Flutamide | Health and Prostate

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Pharmacotherapy in the Management of Prostate Cancer

Posted by admin on October 28th, 2011 No Comments

Prostate cancer is now the second leading cause of death due to cancer in men. Prostate cancer is usually classified as being early/localized (organ confined), locally advanced, metastatic or hormone-relapsed. The management of prostate cancer depends largely upon the stage and the Gleason grade of the tumour, as well as the patient's general medical condition and treatment preference. Surgical intervention is usually reserved for (early) localized prostate cancer, which is deemed to be confined to the prostate capsule. In the more advanced cases surgery is only used for performing channel transurethral resection of prostateto relieve severe lower urinary tract symptoms. The management of prostate cancer is sometimes controversial, not least as the diagnosis of localized or locally advanced prostate cancer is often difficult to establish precisely. Current modalities for diagnosing prostate cancer include prostate-specific antigen (PSA), digital rectal examination, trans-rectal rectal ultrasound scan and computerized tomography / magnetic resonance imaging. Often tumours thought to be localized Read more [...]

Posted in Urological Oncology

Management of localized prostate cancer

Posted by admin on October 28th, 2011 No Comments

Patients with clinically localized prostate cancer are generally offered either active surveillance or radical treatment, depending on their general condition and own preferences. Standard treatments for localized prostate cancer include radical surgery, radiation therapy (external beam or brachytherapy with and without androgen ablation) or active surveillance, which is also termed watchful waiting. There is a lack of randomized controlled trials comparing the various treatments for localized prostate cancer and hence results obtained from trials of other stages of prostate cancer are often extrapolated to localized prostate cancer. Randomized trials have shown a survival benefit for patients with locally advanced prostate cancer receiving hormone therapy plus radiotherapy compared with radiotherapy alone and this observation has sometimes been applied to patients with localized prostate cancer. Treatment options in localized prostate cancer WATCHFUL WAITING Current evidence suggests that patients managed by watchful waiting for more than 15 years often sustain eventual disease progression. Read more [...]

Posted in Urological Oncology

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

Nilutamide

Posted by admin on June 24th, 2011 No Comments

C12H10F3N3O4 • Nilutamide is a nonsteroidal antiandrogen. Uses • Prostate Cancer Nilutamide is used in combination with orchiectomy in the treatment of metastatic prostate cancer that involves distant lymph nodes, bone, or visceral organs (stage D2). Results of controlled clinical studies in patients with metastatic prostate cancer indicate that nilutamide in combination with orchiectomy slows progression of the disease, relieve bone pain associated with metastatic disease, and improve overall survival rate after long-term therapy (8.5 years). Prostate specific antigen (PSA) concentrations should be determined periodically during nilutamide therapy to monitor therapeutic response, including successful remission or possible progression of cancer. If PSA concentrations increase substantially and consistently during nilutamide therapy, the possibility of clinical progression should be evaluated. Progression noted after gonadal ablation (e.g., orchiectomy) and antiandrogen therapy may represent growth that is not androgen dependent. For patients receiving orchiectomy and nilutamide who Read more [...]

Posted in Drugs

Leuprolide Acetate

Posted by admin on June 24th, 2011 No Comments

C59H84N16O12•C2H4O2 • Leuprolide acetate, a synthetic nonapeptide analog of naturally occurring porcine or ovine gonadotropin releasing hormone (GnRH, luteinizing hormone releasing hormone, gonadorelin), may be used as an antineoplastic agent and for its endocrine effects. Drug Interactions The manufacturer states there are no reports to date of drug interactions with leuprolide. The manufacturer also states that because leuprolide is a peptide that is mainly degraded by peptidase and not by cytochrome P-450 microsomal enzymes and because of the drug's low degree of protein binding, drug interactions would not be expected to occur with leuprolide. There is some evidence from studies in mice to suggest that the inhibitory effect of leuprolide on spermatogenesis may be used to therapeutic advantage in the prevention of azoospermia or severe oligospermia that frequently results from therapy with cytotoxic agents. In mice receiving combined therapy with leuprolide and cyclophosphamide, testicular damage was less than that observed in animals receiving cyclophosphamide alone. It has been Read more [...]

Posted in Drugs

Leuprolide Acetate: Cautions

Posted by admin on June 24th, 2011 No Comments

Leuprolide generally is well tolerated and usual dosages (i.e., 1 mg daily) have been associated with fewer adverse systemic effects than usual dosages (i.e., 3 mg daily) of diethylstilbestrol (DES) (no longer commercially available in the US). The most frequent adverse effects associated with leuprolide therapy are hot flushes in males and females and amenorrhea in females. (See Cautions: Endocrine Effects.) These and other effects secondary to hypoestrogenism are the predominant adverse effects observed in females receiving the drug. The safety profiles of the injection and suspension dosage forms of the drug appear to be similar. A worsening (flare) of signs and/or symptoms of hormone-dependent disease (e.g., endometriosis, prostatic carcinoma) has occasionally occurred during the initial 1-2 weeks of leuprolide therapy (secondary to the initial leuprolide-induced stimulation of pituitary release of gonadotropins and resultant ovarian and testicular steroidogenesis) and then subsided during continued therapy. In males with prostate cancer, this transient exacerbation of signs and/or symptoms Read more [...]

