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20-September-2008 09:55:46 - 1 blocker Alpha-1 blockers also called alpha-adrenergic blocking agents constitute a variety of drugs which block α1-adrenergic receptors in arteries and smooth muscles. Contents 1 Indications 2 Examples of alpha blockers 3 Adverse effects and interactions 4 References 5 External links Indications These drugs may be used to treat: benign prostatic hyperplasia BPH1 Lower urinary tract symptoms Post Transurethral microwave thermotherapy TUMT and Transurethral needle ablation of the prostate TUNA procedures high blood pressure hypertension. This is not typically the drug of choice unless the patient also has BPH. symptoms of non inflammatory chronic pelvic pain syndrome, a type of prostatitis. As a side effect they may reduce blood pressure and result in lightheadedness. Examples of alpha blockers Alpha blockers include: Doxazosin2 Cardura Prazosin Minipress Phenoxybenzamine Phentolamine Regitine Tamsulosin Flomaxtra/Flomax Alfuzosin Uroxatral Terazosin Hytrin Tamsulosin is relatively selective for α1a-adrenergic receptors, which are mainly present in the prostate. Hence, it may have a more selective action in BPH with minimal effects on blood pressure. Adverse effects and interactions By reducing α1-adrenergic activity of the blood vessels, these drugs may cause hypotension low blood pressure and interrupt the baroreflex response. In doing so, they may cause dizziness, lightheadedness, or fainting when rising from a lying or sitting posture known as orthostatic hypotension or postural hypotension. For this reason, it is generally recommended that alpha blockers should be taken at bedtime. Additionally, the risk of first dose phenomenon may be reduced by starting at a low dose and titrating upwards as needed. Because these medications may cause orthostatic hypotension, as well as hypotension in general, these agents may interact with other medications that increase risk for hypotension, such as other antihypertensives and vasodilators. As discussed above, tamsulosin may have less risk for hypotension and orthostatic hypotension due to its selectivity for α1a-adrenergic receptors. On the other hand, the drug a elevates risk for floppy iris syndrome, and b might show ADRs characteristic of the sulfa related drugs. References ^ Höfner K December 1999. alpha1-Blocker therapy in the nineties: focus on the disease. Prostate Cancer Prostatic Dis. 2 S4: S9-S15. doi:10.1038/sj.pcan.4500368. PMID 12496768. ^ Yilmaz E, Batislam E, Basar MM, Tuglu D, Ferhat M, Basar H June 2005. The comparison and efficacy of 3 different alpha1-adrenergic blockers for distal ureteral stones. J. Urol. 173 6: 2010-2. doi:10.1097/01.ju.0000158453.60029.0a. PMID 15879806. External links DrugDigest - Alpha blockers RxList.com - Tamsulosin MeSH alpha-Adrenergic+Blockers v d e Receptor agonists, antagonists, and reuptake inhibitors BA/M 5-HT serotonin receptor Serotonin receptor agonist 5-HT4 Serotonin antagonist 5-HT3 Serotonin uptake inhibitor SSRI Dopamine receptor Dopamine agonist Dopamine antagonist Dopamine reuptake inhibitor Adrenergic receptor Adrenergic agonist Alpha, Beta 1/2 Adrenergic antagonist Alpha 1/2, Beta Adrenergic uptake inhibitor Histamine receptor Histamine agonist Histamine antagonist H1, H2, H3 AA GABA receptor GABA agonist GABA antagonist Glutamate receptor NMDA receptor NMDA receptor antagonist AMPA receptor Ampakine Excitatory amino acid agonist Excitatory amino acid antagonist ANS Acetylcholine receptor Cholinergic Muscarinic, Nicotinic Anticholinergic Muscarinic, Nicotinic/Ganglionic blocker/Neuromuscular-blocking drugs