Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hot flushes are the commonest symptom induced by gonadotropin-releasing hormone agonists (GnRHa). We performed an open observational trial to evaluate the efficacy of veralipride, an antidopaminergic drug, in reducing hot flushes in 25 premenopausal women treated with a GnRHa for endometriosis (8 subjects) or menorrhagia (17 subjects). The patients received goserelin depot for 6 months and veralipride was added for the third month. Hot flushes, severe in all women at 2 months, improved in both frequency and intensity in 92% of the subjects during veralipride administration. The benefit obtained persisted until the end of the GnRHa treatment.
 ...
PMID:Veralipride for hot flushes during gonadotropin-releasing hormone agonist treatment. 139 60

Twenty-two pre-menopausal evaluable patients with advanced breast cancer (median age 39 years; ER positive 19, unknown three; prior adjuvant chemotherapy 16) were treated with the LHRH agonist goserelin depot (Zoladex). Serum levels of 17 beta-estradiol and progesterone were suppressed by goserelin within 3-4 weeks of therapy, while serum leuteinizing hormone and follicle stimulating hormone titers remained in the low level of the normal range. Complete or partial response was documented in seven of 22 cases (32%) and occurred in all major sites of disease. Tumor response was documented in women regularly menstruating at the start of therapy. Median time to disease progression was 23 weeks; median duration of response was 64 weeks; overall survival was 141 weeks. Zoladex was well tolerated: only hot flushes in 82% and reversible cutaneous pigmentation in the site of injection in 45% of the patients were observed. In our experience the activity of Zoladex was comparable to that of oophorectomy, without the psychological trauma and the morbidity related to surgical castration.
 ...
PMID:Treatment of pre-menopausal advanced breast cancer with goserelin--a long-acting luteinizing hormone releasing hormone agonist. 153 4

Ten pre-menopausal women with uterine leiomyoma were treated for 1 year with a monthly depot of luteinizing hormone-releasing hormone agonist (LHRA-a), goserelin, combined after the initial 3 months of treatment with conjugated oestrogens 0.3 mg (days 1-25) and medroxy-progesterone acetate 5 mg (days 16-25). Mean leiomyoma volume decreased by 49.3% during the first 3 months when goserelin alone was administered but did not change significantly during the 9 months of combination therapy. There were no significant changes in bone mass or high-density lipoprotein cholesterol during the study whereas hot flushes and menstrual blood loss were well controlled. These results indicate that ovarian suppression with a monthly depot of the LHRH-a, goserelin, combined after 3 months with low-dose hormonal replacement therapy reduced the size and the symptomatology of leiomyoma while preserving the bone mass.
 ...
PMID:Maintained reduction of uterine leiomyoma following addition of hormonal replacement therapy to a monthly luteinizing hormone-releasing hormone agonist implant: a pilot study. 165 23

Cyproterone acetate is a progestational antiandrogen with potent antigonadotropic activity that results in rapid suppression of serum testosterone. Used as a single agent, cyproterone acetate yields a total androgen blockade. It may be combined with low-dose diethylstilbestrol, orchiectomy, or LHRH agonists to improve, in theory, the results of such therapy. In clinical testing, cyproterone acetate has proved equivalent to diethylstilbestrol with markedly less toxicity. It is useful in conjunction with LHRH agonists, either transiently to block the flare phenomenon, or continuously to block peripheral androgen receptors; the necessity for this latter action has not yet been proved. Cyproterone acetate may afford transient objective improvement in patients not responding to other forms of hormone deprivation. Experience in this role is limited. The drug may be used to suppress the hot flushes associated with orchiectomy or LHRH agonist therapy. Cyproterone acetate induces local tumor regression; owing to its reversible effects, it is useful as neoadjuvant or adjuvant androgen withdrawal therapy in patients with lower-stage disease undergoing radical surgery or radiotherapy. Adverse effects are mostly those related to hormone withdrawal, namely, impotence, infertility, and lassitude. Gynecomastia and breast tenderness occur in less than 18% and cardiovascular complications in approximately 10% of treated men.
 ...
PMID:Use of cyproterone acetate in prostate cancer. 182 43

