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20-September-2008 09:55:49 - Prazosin Prazosin Systematic IUPAC name 4-4-amino-6,7-dimethoxy-quinazolin-2-yl piperazin-1-yl-2-furylmethanone Identifiers CAS number 19216-56-9 ATC code C02CA01 PubChem 4893 DrugBank APRD00020 Chemical data Formula C19H21N5O4 Mol. mass 383.401 g/mol Pharmacokinetic data Bioavailability ? Protein binding 97% Metabolism ? Half life 2-3 hours Excretion ? Therapeutic considerations Pregnancy cat. ? Legal status POMUK Routes Oral Prazosin, trade names Minipress,Vasoflex and Hypovase, is a sympatholytic drug used to treat high blood pressure hypertension. It belongs to the class of alpha-adrenergic blockers, which lower blood pressure by relaxing blood vessels. Specifically, prazosin is selective for the alpha-1 receptors on vascular smooth muscle. These receptors are responsible for the vasoconstrictive action of norepinephrine, which would normally raises blood pressure. By blocking these receptors, prazosin reduces blood pressure. Contents 1 Use 2 Side effects 3 Prazosin in scorpion stings 4 References Use Prazosin is orally active and has a minimal effect on cardiac function due to its alpha-1 receptor selectivity. Unlike other less selective alpha blockers that also block presynaptic alpha-2 receptors, it doesn't prevent inhibition of norepinephrine release. Uninhibited norepinephrine release usually causes an increased reflex tachycardia through the sympathetic baroreflex response that, in turn, increases cardiac output. However, when blood pressure drops, the body does not increase cardiac output to compensate for the loss in pressure when a person takes prazosin.citation needed The antihypertensive characteristics of prazosin make it a second-line choice for the treatment of high blood pressure.1 Prazosin is also useful in treating urinary hesitancy associated with prostatic hyperplasia by blocking alpha-1 receptors, which control constriction of both the prostate and ureters. Although not a first line choice for either hypertension or prostatic hyperplasia, it is an excellent choice for patients who present with both problems concomitatntly.1 This medication has shown to be effective in treating severe nightmares in children, associated with PTSD symptoms.citation needed Also veterans have been treated successfully at the Oregon VA for sleep disturbance related to PTSD. Doses are lower for this purpose than for control of blood pressure.citation needed Side effects Side effects of prazosin include orthostatic hypotension, syncope, and nasal congestion. The orthostatic hypotension and syncope are associated with the body's poor ability to control blood pressure without active alpha-adrenergic receptors. Patients on prazosin should be told not to stand up too quickly, since their poor baroreflex may cause them to faint as all their blood rushes to their feet. The nasal congestion is due to dilation of vessels in the nasal mucosa. One phenomenon associated with prazosin is known as the first dose response, in which the side effects of the drug, especially orthostatic hypotension, are especially pronounced after the first dose. Another common side effect of prazosin and doxazosin is priapism.23 Prazosin in scorpion stings Since 1983 prazosin has revolutionized the management of severe scorpion stings.4 References ^ a b Shen, Howard 2008. Illustrated Pharmacology Memory Cards: PharMnemonics. Minireview, 13. ISBN 1-59541-101-1. ^ Bhalla AK, Hoffbrand BI, Phatak PS, Reuben SR October 1979. Prazosin and priapism. Br Med J 2 6197: 1039. PMID 519276. ^ Avisrror MU, Fernandez IA, Sánchez AS, García-Pando AC, Arias LM, del Pozo JG January 2000. Doxazosin and priapism. J. Urol. 163 1: 238. PMID 10604360. ^ Bawaskar HS, Bawaskar PH Jan 2007. Utility of scorpion antivenin vs prazosin in the management of severe Mesobuthus tamulus Indian red scorpion envenoming at rural setting. J Assoc Physicians India 55: 14-21. PMID 17444339. 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 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 Tablets This pharmacology-related article is a stub. Retrieved from http://en..org/wiki/Prazosin Categories: Alpha blockers | Furans | Quinazolines | Pharmacology stubsHidden categories: All articles with statements | Articles with statements since August 2008 | Articles with statements since February 2008 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 Français Hrvatski 日本語 This page was last modified on 16 August 2008, at 22:57
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