[1], Another mechanism involves a change in the hair cycle. Works with hormones to stop stimulating growth of tumors. Assess for the mentioned cautions and contraindications (e.g. Inhibiting DNA production in cells that depend on certain natural metabolites to produce their DNA. How soon after therapy should blood tests be done to monitor bone marrow function? The benefit of sunitinib remained statistically significant when stratified for a multitude of prespecified baseline factors. Laser hair removal is an effective method of hair removal on hairs that have color. to establish baseline data before drug therapy begins, to determine effectiveness of therapy, and to evaluate for occurrence of any adverse effects associated with drug therapy. CPA is taken by mouth one to three times per day. Smells good. 6-deschloro-6,7-epoxy cyproterone [15423-97-9] (6). Microsoft is quietly building a mobile Xbox store that will rely on Activision and King games. [44][45], Higher dosages of CPA are used in combination with an estrogen specifically at doses of 25 to 100mg/day cyclically in the treatment of hirsutism in women. Approach to Internal Medicine is meant to be a practical field guide. WebWe would like to show you a description here but the site wont allow us. In more traditional antineoplastic chemotherapy, normal cells are also affected. WebLucretia Mott (born January 3, 1793) was an American Quaker, abolitionist, women's rights activist, and social reformer.This autographed photograph of Mott was taken by the Philadelphia-based photographer Frederick Gutekunst around the 1870s, and is in the collection of the National Woman's Party.The image was twice published in issues of The Administer medication according to scheduled protocol and in combination with other drugs as indicated to improve effectiveness. What We Like. Chip designs are dynamically modified to integrate nonuniform distributions of highly localized individual nanostructures. Mitotic inhibitors alter the M phase of the cell cycle. Only 50 cases of congenital hypertrichosis lanuginosa have been recorded since the Middle Ages,[3] and fewer than 100 cases of congenital generalized hypertrichosis have been documented in scientific publications and by the media. Chip designs are dynamically modified to integrate nonuniform distributions of highly localized individual nanostructures. Price at time of publish: $25. In the primary endpoint of this study, median time to tumor progression (TTP) was more than four-fold longer with sunitinib (27 weeks) compared with placebo (six weeks, P<.0001). LECTURE NOTES For Health Science Students Pharmacology, Apuntes Resumen Farmacologa Preguntas de aplicacin MUY BUENO, Essentials of medical pharmacology tripathie, Satoskar Bhandarker cology ilovepdf compressed, Special Thanks to: The //Iustrators The Book Reviewers. 3. These agents are only specific to cancer cells and spare the healthy cells its devastating effects. Some hormones are used to block the release of gonadotropic hormones in breast or prostate cancer if the tumors are responsive to gonadotropic hormones. [14] It has been recommended as a second-line therapy for patients whose tumors develop mutations in c-KIT that make them resistant to imatinib, or who the cannot tolerate the drug.[15][16]. [55] But such doses also show lower effectiveness in the treatment of acne in men. The incidence of grade 3 (severe) fatigue was similar between the two groups, and no grade 4 fatigue was reported. Selective oxidation of the C6=C7 olefin with benzoyl peroxide gives the epoxide, i.e. [121] For this reason, CPA has mostly been superseded by GnRH agonists in the treatment of precocious puberty. WebA nanoscale fiducial marker system combined with automated microscopy and computer vision algorithms enables high-throughput nanomaterial characterization and device manufacturing. It is also used to treat breast cancer and endometrial cancer, and has been used in birth control. Drugs boost the immune system in its efforts to combat the abnormal cells and do not necessarily assume its roles. [33], Between April 2009 and May 2011 Pfizer has reported unsuccessful late-stage trials in breast cancer, metastatic colorectal cancer, advanced non-small-cell lung cancer, and castration-resistant prostate cancer. * In addition, T/F types MCQs are given at the end of every chapter, & two additional chapters at the end of book 2. [32], One record in history concerning congenital hypertrichosis lanuginosa is the hairy family of Burma, a four-generational pedigree of the condition. 