A 68-year-old man with metastatic prostate adenocarcinoma (PSA 187 ng/mL) initiates continuous GnRH analog therapy. Vital signs are stable: BP 138/82, HR 76, RR 16, temp 37°C. The oncologist warns about transient testosterone elevation before pituitary downregulation occurs. Serum testosterone is currently 650 ng/dL. No gynecomastia is present. Which medication was most likely prescribed to address the initial testosterone surge and prevent clinical flare?

  1. A)LeuprolideGABARITO
  2. B)Finasteride
  3. C)Spironolactone
  4. D)Clomiphene
  5. E)Flutamide

Explicação

Continuous leuprolide initially stimulates pituitary gonadotropin release, causing a flare in testosterone, but then downregulates GnRH receptors and suppresses LH and FSH. That biphasic pattern is classic for continuous GnRH agonist therapy in prostate cancer... Ver explicação completa e trilha adaptativa →

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