Benign Prostatic Hyperplasia – Prostate Cancer – Prostatitis

Archive for the ‘Drugs: α-blockers’ Category

UroXatral: Drug for Treatment of BPH

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Trade Name Drug: UroXatral Generic Name Drug: Alfuzosin HCl Company: Sanofi-Synthelabo Indication / Use: Benign prostatic hyperplasia Approval Date / FDA Class: 12 06 2003 / 1S Development and Mechanism of Action:Benign prostatic hyperplasia (BPH) is defined histologically. Clinically, it is characterized by lower urinary tract symptoms (urinary frequency, urgency, a weak and intermittent stream, needing to strain, a sense of incomplete emptying, and nocturia) and can lead to complications, including acute urinary retention. The mechanisms by which BPH causes symptoms and complications are unclear, although obstruction of the bladder outlet is an important factor. The best documented risk factors are increasing age and functioning testes. Estimates of the prevalence of symptomatic BPH indicate that approximately 50% of men ages 51 to 60 have benign prostatic hyperplasia. Community- and practice-based studies suggest that men with lower urinary tract symptoms can expect slow progression of the symptoms. However, symptoms can wax and wane without treatment. In men with symptoms of BPH, Read more [...]

Selective and non-selective α-blockers for BPH: Application

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Application to clinical practice An important issue is extrapolation of the results of alfuzosin (Uroxatral) to the terazosin (Hytrin) we prescribe in Canada. Although the affinity αa/αb receptor ratio is similar for alfuzosin and terazosin, their incidence of association with signs of hypotension differ. In placebo-controlled trials, patients treated with terazosin experienced obvious signs of hypotension, whereas incidence among patients receiving tamsulosin (Flomax) and alfuzosin (Uroxatral) was similar to that among patients treated with placebo. This indirect comparison between α-blockers has, of course, important limitations but should be borne in mind when extrapolating results to terazosin (Hytrin). Two trials have directly compared tamsulosin (Flomax) with terazosin (Hytrin). One single-blind trial was conducted among Asian men with high-normal blood pressure levels and symptomatic benign prostatic hyperplasia (BPH). They received 0.2 mg of tamsulosin (half the dose white men would receive) or 5 mg of terazosin daily. Both groups experienced significant improvement in Qmax and symptom Read more [...]

Selective and non-selective α-blockers for BPH

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Relevance to family physicians Symptomatic benign prostatic hyperplasia (BPH) is a common condition encountered in about 50% of male patients older than 50. Prevalence increases with age. In the last few years, pharmacologic treatment and watchful waiting have played an increasing role in treating symptomatic BPH. Until recently, pharmacologic options were limited to non-selective α-blockers and finasteride (Proscar). Non-selective α-blockers are usually first-line agents because their onset of action is fast (4 to 6 weeks); their efficacy is maintained, especially in patients with smaller prostates; and they are not expensive. Non-selective α-blockers, initially developed to treat hypertension, can cause side effects, such as postural hypotension, dizziness, headache, palpitations, and syncope. Tamsulosin (Flomax), a selective α-blocker, has been commercially available in Canada since June 1998. Because it is more urospecific than other α-blockers, it has less potential for causing symptomatic hypotension. The dose of tamsulosin does not need to be titrated and this might, therefore, decrease Read more [...]