2011 Oct;89(4):295-302.PMID: 21789637) The only potential issue here is that DHEA is an androgen and a precursor to testosterone, so taking too much DHEA (for YOU) can cause the appearance of secondary male sexual characteristics in women e.g., acne, growth of excess body and facial hair, loss of scalp hair. WebCompletely Bare Don't Grow There Body Moisturizer and Hair Growth Inhibitor - 6.7 fl oz $10.99 When purchased online. WebTony Stark is a genius inventor and billionaire industrialist, who suits up in his armor of cutting-edge technology to become the super hero Iron Man. [47][51], The efficacy of the combination of an estrogen and CPA in the treatment of hirsutism in women appears to be due to marked suppression of total and free androgen levels as well as additional blockade of the androgen receptor. Antimetabolites are S phase-specific. The resulting hair growth is known as malignant down. WebClinico - Basic PHARMACOLOGY has been written in view of changing examination pattern from subjective type to MCQ type, esp.in Karachi. [16], Hirsutism is both congenital and acquired. [6], In November 2010, Sutent gained approval from the European Commission for the treatment of 'unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumors with disease progression in adults'. [58], CPA has also been used as a puberty blocker and hence as an antiandrogen and antiestrogen to suppress puberty in transgender youth, although GnRH modulators are primarily used for this purpose. While their action is intended to target abnormal cells, normal cells are also affected. In a phase III study, median progression-free survival was significantly longer in the sunitinib group (11 months) than in the IFN group (five months), a hazard ratio of 0.42. Sunitinib is marketed by Pfizer as Sutent, and is subject to patents and market exclusivity as a new chemical entity until February 15, 2021. dactinomycinD. Evidence-based guidelines for the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). [1][7], Congenital forms of hypertrichosis are caused by genetic mutations, and are extremely rare, unlike acquired forms. Common side effects of high-dose CPA in men include gynecomastia (breast development) and feminization. WebBikini waxing is the removal of pubic hair using a special wax, which can be hot or cold, that adheres to hairs and pulls them out when the wax is removed quickly from the skin, usually with a cloth strip. While overseeing a manufacturing plant in a foreign country, Stark was She is currently furthering her studies and is seriously considering being a student as her profession. [4], Like RCC, GIST does not generally respond to standard chemotherapy or radiation. In general, students identify their role in patient care either by trial & error, or through the beneficence of more senior students, residents or consultants. Chat with a Beauty Consultant. [5], Sunitinib was relatively well tolerated. In Stock. WebBikini waxing is the removal of pubic hair using a special wax, which can be hot or cold, that adheres to hairs and pulls them out when the wax is removed quickly from the skin, usually with a cloth strip. 3, Hagerstown, MD 21742; phone 800-638-3030; fax 301-223-2400. [23], Acquired generalized hypertrichosis may be caused by cancer. GI: nausea, vomiting, anorexia, diarrhea, mucous membrane deterioration, hepatic toxicity. WebClinico - Basic PHARMACOLOGY has been written in view of changing examination pattern from subjective type to MCQ type, esp.in Karachi. Need help with your assignment essay? [23][24] CPA is also marketed in combination with estradiol valerate as Climen, Climene, Elamax, and Femilar. [68][41] Few quantitative data are available on many of the potential side effects of CPA. A lot of unwanted crossovers happen when the dye itself creeps onto the ears, forehead, and neck. [1] Hypertrichosis involves this same type of switching, but in areas that do not normally produce terminal hair. Contraindications. WebA DNA test is completely safe and the genetic information is accurate. Please visit our nursing test bank page for more NCLEX practice questions. Completely Bare Don't Grow THERE Body Moisturizer & Hair Inhibitor. [17] If caused by increased levels of androgens, it can be treated with medications that reduce androgen levels. [16] Increases in androgen (male hormone) levels are the primary cause of most hirsutism cases. [25][26] This was overturned in February 2009 after pricing changes and public responses. Altrovandus dubbed them the Ambras family, after Ambras Castle near Innsbruck, where portraits of the family were found. [119] Reduced sexual desire and erectile function occurs with CPA by the end of the first week of treatment, and becomes maximal within three to four weeks. Patients in the study were allowed to receive other therapies once they had progressed on their study treatment. In this study, 34% of sunitinib patients reported any grade of fatigue, compared with 22% for placebo. [43] CPA is one of the most