Posted in Drugs

Leuprolide Acetate: Dosage and Administration

Posted by admin on June 24th, 2011 No Comments

• Reconstitution and Administration Leuprolide acetate suspension is administered IM, and leuprolide acetate injection is administered subcutaneously. The manufacturer states that the suspension is not intended for self-administration and therefore should be administered under the supervision of a physician. Various dosage forms of the drug have also been administered IV72, 77 and intranasally, but these routes of administration currently are not recommended. Injection sites should be rotated periodically. Leuprolide acetate injection should be inspected visually for particulate matter and discoloration prior to administration. Leuprolide acetate powder for injectable suspension should be reconstituted using only the diluent provided by the manufacturer; other diluents should not be substituted. To reconstitute the suspensions containing 3.75, 7.5, 11.25, or 15 mg of drug per dose, 1 mL of the diluent should be withdrawn from the ampul (using a syringe with a 22-gauge needle) and added to the vial containing the powder for injectable suspension. To reconstitute the suspensions containing Read more [...]

Posted in Drugs

Leuprolide Acetate: Uses

Posted by admin on June 24th, 2011 No Comments

• Prostate Cancer Leuprolide acetate is used for the palliative treatment of advanced prostate cancer. The drug currently is considered alternative therapy for patients with inoperable prostatic tumors and/or who are intolerant to estrogen therapy (i.e., those at risk of estrogen-induced thromboembolic and thrombotic disorders, other cardiovascular effects, or other adverse effects) and for patients who refuse orchiectomy and/or estrogen therapy. Most clinical studies with the drug have been performed in patients with prostate cancer clinically diagnosed as stage D2 (i.e., tumor with metastases to distant lymph nodes, bone, and/or viscera). Responses to leuprolide therapy generally have been evaluated based on the criteria of the National Prostatic Cancer Project (NPCP). Leuprolide acetate injection and suspension have been shown to have comparable efficacy and safety in the treatment of advanced prostate cancer. Although direct comparison in clinical trials has not been performed, the safety and efficacy of the 4-month depot injection appear similar to the other leuprolide depot formulations. Read more [...]

Posted in Drugs

Goserelin Acetate

Posted by admin on June 24th, 2011 No Comments

C 59H 84N 18O 14 • Goserelin acetate, a synthetic decapeptide analog of gonadotropin-releasing hormone (GnRH, luteinizing hormone-releasing hormone, gonadorelin), may be used as an antineoplastic agent and for its endocrine effects. Uses • Prostate Cancer Goserelin acetate is used for the palliative treatment of advanced prostate cancer. Therapy with a GnRH agonist (e.g., goserelin) currently is considered one of several first-line options for hormonal therapy in patients with prostate cancer; other options include orchiectomy, estrogens, and antiandrogens. In controlled clinical studies in patients with advanced prostate cancer, goserelin (3.6 mg administered subcutaneously every 4 weeks) was as effective as orchiectomy as determined by the degree of testosterone suppression, duration of response and survival, and/or objective response rate. Results of several dose-response studies in patients with advanced prostate cancer indicate that pharmacodynamic effects (i.e., reductions in serum testosterone and prostate specific antigen [PSA] concentrations) associated with administration Read more [...]

Posted in Drugs

Goserelin Acetate: Dosage and Administration

Posted by admin on June 24th, 2011 No Comments

• General Goserelin acetate is administered as a biodegradable implant subcutaneously into the upper abdominal wall, under the supervision of a clinician. Implants containing 3.6 mg of goserelin are administered every 4 weeks. When indicated, implants containing 10. mg of goserelin are administered every 12 weeks. 2 6 Although a delay of a few days is permitted, the manufacturer states that every effort should be made to adhere to the recommended schedule. A local anesthetic may be given prior to implantation of goserelin. In the event that the implant needs to be removed, it may be located by ultrasound. The manufacturer's labeling should be consulted for proper methods of administration and associated precautions. Dosage of goserelin acetate is expressed in terms of goserelin. • Prostate Cancer For the palliative treatment of advanced prostate cancer, the usual dosage of goserelin in men is 3.6 or 10.8 mg implanted subcutaneously every 4 or 12 weeks, respectively. For this indication, goserelin is intended for long-term administration unless it is clinically inappropriate. When Read more [...]

Posted in Drugs

Posts Tagged ‘Flutamide’

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