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Benign Prostatic Hyperplasia

Posted by admin on July 11th, 2011 No Comments

Definition Benign prostatic hyperplasia, a nearly ubiquitous condition, is the most common benign neoplasm of American men and occurs as a result of hormone-driven prostate growth. Pathophysiology The prostate gland comprises three types of tissue: epithelial or glandular, stromal or smooth muscle, and capsule. Both stromal tissue and capsule are embedded with О±1-adrenergic receptors. The precise pathophysiologic mechanisms that cause Benign prostatic hyperplasia are not clear. However, both intraprostatic dihydrotestosterone and type II 5 О±-reductase are thought to be involved. Benign prostatic hyperplasia commonly results from both static (gradual enlargement of the prostate) and dynamic (agents or situations that increase О±-adrenergic tone and constrict the gland's smooth muscle) factors. Examples of drugs that can exacerbate symptoms include testosterone, О±-adrenergic agonists (e.g., decongestants), anticholinergics (e.g., antihistamines, phenothiazines, tricyclic antidepressants, anticholinergic antispasmodics, Read more [...]

Posted in Benign Prostatic Hyperplasia

Flutamide

Posted by admin on June 24th, 2011 No Comments

C11H11F3N2O3 • Flutamide, a nonsteroidal antiandrogen, is an antineoplastic agent. Uses • Prostate Cancer Flutamide is used in combination with a gonadotropin-releasing hormone (GnRH) analog (e.g., goserelin, leuprolide acetate) in the treatment of prostate cancer that is clinically localized, such as that confined to the prostate but with extensive involvement of one lobe or with involvement of both lobes (stage B2) and that localized to the periprostatic area but extending beyond the capsule and possibly affecting seminal vesicles (stage C). Flutamide also is used in combination with a GnRH analog in the treatment of metastatic prostate cancer that involves distant lymph nodes, bone, or visceral organs (stage D2). For additional information on combined antiandrogenic and GnRH analog therapy. Prostate specific antigen (PSA) concentrations should be determined periodically during combined flutamide and GnRH analog therapy to monitor therapeutic response, including successful remission or possible progression of cancer. If PSA concentrations increase substantially and consistently Read more [...]

Posted in Drugs

Luteinizing Hormone-Releasing Hormone Antagonists

Posted by admin on May 6th, 2011 No Comments

Overview. LHRH antagonists are the most recent class of hormonal therapy to enter the CaP armamentarium. Mechanism Of Action. Compared with LHRH analogues (e.g., goserelin, leuprolide acetate), which produce their effect by activating and then desensitizing androgen-producing cells to LHRH, LHRH antagonists directly block the effect of the releasing hormone. Abarelix. NOTE: This drug has been discontinued. The LHRH antagonist abarelix (Praecis Pharmaceuticals / Schering AG's Ple-naxis) received FDA approval in 2003 for the palliative treatment of men with advanced, symptomatic CaP for whom the temporary testosterone "flare" associated with LHRH analogue treatment could be dangerous and who refuse orchiec-tomy. However, in 2005, Praecis Pharmaceuticals has voluntarily discontinued selling Plenaxis to new patients in the United States for economic / commercial reasons. In fact, clinicians interviewed say, flare is easily prevented by combining an antiandrogen with an LHRH analogue and that abarelix never fulfilled an urgent unmet need. Nonsteroidal Antiandrogens Overview. The three Read more [...]

Posted in Prostate Cancer

Current Therapies

Posted by admin on May 6th, 2011 No Comments

The main treatment modalities for prostate cancer (CaP) include "watchful waiting"; local therapy (prostatectomy or radiotherapy, either external beam radiation therapy [EBRT] or brachytherapy); hormonal therapy; and chemotherapy. Watchful waiting is generally reserved for elderly men, who, because of short life expectancy or slowly progressing disease, are likely to die with CaP rather than because of CaP. Local therapies alone can often cure patients diagnosed with early-stage (I or II) prostate-confined disease. Hormonal therapy is used primarily to delay disease progression when local therapies have failed. Chemotherapy is generally reserved for hormone-refractory disease to palliate symptoms. A growing trend in CaP treatment is the use of intermittent therapy. Hormonal therapies are often administered for three years or more as adjuvant therapy. Although their sideeffect profile is mild compared with that of many chemotherapy agents, they do have several undesirable effects (e.g., hot flashes, sexual dysfunction, gynecomastia [excessive development of mammary glands]). To reduce these side Read more [...]