commonly used medications in the treatment of hirsutism, hyperandrogenism, and polycystic ovary syndrome in women throughout the world. Do your research and use credible sources. Enter the email address you signed up with and we'll email you a reset link. Sunitinib also inhibits CD117 (c-KIT),[13] the receptor tyrosine kinase that (when improperly activated by mutation) drives the majority of gastrointestinal stromal cell tumors. [72][73][74][75][76][77][78] It is used orally at a dosage of 10 to 100mg/day and by intramuscular injection at a dosage of 300mg once every 4weeks. Do your research and use credible sources. Format of this book Topics of the modules are carefully selected according the needs of undergraduate surgical students & postgraduate general surgery trainees. If all feels right, apply the wax against the direction of hair growth, let sit until it hardens, and go to town. You can download the paper by clicking the button above. Dr. Muhammad Shamim 21st January, 2009. [27] Therefore, sunitinib is recommended as a first-line treatment option for people with advanced and/or metastatic renal cell carcinoma who are suitable for immunotherapy and have an ECOG performance status of 0 or 1 (i.e. Causing a mutant DNA moleculeB. A 10 week cycle should be considered a bare minimum however, with 12 to 14 weeks allowing the most benefits thanks to the longer half life of this 4 ester combination. [23][24][186][187], It has been said that the lack of availability of CPA in the United States explains why there are relatively few studies of it in the treatment of androgen-dependent conditions such as hyperandrogenism and hirsutism in women. [34][39][64][65][66][67] It is almost always combined with an estrogen, such as ethinylestradiol, when it is used in the treatment of PCOS in women. [23], CPA is widely available throughout the world, and is marketed in almost every developed country,[185] with the notable major exceptions of the United States and Japan. We got you covered! [citation needed], Sunitinib adverse events are considered somewhat manageable and the incidence of serious adverse events low. [189][190] In any case, CPA has been described as a "first-generation" progestin similarly to closely related progestins like chlormadinone acetate, medroxyprogesterone acetate, and megestrol acetate. Answer: C. keloid formation on previous IV site. This is not particularly efficient & diminishes the potential for learning & fun. [5][9], The most common adverse events associated with sunitinib therapy are fatigue, diarrhea, nausea, anorexia, hypertension, a yellow skin discoloration, hand-foot skin reaction, and stomatitis. 3. EchinaceaC. Affordable. A footnote in Microsoft's submission to the UK's Competition and Markets Authority (CMA) has let slip the reason behind Call of Duty's absence from the Xbox Game Pass library: Sony and However, you will quickly learn to identify where to fit in the different aspects of the patients story. Clinical examination techniques are described in step-by-step detail, with aids of photographs. [143][49] Some of the side effects of CPA can be improved or fully prevented if it is combined with an estrogen to prevent estrogen deficiency. Education, support, and referrals to appropriate specialists are important. The underbanked represented 14% of U.S. households, or 18. WebOur Commitment to Anti-Discrimination. Your experience with history taking and physical examination will grow and expand, and the steps of clinical reasoning will soon begin with the first moments of the patient encounter: identifying problem symptoms and abnormal findings ; linking findings to an underlying process of pathophysiology or psycho-pathology; and establishing and testing a set of explanatory hypotheses. About this item. 1. WebA nanoscale fiducial marker system combined with automated microscopy and computer vision algorithms enables high-throughput nanomaterial characterization and device manufacturing. [2] Depilation methods, such as trimming, shaving, and depilatories, remove hair to the level of the skin and produce results that last several hours to several days. Use has been somewhat limited because neoplastic cells rapidly develop resistance to these agents. At that time, patients receiving placebo were offered to switch over to sunitinib. WebBikini waxing is the removal of pubic hair using a special wax, which can be hot or cold, that adheres to hairs and pulls them out when the wax is removed quickly from the skin, usually with a cloth strip. Affordable. [136][138], Contraindications of CPA include:[139][140][52], When CPA is used in combination with an estrogen, contraindications for birth control pills should also be considered. This is a relatively unique condition with a high incidence