27.GnRH ANALOGUES NOT USED IN
A.PRECOCIOUS PUBERTY
B.IVF
C.CA PROSTRATE
D.DECREASED BMD
ANS:DECREASED BMD
PRECOCIOUS PUBERTY
Management
For cases of central precocious puberty (CPP) with no underlying brain pathology and no psychosocial complications, treatment for the pubertal changes alone may not be required. Puberty can be arrested and growth hormone given if the height prognosis is poor. Examples of treatment include:
Surgery: tumours may require resection but resection rarely causes regression of the pubertal changes.1
Medical treatments include:
Gonadotrophin-releasing hormone (GnRH) agonists are used in CPP, as well as for other aetiologies, including McCune-Albright syndrome (MAS) and testotoxicosis.
Glucocorticoids are used for congenital adrenal hyperplasia (CAH).
Testolactone is an aromatase inhibitor (therefore inhibits steroid biosynthesis). It is used most commonly for MAS but also in testotoxicosis.
Tamoxifen may be used in MAS.
Ketoconazole may be used (for example in testotoxicosis) to inhibit steroid biosynthesis.
Cyproterone acetate may be used for anti-androgen action. Flutamide is also used to counter androgen excess.
Medroxyprogesterone (a progesterone analogue) has also been used.
CA PROSTRATE
GnRH analogs
Analogs of gonadotropin-releasing hormone (GnRH) can be used to induce a chemical castration, that is, complete suppression of the production of estrogen and progesterone from the female ovaries, or complete suppression of testosterone production from the male testes. This is due to a negative feedback effect of continuous stimulation of the pituitary gland by these hormones. Leuprolide and goserelin are GnRH analogs which are used primarily for the treatment of hormone-responsive prostate cancer. Because the initial endocrine response to GnRH analogs is actually hypersecretion of gonadal steroids, hormone receptor antagonists such as flutamide are typically used to prevent a transient boost in tumor growth.
IVF
A gonadotropin-releasing hormone antagonist (GnRH antagonist) is an analogue that blocks the GnRH receptor resulting in an immediate drop in gonadotropin (FSH, LH) secretion. The GnRH antagonist is primarily used in IVF treatments to block natural ovulation.
DECREASED BMD
In GnRH anlogue theraphy there will decreased bmd so its not used in trt of decreased bmd
A.PRECOCIOUS PUBERTY
B.IVF
C.CA PROSTRATE
D.DECREASED BMD
ANS:DECREASED BMD
PRECOCIOUS PUBERTY
Management
For cases of central precocious puberty (CPP) with no underlying brain pathology and no psychosocial complications, treatment for the pubertal changes alone may not be required. Puberty can be arrested and growth hormone given if the height prognosis is poor. Examples of treatment include:
Surgery: tumours may require resection but resection rarely causes regression of the pubertal changes.1
Medical treatments include:
Gonadotrophin-releasing hormone (GnRH) agonists are used in CPP, as well as for other aetiologies, including McCune-Albright syndrome (MAS) and testotoxicosis.
Glucocorticoids are used for congenital adrenal hyperplasia (CAH).
Testolactone is an aromatase inhibitor (therefore inhibits steroid biosynthesis). It is used most commonly for MAS but also in testotoxicosis.
Tamoxifen may be used in MAS.
Ketoconazole may be used (for example in testotoxicosis) to inhibit steroid biosynthesis.
Cyproterone acetate may be used for anti-androgen action. Flutamide is also used to counter androgen excess.
Medroxyprogesterone (a progesterone analogue) has also been used.
CA PROSTRATE
GnRH analogs
Analogs of gonadotropin-releasing hormone (GnRH) can be used to induce a chemical castration, that is, complete suppression of the production of estrogen and progesterone from the female ovaries, or complete suppression of testosterone production from the male testes. This is due to a negative feedback effect of continuous stimulation of the pituitary gland by these hormones. Leuprolide and goserelin are GnRH analogs which are used primarily for the treatment of hormone-responsive prostate cancer. Because the initial endocrine response to GnRH analogs is actually hypersecretion of gonadal steroids, hormone receptor antagonists such as flutamide are typically used to prevent a transient boost in tumor growth.
IVF
A gonadotropin-releasing hormone antagonist (GnRH antagonist) is an analogue that blocks the GnRH receptor resulting in an immediate drop in gonadotropin (FSH, LH) secretion. The GnRH antagonist is primarily used in IVF treatments to block natural ovulation.
DECREASED BMD
In GnRH anlogue theraphy there will decreased bmd so its not used in trt of decreased bmd
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