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Prostate Cancer (Non-pharmalogical treatment options (Orchidectomy, radial…
Prostate Cancer
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Anti-androgens
MOA competitively inhibit the effect of androgens peripherally by competing with testosterone and DHT for binding sites at the prostate.
E.g. Flutamide, alpha-1 adrenergic antagonist (terazosin).
ADRs No effect on pituitary function so less side effects.
Alpha-1 antagonists may cause orthostatic hypotension and dizziness. They interact with (PDE)-5 inhibitors such as sildenafil.
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LHRH antagonist
MOA Competitive binding to LHRH receptors in the pituitary, surpassing LH release → sustained decrease in testosterone.
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Normal Physiology
Hypothalamus secretes LHRH
Anterior pituitary secretes LH which causes the testis to secrete testosterone and DHT.
Anterior pituitary secretes ACTH which causes the adrenal glands to secrete dihydropiondrosterone and androstenedione. These act on the prostate.
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