and significant mortality, but one which is both under-and overdiag-nosed in clinical practice. Sunitinib reduced the relative risk of disease progression or death by 67%, and the risk of death alone by 51%. These drugs act on and kill altered human cells. DePaul University does not discriminate on the basis of race, color, ethnicity, religion, sex, gender, gender identity, sexual orientation, national origin, age, marital status, pregnancy, parental status, family relationship status, physical or mental disability, military status, genetic information or other status protected Option B is for antimetabolites. [1] Hypertrichosis can be either congenital (present at birth) or acquired later in life. Your ability to gather a sensitive and nuanced history and to perform a thorough and accurate examination deepens your patient relationships, focuses your patient assessment, and sets the direction of your clinical thinking. Genetic abnormalities are passed along daughter cells, eventually producing a. Consequently, original cell characteristics are lost. Respiratory: pulmonary toxicity, interstitial pneumonitis. Plan for rest periods because fatigue and weakness are common effects of the drug. 2011 Oct;89(4):295-302.PMID: 21789637) The only potential issue here is that DHEA is an androgen and a precursor to testosterone, so taking too much DHEA (for YOU) can cause the appearance of secondary male sexual characteristics in women e.g., acne, growth of excess body and facial hair, loss of scalp hair. 7. Others may block androgen-receptor sites directly. [8], In summer 2019, at least 17 Spanish children have developed so-called werewolf syndrome, Spain's health ministry has said. Causing a mutant DNA molecule. Patients receiving sunitinib had a better quality of life than IFN. 10. Dose reductions were required in 50% of the patients studied in RCC in order to manage the significant toxicities of this agent. Ataxia refers to poor coordination and telangiectasia to small dilated blood vessels, both of which are hallmarks of the disease. California voters have now received their mail ballots, and the November 8 general election has entered its final stage. Mechanism of action given in a concept - making, easy, arrow - form. Option D is for hormones and hormone modulators. Organic Cheese only from brands that grow their own cows and do not use any kind of hormones to growth (or fatten). Academia.edu no longer supports Internet Explorer. [17] In 1965, the antiandrogenic effects of CPA were discovered. Blocking the stimulation of growing cancer cells that are sensitive to the presence of that hormone. MGA is generally formulated alone, although it has been combined [53][54][55][56] It can also halt further progression of scalp hair loss in men. Hair in hypertrichosis is usually longer than expected[7] and may consist of any hair type (lanugo, vellus, or terminal). Pharmacological effects described under subheads of systems & organs. About 83% of sunitinib patients experienced a treatment-related adverse event of any severity, as did 59% of patients who received placebo. A. hypomagnesemiaB. Calcif Tissue Int. this nice numerical analysis to study differential equation. [5], Among the secondary endpoints, the difference in progression-free survival (PFS) was similar to that in TTP (24 weeks vs six weeks, P<.0001). WebThe team at Legacy kept it simple. [23][24] Sutent is one of the most expensive drugs widely marketed. Either breaking up DNA links or preventing DNA synthesis. AT affects many parts of the body: CPA can also be used to reduce sex drive in individuals with inappropriate sexual behaviors, such as people with intellectual disability and dementia. Recommended resources and reference books. Other therapeutic options in this setting are pazopanib (Votrient), sorafenib (Nexavar), temsirolimus (Torisel), interleukin-2 (Proleukin), everolimus (Afinitor), bevacizumab (Avastin), and aldesleukin. Therapeutic Action. $9.89. [citation needed] The medication is approved in more than 20countries for this indication and is predominantly employed in Canada, Europe, and the Middle East. WebClinico - Basic PHARMACOLOGY has been written in view of changing examination pattern from subjective type to MCQ type, esp.in Karachi. [69], CPA is widely used as an antiandrogen and progestogen in feminizing hormone therapy for transgender women. Prior to sunitinib, patients had no therapeutic option once they became resistant to imatinib. [199] CPA is not satisfactorily effective as topical antiandrogen, for instance in the treatment of acne. While overseeing a manufacturing plant in a foreign country, Stark was However, they are also toxic to human cells. WebSonic the Hedgehog (, Sonikku za Hejjihoggu?, born 23 June) is the titular main protagonist