Posted in Prostate Cancer

Flutamide

Posted by admin on July 20th, 2010 No Comments

(British Approved Name, US Adopted Name, rINN) Drug Nomenclature International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish): Synonyms: Flutamid; Flutamida; Flutamidas; Flutamidi; Flutamidum; Sch-13521 BAN: Flutamide USAN: Flutamide INN: Flutamide [rINN (en)] INN: Flutamida [rINN (es)] INN: Flutamide [rINN (fr)] INN: Flutamidum [rINN (la)] INN: Флутамид [rINN (ru)] Chemical name: α´,α´,α´-Trifluoro-4´-nitroisobutyro-m-toluidide; α,α,α-Trifluoro-2-methyl-4´-nitro-m-propionotoluidide Molecular formula: C11H11F3N2O3 =276.2 CAS: 13311-84-7 ATC code: L02BB01 Read code: y02p1 Pharmacopoeias. In Europe and US. European Pharmacopoeia, 6th ed., 2008 and Supplements 6.1 and 6.2 (Flutamide). A pale yellow, crystalline powder. Practically insoluble in water; freely soluble in alcohol and in acetone. Protect from light. The United States Pharmacopeia 31, 2008 (Flutamide). A pale yellow, crystalline powder. Practically insoluble in water, in liquid paraffin, and in petroleum spirit; freely soluble in acetone, in ethyl acetate, Read more [...]

Posted in Drugs

FLUTAMIDE

Posted by admin on May 6th, 2010 No Comments

FLUTAMIDE (FLUTE-am-eyed) Other Names for this Medication: Euflex®, Drogenil®, Eulexin ®, Apo-flutamide®, Novo-flutamide®, Pms-flutamide® (Brand Names) Appearance Oral Tablets: Round, pale yellow, tablet containing 250 mg of flutamide. Why this Medication is Used This medication may be used alone, or in combination with other medications for the treatment of prostate cancer. Flutamide blocks the male hormone that stimulates the growth of prostate cancer cells. How do you take this Medication Oral Tablets: Take this drug by mouth, with or without food, as ordered by your doctor. Precautions • Other medications may interact with Flutamide. Do not start taking new medications without first checking with your doctor or pharmacist. Tell your doctor if you are taking blood-thinning drugs such as Coumadin® (Warfarin). • Tell all other doctors or dentists that you are taking Flutamide, before you receive treatment from them. • Store Flutamide tablets at room temperature. Keep out of the reach of children. For more information on this medication, please call your doctor, Read more [...]

Posted in Drugs

Pharmacotherapy for BPH (Benign Prostatic Hyperplasia)

Posted by admin on March 3rd, 2010 No Comments

Mechanisms of Obstruction and Rationale for Pharmacotherapy Current pharmacotherapy for Benign Prostatic Hyperplasia (BPH) is based on agents that relax the smooth muscles of prostatic urethra and stroma and those that deprive acinar cells of androgen. Various agents have been tried in the treatment of BPH (Table). They may be broadly grouped into those affecting the dynamic component of urethral obstruction, namely the smooth muscle and prostatic stroma, and those affecting the glandular elements by androgen deprivation. The mechanism of action of many agents claimed to be useful in Benign Prostatic Hyperplasia is not clearly understood. TABLE — Drugs That Have Been Tried in the Medical Management of Benign Prostatic Hyperplasia (Some agents act by more than one mechanism) Drug Class Drug (Code Designation) Trade Name α1-Adrenergic antagonists Prazosin HCl Minipress Terazosin HCl Hytrin Doxazosin mesylate Cardura Phentolamine mesylate YM-617 Nicergoline Sermion Indoramin Baratol Ketanserin Yohimbine HCI Antiandrogens Selective 5α-Reductase Read more [...]

Posted in Pharmacotherapy

The Prostate. Part 1

Posted by admin on November 26th, 2009 No Comments

Pathophysiology of the Prostate Gland: Benign Prostatic Hyperplasia and Cancer The prostate is a small, walnut-shaped gland that lies below the urinary bladder and surrounds the urethra. The gland secretes a fluid that accounts for about 30% of the volume of semen and functions to lubricate the urethra and increase sperm motility. As a man ages, his prostate grows. Growths can be either benign (benign prostatic hyperplasia, or BPH) or malignant. If malignant, they can have an indolent course, or they can metastasize and become life-threatening. Benign prostatic hyperplasia is characterized by histologic changes in the prostate (hyperplastic nodules in the periurethral area) that result from prolonged exposure to androgens. There is both a static and a dynamic component to prostate enlargement; the static component is related to the increase in prostate size due to proliferation of smooth muscle cells in the prostatic stroma, and the dynamic component, to the increase in smooth muscle tone in the prostate and bladder neck. Symptoms due to obstruction include urinary hesitancy, intermittency, Read more [...]

Posted in Prostate Gland

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