For almost a century surgical castration represented the initial standard therapy for metastatic breast cancer in premenopausal women with hormone dependent tumors. Today the suppression of ovarian function can also be obtained by the administration of supraphysiologic doses of luteinizing hormone releasing hormone (LHRH) agonists. From April 1987 to February 1989, 23 premenopausal patients with advanced breast cancer (median age 39 years, range 28-52, ER positive 20, unknown 3; prior chemotherapy 17) were treated with the LHRH agonist goserelin depot (Zoladex) at the dose of 3.6 mg. every 4 weeks. Twenty-two patients were evaluable. Serum levels of 17 beta estradiol, progesterone, FSH and LH were suppressed by goserelin and fell to postmenopausal values within 8 weeks of therapy in 77% of cases. Complete response (CR) plus partial response (PR) was documented in 7 of 22 (32%) and occurred in all major sites of disease. Five patients achieved CR (soft tissue 3, viscera 2). Response rate was higher in patients not previously treated with chemotherapy (4/6). In the present series, all responses were seen in women greater than 35 years old, regularly menstruating at the start of treatment. Time to progression for the entire case series was 22 weeks and for responders 64 weeks. Oophorectomy was performed after disease progression in four patients without success. Goserelin was well tolerated. Local cutaneous dyschromia occurred in 45% and hot flushes in 82%. Treatment efficacy of goserelin is comparable to that of oophorectomy, without the psychological trauma and the morbidity related to surgical castration.
 ...
PMID:Medical castration with zoladex: a conservative approach to premenopausal breast cancer. 182 40

Cyproterone acetate (CPA) has been discovered more than 25 years ago and it was the first antiandrogen suitable for clinical use. CPA inhibits the action of endogenous and exogenous androgens at all androgen target organs; these include the prostate, seminal vesicles, testes, and the vas deferens. However, this antiandrogen also antagonizes less sex-specific effects of androgens, for example ossification of the epiphyseal cartilage, sebaceous gland function and skin thickness. Indications for CPA: Prostate cancer, androgen induced disorders of the skin (acne, seborrhoea, hirsutism, alopecia), precocious puberty and sexual disorders in men. Concerning sexual deviations clinical trials started in 1966. CPA leads to loss of libido and the ability to achieve erection, followed by the inability to achieve orgasm, after about 14 days of treatment (100-200 mg daily orally or 300 mg weekly i.m.). These effects are reversed in the same order as the onset. About 75 to 80% of patients respond to this therapy. CPA is generally well tolerated. Tiredness, lack of drive, listlessness and depressive moods have been reported as non-specific side-effects. Slight gynecomastia occurs in about 20% of patients. There are no good alternatives in this indication. Pure antiandrogens are unsuitable, because these are unable to inhibit libido sufficiently. Tranquilizers are not very effective, high doses of estrogens are associated with severe (cardiovascular) side effects. Orchidectomy is an irreversible intervention, LHRH analogues are associated with hot flushes and the initial increase in testosterone (flare phenomenon).
 ...
PMID:Cyproterone acetate in the treatment of sexual disorders: pharmacological base and clinical experience. 183 80

Objective measures of vasomotor flushes have clarified their biologic basis and have established the peripheral reactions as compensatory mechanisms for hypothalamic thermoregulatory instability. Subsequently, investigations into the pathogenesis of flushes pointed to increasingly higher levels of control. The observed relationship between estrogen deprivation and vasomotor instability led to the hypothesis of a cause-effect relationship with LH and FSH. However, patients with pituitary insufficiency were found to have hot flushes despite a lack of LH and FSH secretion. Hypothalamic secretion of gonadotropin-releasing hormone (GnRH) was studied for possible correlation with vasomotor episodes. Patients with and without symptoms had similar levels of LH secretion, but those who had symptoms and were closer to menopause had higher peripheral levels of immunoreactive GnRH, implying involvement of a hypothalamic mechanism, although not a cause-effect relationship. With prolonged estrogen deficiency, immunoreactive GnRH levels decline. Vasomotor episodes occur after estrogen withdrawal in subgroups of patients without appreciable secretion of GnRH, although LH and FSH secretions remain elevated. Vasomotor flushes are treated most effectively with estrogen. Agents such as medroxyprogesterone acetate and lofexidine may reduce the incidence of flushes.
 ...
PMID:Physiology and treatment of hot flushes. 217 88

