GnRH Agonists and Antagonists for NEET/AIIMS/USMLE/FMGE/PLAB скачать в хорошем качестве

GnRH Agonists and Antagonists for NEET/AIIMS/USMLE/FMGE/PLAB

GnRH Agonists and Antagonists for NEET/AIIMS/USMLE/FMGE/PLAB GNRH Agonists: • GNRH agonists like goserelin (zoladex) can be used at pulsatile or continuous doses. At pulsatile doses, they mimic physiological effect and increases LH and FSH and hence can be used for treatment of anovulation, oligospermia and delayed puberty. • At continuous doses there is an initial rise followed by decrease in LH/FSH. Hence at continuous doses they are used for treatment of breast cancer, fibroids and endometriosis in females and prostate cancer in males. Other uses are precocious puberty, acute intermittent porphyria and priapism. At continuous doses there could be initial worsening of symptoms due to transient increase in LH/FSH. GNRH Antagonists: • GNRH antagonists are given at continuous doses and the only effect seen is a decrease in LH/FSH. Hence there is no initial worsening as seen with agonists. • Ganirelix, abarelix, degarelix and cetrorelix are used by subcutaneous injection for conditions like GNRH agonists are used. Degarelix is used in prostate cancer and cetrorelix for endometriosis and uterine fibroids. • The use specific to this class is to prevent premature ovulation in treatment of infertility. • These are absolutely contraindicated in pregnancy. • Side-effects are similar to GNRH agonists and apart from that degarelix can cause QT prolongation as well.