Antiadrenergic agents ( Peripherally acting )include-

Reserpine, Guanithidine monosulphate, Guandrel sulfate, ( Alpha-1- blockers), Prazosin,Terazosin, Doxazosin, Tamsulosin, Silodosin, Alfuzosin Hcl

Refer - Prazosin

Orthostatic hypotension potentiated by beta-blockers, calcium channel blockers,diuretics. Useful combination with antihypertensives.

Hypertension

 Antiadrenergic agents ( Peripherally acting )include-

Reserpine, Guanithidine monosulphate, Guandrel sulfate, ( Alpha-1- blockers), Prazosin,Terazosin, Doxazosin, Tamsulosin, Silodosin, Alfuzosin Hcl

Refer - Prazosin

New Drugs Approved by (DCI) Drug Controller  GENERAL -  India  For Marketing                                                                                                     (Ref- IDMA Publication)

Name of Drug                   Indication                             Date of Approval

Adverse Reactions-
               

Alpha- 1 - adrenergic Blocker Adverse Reactions

TERAZOSIN-  

CARDIOVASCULAR -              Palpitations  4% , Postural hypotenson 1%,
                                                   Tachycardia  2 %  Arrhythmia >1%,
                                                   Vasodilation > 1%

CNS-                                          Dizziness  20% Asthenia 11%.
                                                    Somnolence  5%, Paresthesia  3%             
                                                  Nervousness 2%,   Depression 0.3%
                                                  

DERMATOLOGIC -                  Pruritus > 1%, Rash > 1%, Sweating > 1%

GI -                                            Nausea 4% , Vomiting >1% Dry mouth > 1%
                                                   Diarrhoea > 1% Constipation> 1%
                                                  Abdominal discomfort >1% Flatulence > 1%
                                                  Dyspepsia > 1%

GU-                                         Impotence  1% Urinary frequency >1%
                                                Incontinence > 1%

MUSCULOSKELETAL -          Shoulder neck/back extremity pain 4%
                                               Arthiritis, joint disoder muscle pain  > 1%
                                                Arthalgia > 1%

RESPIRATORY -                    Nasal congestion 6%  Dyspnea 3% 
                                                  Sinusitis 3% Epistaxis > 1%

SPECIAL SENSES-               Blurred vision 2% Conjuntivitis >1% 
                                                Abnornal vision > 1% Tinnitus > 1%

MISCELLANEOUS -             Headache  16%  Peripheral edema 6%
                                              Edema 1% Fever > 1%

Hypersens.

Special precautions:

Elderly,pregnancy,lactation,

syncope and first dose effect,

prostatic cancer(may be confused with BHP),orthostatic hypotension.

Indications:

Hypertension

Dosage:

Adjust dose and dosage interval(12 to 24 hours) individually. Initial- 1 mg at bed time for all patients.

Do not exceed this dose.

Subsequent doses- recommended dose is 1 to 5 mg daily. Some patients may benefit from doses as high as 20 mg/day.

Monitor blood pressure at the end of dosing interval to be sure that control is maintained.

EVIDENCE BASED MEDICINE

Management of Benign Prostatic Hypertrophy (BPH)

Comparative effectiveness of various interventions

Beneficial

1. Aplha blockers (parzosin, alfuzosin, indoramin, terazosin, doxazosin,tamsulosin)

2. 5-alpha -reductase inhibitors (e.g. finastreride)

3. Transureythral resection (TURP)

4. Transurethral microwave thermotherapy (TUMT)

5. Trnasurethral needle ablation (TUNA)

Unknown effectiveness

1. TURP versus less invasive techniques

KEY POINTS

1. Randomised controlled trials (RCTs) have found that both alpha-blockers and 5-alpha-reductase-inhibitors are more effective than placebo in improving lower urinary tract symptoms in men with BPH.

2. One trial found that alpha-blockers (e.g.prazosin ) were more effective than 5-alpha- reductase inhibitors (finasteride) in men not selected for having large prostrates.

3. Neither drug has been compared directly with surgical treatment

4. There is limited evidence from one trial that TURP is more effective than watchful waiting in improving symptoms and reducing complications, and does not increase the risk of ercetile dysfunction or incontinuence.

5. TURP has not yet been adequately compared with medical treatments or with newer less invasive techniques.

6. TUMT is more effective than sham treatment at reducing symptoms. There is no difference beween TURP and TUMT with regard to short term relief

7. One trial found that TURP was more effective than TUNA in men with BPH.

Antiadrenergic agents ( Peripherally acting )include-

Reserpine, Guanithidine monosulphate, Guandrel sulfate, ( Alpha-1- blockers), Prazosin,Terazosin, Doxazosin, Tamsulosin, Silodosin, Alfuzosin Hcl

Refer - Prazosin

Not available

Contraindicated for use during pregnancy and lactation