Twelve months after modified radical mastectomy with axillary dissection (4 out of 13 nodes found positive) in a 66-year old man, bone scintigraphy showed multiple bone metastases. Treatment was started with the combined administration of an LHRH agonist and the pure antiandrogen Flutamide. Six and a half months later, bone scintigraphy was normal while serum testosterone was reduced to 10% of control and the serum concentration of the adrenal steroids was decreased by 23 to 45%. Following relapse of the disease at 12 months, more complete blockade of adrenal steroid secretion was achieved with aminoglutethimide and hydrocortisone. Stability of the disease was then observed up to the last evaluation performed in January 1990 (5 years of stable disease). Since the adrenal steroids are converted into active androgens and estrogens in peripheral tissues, including the breast, the combined therapy has the advantage of reducing the source of potentially active estrogens and androgens while blocking the action of androgens in target tissues. No side-effects other than those due to hypoandrogenicity, namely hot flushes and loss of libido and potency were observed. This well-tolerated treatment achieves complete medical castration, partial medical adrenalectomy, and neutralization of peripheral androgen action.
 ...
PMID:Complete response to combination therapy with an LHRH agonist and flutamide in metastatic male breast cancer: a case report. 227 22

Buserelin is a synthetic gonadotropin-releasing hormone (GnRH) analog which is more potent than natural GnRH. Prolonged administration of the drug produces, after a short phase of stimulation, a selective and durable inhibition of secretion of pituitary gonadotropins, resulting in medical castration. In pilot and controlled studies buserelin shows a response rate that is similar to that of diethylstilbestrol or orchiectomy in the palliative treatment of advanced prostatic cancer, but larger and better designed studies are needed before reaching definitive conclusions about the duration of response and survival. The most common adverse effects of buserelin are loss of libido and/or impotence, hot flushes and possible flare-up of prostatic carcinoma symptoms in the first week of therapy. The combination of buserelin with an antiandrogen could avoid the flare syndrome; whether the combination has advantages compared to administration of buserelin alone requires confirmation from the large randomized studies still in progress.
 ...
PMID:Buserelin in the treatment of prostatic cancer. 250 41

Five out of 6 normally-menstruating women who were treated with a potent gonadotropin-releasing hormone (Gn-RH) agonist in order to achieve medical hypophysectomy developed hot flushes despite having normal oestradiol (E2) levels. The Gn-RH agonist was administered subcutaneously for 6 days and then intranasally for a further 14 days. A dose of 2 mg of E2 benzoate was injected intramuscularly once a week for 2 consecutive weeks. This combined treatment resulted in low peripheral gonadotropin levels but normal serum E2 concentrations. Four (4) women developed mild to moderate hot flushes and there was 1 case of flushes severe enough to necessitate cessation of treatment. The flushes occurred in the second week of Gn-RH analogue treatment when the level of serum luteinizing hormone (LH) was low and the pituitary was unresponsive to provocative tests, despite the fact that the patients' E2 levels were normal (mean 250 +/- 25 pg/ml). It is suggested that neither LH pulsatility nor low peripheral E2 levels are mainly responsible for the development of hot flushes. It is possible that Gn-RH, a hypothalamic decapeptide, may play a major role or act as a mediator in the aetiology of hot flushes.
 ...
PMID:Hot flushes during Gn-RH analogue administration despite normal serum oestradiol levels. 251 68


1 2 3 4 Next >>