GnRh Lhrh agonists

The main clinical use of these drugs is the treatment of prostatic carcinoma. When a GnRH agonist is given in pulses by injection, it mimics the natural action of GnRH itself and induces the release of LH from the pituitary gland. However, if a GnRH agonist is given continuously, the pituitary is first stimulated, but after some days the response ceases. During the period of initial stimulation, more LH is released and consequently there is a surge in testosterone production, called a flare, and during this time about 1 in 10 men with metastatic cancer may experience a temporary worsening of their symptoms. For this reason, GnRH agonists are associated with an antiandrogen or an inhibitor of androgen synthesis prior and during the first weeks of the treatment. After a few days, the pituitary becomes desensitized by the continuous presence of the hormone, loses its membrane receptors for GnRH and stops releasing LH, leading to a decline of testosterone production and ending in levels similar to those achieved by orchidectomy.

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