of the Sonic the Hedgehog series and Sega's mascot. Sunitinib inhibits cellular signalling by targeting multiple receptor tyrosine kinases (RTKs). [1][13] It can also produce weak cortisol-like effects at very high doses. [13] It has near-complete oral bioavailability, is highly and exclusively bound to albumin in terms of plasma protein binding, is metabolized in the liver by hydroxylation and conjugation, has 15-hydroxycyproterone acetate (15-OH-CPA) as a single major active metabolite, has a long elimination half-life of about 2 to 4days regardless of route of administration, and is excreted in feces primarily and to a lesser extent in urine. Short & long questions * Format of the book adopted is such that any short or long question in Pharmacology will be answered. [12] Patients with mRCC and sunitinib-induced hypertension had better outcomes than those without treatment-induced HTN (objective response rate: 54.8% vs 8.7%; median PFS: 12.5 months, 95% confidence interval [CI] = 10.9 to 13.7 vs 2.5 months, 95% CI = 2.3 to 3.8 months; and OS: 30.9 months, 95% CI = 27.9 to 33.7 vs 7.2 months, 95% CI = 5.6 to 10.7 months; P < .001 for all). [100][101] A dosage range of oral CPA of 100 to 300mg/day is used in the treatment of prostate cancer, but generally 150 to 200mg/day oral CPA is used. CPA is relatively safe in acute overdose. [69][70][71] Climen was the first product for use in menopausal hormone therapy containing CPA to be marketed. A 10 week cycle should be considered a bare minimum however, with 12 to 14 weeks allowing the most benefits thanks to the longer half life of this 4 ester combination. All hypertrichosis, congenital or acquired, can be reduced through hair removal. She travelled around Europe, living in court and appearing before the nobility in cities such as London and Paris. Three groups of drugs are cancer cell-specific: protein tyrosine kinase inhibitors, epidermal growth factor inhibitor, and proteasome inhibitor. In addition, sunitinib binds other receptors. Academia.edu no longer supports Internet Explorer. A. View the article. If any risks are seen in the DNA test results, genetic counseling is available to discuss them and any needed medical care. [5] Courtesy of Amazon. Hypertrichosis can be either congenital (present at birth) or acquired later in life. 5. [79][80] Studies have found that 10, 25, and 50mg/day CPA in combination with estrogen all result in equivalent and full testosterone suppression in transgender women. I have tried to capture those core behaviors that define clinical excellence & will have prolonged applicability, even in a technology driven world. Keep the dye where it belongs: on your hair. If you take a bulking stack like this for just 60 days, you can expect to gain upwards of 25-30 pounds of muscle (at the bare minimum), especially if your diet and workout routine are good. Important & relevant points in history taking are given in each module with an emphasis to formulate a working diagnosis before clinical examination. [170] CPA was first approved for medical use in 1973 in Europe under the brand name Androcur. [140][147] For comparison, the dose of CPA used in birth control pills is 2mg/day. Options A, B, and D, may be a sign of hepatic and renal toxicity. Perform a thorough physical assessment (other medications taken, orientation and reflexes, vital signs, bowel sounds, etc.) WebDec. [57][58][54][55][61][62][63] In addition, lower dosages of CPA, such as 25mg/day, have been found to be better-tolerated in men. It has been hypothesized that this could be due to facial hypertrichosis. View On Ulta. The dehydrogenation of 17-hydroxyprogesterone acetate [302-23-8] (1) with chloranil (tetrachloro-p-benzoquinone) gives a compound that has been called melengestro acetate [425-51-4] (2). [8] Extensive hypertrichosis carries an emotional burden and can cause cosmetic embarrassment; however, some people attempt no treatments because they say it defines who they are. At which stage of cell cycle is alkylating agent specific? [34], CCN(CC)CCNC(=O)c1c(c([nH]c1C)/C=C\2/c3cc(ccc3NC2=O)F)C, InChI=1S/C22H27FN4O2/c1-5-27(6-2)10-9-24-22(29)20-13(3)19(25-14(20)4)12-17-16-11-15(23)7-8-18(16)26-21(17)28/h7-8,11-12,25H,5-6,9-10H2,1-4H3,(H,24,29)(H,26,28)/b17-12-, as salt:InChI=1S/C22H27FN4O2.C4H6O5/c1-5-27(6-2)10-9-24-22(29)20-13(3)19(25-14(20)4)12-17-16-11-15(23)7-8-18(16)26-21(17)28;5-2(4(8)9)1-3(6)7/h7-8,11-12,25H,5-6,9-10H2,1-4H3,(H,24,29)(H,26,28);2,5H,1H2,(H,6,7)(H,8,9)/b17-12-;/t;2-/m.0/s1, BMJ 31-Jan-2009 "NICE and the challenge of cancer drugs" p271, Learn how and when to remove this template message, https://www.tga.gov.au/resources/prescription-medicines-registrations/sunitinib-msn-sunitinib-malate-50-mg-hard-capsule-bottle-accelagen-pty-ltd, "FDA approves new