Acetylcholinesterase inhibitor Adrenergic receptor SANS only -- see above for details PANS Parasympathomimetic Cholinergic, Acetylcholinesterase inhibitor - Parasympatholytic Anticholinergic, Ganglionic blocker SANS Sympathomimetic Adrenergic agonist, Monoamine oxidase inhibitor - Sympatholytic Adrenergic antagonist, Alpha blocker, Ganglionic blocker v d e Adrenergic antagonists α α1 selective Doxazosin · Prazosin · Alfuzosin · Terazosin · Indoramin · Urapidil · Trimazosin · Moxisylyte · 1A Tamsulosin, Silodosin α2 selective Atipamezole · Efaroxan · Idazoxan · Yohimbine · Benzylpiperazine · Rauwolscine · Mirtazapine Non-selective α reversible Phentolamine · irreversible Phenoxybenzamine β β1 selective cardioselective Atenolol · Acebutolol · Celiprolol · Betaxolol · Bisoprolol · Esmolol · Metoprolol · Nebivolol β2 selective Butaxamine · ICI 118551 β3 selective SR 59230A Non-selective β Alprenolol · Amosulalol · Metipranolol · Nadolol · Oxprenolol · Penbutolol · Pindolol · Propranolol · Tertatolol · Timolol · Tilisolol · Sotalol Mixed α1/β Carvedilol · Labetalol · Arotinolol v d e Antihypertensives C02 and diuretics C03 Sympatholytic agents Centrally acting/antiadrenergics α2 agonist Clonidine, Guanfacine, Methyldopa imidazoline receptor agonist Moxonidine, Rilmenidine adrenergic uptake inhibitor Rescinnamine, Reserpine Ganglion-blocking/nicotinic antagonist Mecamylamine, Trimethaphan Peripherally acting/antiadrenergics α1 blockers: Prazosin Indoramin Trimazosin Doxazosin Urapidil Guanidine derivatives: Betanidine Guanethidine Guanoxan Debrisoquine Guanoclor Guanazodine Guanoxabenz Vasodilators Diazoxide hydrazinophthalazine Hydralazine, Dihydralazine, Endralazine, Cadralazine Minoxidil Nitroprusside Phentolamine Other antihypertensives serotonin antagonist Ketanserin endothelin receptor antagonist Bosentan, Ambrisentan, Sitaxsentan MAOI Pargyline THI Metirosine Diuretics Low ceiling Thiazides at DCT Bendroflumethiazide Hydroflumethiazide Hydrochlorothiazide Chlorothiazide Polythiazide Trichlormethiazide Cyclopenthiazide Methyclothiazide Cyclothiazide Mebutizide Sulfonamides Quinethazone Clopamide Chlortalidone Mefruside Clofenamide Metolazone Meticrane Xipamide Indapamide Clorexolone Fenquizone Other Mersalyl Theobromine Cicletanine osmotic Mannitol, Urea carbonic anhydrase inhibitor at PT Acetazolamide High ceiling Loop diuretic at AL Bumetanide, Furosemide, Torasemide, Ethacrynic acid Potassium-sparing at CD ESC blockers Amiloride, Triamterene aldosterone antagonists Spironolactone, Eplerenone, Potassium canrenoate, Canrenone v d e Urologicals G04 Acidifiers Ammonium chloride, Calcium chloride Urinary antispasmodics primarily antimuscarinics Darifenacin, Emepronium, Fesoterodine, Flavoxate, Imidafenacin, Meladrazine, Oxybutynin, Propiverine, Solifenacin, Terodiline, Tolterodine, Trospium For erectile dysfunction Prostaglandins E Alprostadil PDE5 inhibitors Avanafil - Sildenafil - Tadalafil - Udenafil - Vardenafil Alpha blockers Moxisylyte - Phentolamine - Yohimbine Others Apomorphine - Papaverine Other urologicals Acetohydroxamic acid, Collagen, Dimethyl sulfoxide, Magnesium hydroxide, Pentosan polysulfate, Phenazopyridine, Phenyl salicylate, Succinimide For BPH 5α-reductase inhibitors Dutasteride, Finasteride Alpha blockers α1 Alfuzosin, Doxazosin, Silodosin, Tamsulosin, Terazosin Herbals Pygeum africanum, Serenoa repens Retrieved from http://en..org/wiki/Alpha-1_blocker Categories: Alpha blockers Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Español Français Italiano עברית 日本語 This page was last modified on 16 August 2008, at 23:15
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