The use of ketoconazole in the emergency management of disseminated intravascular coagulation due to metastatic prostatic cancer

Franklin C. Lowe, W. J. Somers

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

The disseminated intravascular coagulation syndrome is an untoward side effect of metastatic adenocarcinoma of the prostate. In addition to appropriate replacement of blood, platelets and clotting factors, prompt treatment of the prostatic carcinoma is required to correct the underlying pathophysiological defect. Ketoconazole is the ideal method for hormonal manipulation for patients with life-threatening complications of prostatic carcinoma (disseminated intravascular coagulation and acute paraparesis/paraplegia) because of its prompt onset of action in decreasing circulating concentrations of androgens to castrate levels. Serum testosterone levels are castrate within 48 hours of the initiation of therapy with ketoconazole as opposed to a minimum of 10 to 14 days with estrogens. A patient with spontaneous bleeding from disseminated intravascular coagulation was treated with 400 mg. ketoconazole every 8 hours and bleeding stopped within 48 hours. Ketoconazole is particularly valuable when a prompt therapeutic response is needed and orchiectomy is contraindicated because of bleeding diathesis (as in dissseminated intravascular coagulation), delay in histological confirmation (as in acute paraparesis/paraplegia) or patient reluctance to undergo castration.

Original languageEnglish (US)
Pages (from-to)1000-1002
Number of pages3
JournalJournal of Urology
Volume137
Issue number5
StatePublished - 1987
Externally publishedYes

Fingerprint

Ketoconazole
Disseminated Intravascular Coagulation
Prostatic Neoplasms
Emergencies
Paraparesis
Paraplegia
Hemorrhage
Carcinoma
Blood Coagulation Factors
Orchiectomy
Castration
Disease Susceptibility
Blood Coagulation
Androgens
Testosterone
Prostate
Estrogens
Adenocarcinoma
Therapeutics
Blood Platelets

ASJC Scopus subject areas

  • Urology

Cite this

The use of ketoconazole in the emergency management of disseminated intravascular coagulation due to metastatic prostatic cancer. / Lowe, Franklin C.; Somers, W. J.

In: Journal of Urology, Vol. 137, No. 5, 1987, p. 1000-1002.

Research output: Contribution to journalArticle

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