treatment for gastrointestinal and kidney cancer", "Phase II Trial of Sunitinib (SU011248) in Patients With Recurrent or Inoperable Meningioma", "Pfizer Scores New Approval for Sutent in Europe", FDA approves Sutent for rare type of pancreatic cancer, http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confID=55&abstractID=32895, "Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma", Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. [106][108][107] The combination results in suppression of testosterone levels into the castrate range, which normally cannot be achieved with CPA alone. [63] The male rat pups had been feminized, and this resultant finding constituted the discovery of the powerful antiandrogenic activity of CPA. Price at time of publish: $25. 9. short QT syndromeC. To browse Academia.edu and the wider internet faster and more securely, please take a few seconds toupgrade your browser. When it was first published, this first-year chemistry text revolutionized the teaching of chemistry by presenting it in [45] CPA at a dosage of 50mg/day in combination with 100g/day transdermal estradiol patches has been found to be effective in the treatment of hirsutism similarly to the combination of CPA with ethinylestradiol. It was seen that the overall survival, progression free survival and drug adherence were significantly higher in the patients who received Sunitinib on the alternative schedule. [41] High-dose CPA alone likewise has been found to improve symptoms of acne by 75 to 90% in women. Enter the email address you signed up with and we'll email you a reset link. Reacting this with diazomethane results in a 1,3-dipolar addition reaction at C1C2 of the double bond of the steroid system, which forms a derivative of dihydropyrazole, CID:134990386 (4). Early studies have shown single-agent efficacy in a number of different areas. A. G1 phaseB. 3 weeks afterD. [25][28] This was reportedly due to concerns about breast tumors observed with high-dose pregnane progestogens in beagle dogs as well as concerns about potential teratogenicity in pregnant women. [7] In May 2011, the USFDA approved Sunitinib for treating patients with 'progressive neuroendocrine cancerous tumors located in the pancreas that cannot be removed by surgery or that have spread to other parts of the body (metastatic)'.[8]. To browse Academia.edu and the wider internet faster and more securely, please take a few seconds toupgrade your browser. Adverse events were generally moderate and easily managed by dose reduction, dose interruption, or other treatment. Bear in mind that during the interview this information will not spring forth in this order! [44][45][52], CPA has been found to be effective in the treatment of acne in males, with marked improvement in symptoms observed at dosages of 25, 50, and 100mg/day in different studies. WebPassword requirements: 6 to 30 characters long; ASCII characters only (characters found on a standard US keyboard); must contain at least 4 different symbols; Those who have a checking or savings account, but also use financial alternatives like check cashing services are considered underbanked. to prevent metastasis of neoplasms. Viva * Each drug or group of drugs has been discussed in appropriate subheadings with numbering of matter, which will ensure better answering in Viva. [7] The excess can be in the form of excessive length or density and may consist of any hair type (lanugo, vellus, or terminal). [29] Four of his seven children were also afflicted with hypertrichosis and painted. [32], CPA is used as an antiandrogen to treat androgen-dependent skin and hair conditions such as acne, seborrhea, hirsutism (excessive hair growth), scalp hair loss, and hidradenitis suppurativa in women. Arrange for blood tests before, periodically during, and for at least 3 weeks after therapy to monitor bone marrow function to aid in determining the need for a change in dose or discontinuation of the drug. Treatment of a variety of tumors and leukemias. These drugs can work by affecting cell survival or by boosting the immune system in its efforts to combat the abnormal cells. $9.89. Suggestions Any suggestion for the improvement of this book will be acknowledged with thanks. These drugs have potentially adverse effects which limit their usefulness in patients with pre-existing disease and those who are debilitated. WebDownload scientific diagram | Exogenous cyanide induces blast resistance in intact Nipponbare plant. 3, Hagerstown, MD 21742; phone 800-638-3030; fax 301-223-2400. [1][4][10], CPA, also known as 1,2-methylene-6-chloro-17-acetoxy-6-progesterone or as 1,2-methylene-6-chloro-17-hydroxypregna-4,6-diene-3,20-dione acetate, is a synthetic pregnane steroid and an acetylated derivative of 17-hydroxyprogesterone.