age 45 for African Americans or strong family history
When is treatment started for prostate cancer?
When a ptient with LE of > or = 10 years shows tumor progession
When is palliative care started for prostate cancer?
When a patient with < 10 years LE shows tumor has started to progress
The first choice treatment for Prostate cancer is:
- Followed by Radiation +/- ADT therapy
How long is Radiation and ADT therapy continued in a high risk patient with prostate cancer?
How long is Radiation and ADT therapy continued in a low risk patient with prostate cancer?
How can you reduce side effects of Andorgne deprivation therapy?
When should you do continuous androgen deprivation therapy in prostate cancer?
When the gleason score is > or = to 8
What drug classes are used for androgen deprivation therapy?
- LH-RH AGONISTS
What are the LH-RH agonists:
- Goserelin (Zoladex)
- Leuprolide (Lupron)
- Triptorelin (Trelstar LA)
What drug class does Goserelin (Zoladex) fall into?
What drug class does Leuprolide (Lupron) fall into?
What drug class does Triptorelin (Trelstar LA) fall into?
What drug class does Degarelix (Firmagon) fall into?
What drug class does Abaralix (Plenaxis) fall into?
What are the SE of LH-RH agonists?
- Hot flashes
- Injections site reactions
- Sexual dysfunction
- OP – give Ca and Vit D
- Increased risk of DM or CV
- Weight gain
- Tumor flare with metastatic disease– control with antiandrogens
What drugs can be sued to control tumor flare?
All men over 50 receiving LH-RH agonists or ANTagonists should receive what other drugs and why?
- For prevention of fractures form OP:
- Calcium 1200 mg QD
- Vitamin D3 800-1000 IU QD
- FRAX assessment
- Bisphosphonates may be used – Zolendronic HA or Alendronate
What are the Antiandrogens?
- Bicalutamide (Casodex)
- Flutamine (Eulexin)
- Nilutamide (Nilandrone)
What are the treatment options for Castrate sensitive metastatic disease?
- ADT therapy
- Bilateral orichietomy
- LH-RH agonist/antagonists +/- antiandrogens
What are the LH-RH ANTagonists?
What is the brand name for Goserelin?
What is the brand name for Leuprolide?
What is the brand name for Triptorelin?
What is the brand name for Degarelix?
What is the generic name for Zoladex?
What is the generic name for Lupron?
What is the generic name for Trelstar LA?
What is the generic name for Firmagon?
What would you like to do?
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