Alpha-Blocker (1/5): Side Effects and Contraindications
- Alpha-blocker (1/5): General pharmacology
- Alpha-blocker (2/5): Terazosin
- Alpha-blocker (3/5): Doxazosin
- Alpha-blocker (4/5): Tamsulosin
- Alpha-blocker (5/5): Alfuzosin
Review Literatur: (Chapple, 2004).
Alpha-Blocker: Mechanism of Action
Postsynaptic alpha1-blockade leads to:
- Arterial and venous vasodilation, hypotension
- Smooth muscle relaxation of the prostate, bladder neck and the urethra. Alpha-blocker improve the dynamic component of subvesical obstruction due to benign prostatic hyperplasia (BPH).
- Positive effect on the lipid metabolism by lowering cholesterol and triglycerides
- Following sub-types of alpha1-receptors are known: A, B, D and L. Type alpha1A appears to be most important in the prostate for the inhibition of subvesical obstruction.
Side Effects of Alpha-Blocker
- Hypotension, orthostatic syncope, reflex tachycardia
- Stuffy nose
- Retrograde ejaculation
- Tachyphylaxis in the treatment of hypertension due to volume retention and peripheral edema.
- Dizziness, weakness
- Overall rate of side effects is between 10–30%, selective alpha1A-blocker have a reduced cardiovascular side effect rate.
Contraindications of Alpha-Blocker
Urological Contraindications:
Conservative treatment of BPH is not indicated, if surgical treatment is imperative: chronic urinary retention with renal failure, recurrent hematuria due to prostatic enlargement, recurrent infections and bladder stones.
Cardiac Contraindications:
Hypotension, mechanical heart failure (valvular, pulmonary embolism, pericarditis), congestive heart failure.
Other contraindications:
Alpha-blocker are contraindicated for cataract surgery, as this may cause an intraoperative floppy iris syndrome.
| Pharmacology | Index | Terazosin |
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References
- Chapple 2004 CHAPPLE, C. R.:
- Pharmacological therapy of benign prostatic hyperplasia/lower urinary
tract symptoms: an overview for the practising clinician.
In: BJU Int
94 (2004), Nr. 5, S. 738–44
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Dr. med. Dirk Manski
man...@urologielehrbuch.de