Benign Prostatic Hyperplasia – Prostate Cancer – Prostatitis

Posts Tagged ‘Uroxatral’

Benign Prostatic Hyperplasia

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Definition Benign prostatic hyperplasia, a nearly ubiquitous condition, is the most common benign neoplasm of American men and occurs as a result of hormone-driven prostate growth. Pathophysiology The prostate gland comprises three types of tissue: epithelial or glandular, stromal or smooth muscle, and capsule. Both stromal tissue and capsule are embedded with О±1-adrenergic receptors. The precise pathophysiologic mechanisms that cause Benign prostatic hyperplasia are not clear. However, both intraprostatic dihydrotestosterone and type II 5 О±-reductase are thought to be involved. Benign prostatic hyperplasia commonly results from both static (gradual enlargement of the prostate) and dynamic (agents or situations that increase О±-adrenergic tone and constrict the gland's smooth muscle) factors. Examples of drugs that can exacerbate symptoms include testosterone, О±-adrenergic agonists (e.g., decongestants), anticholinergics (e.g., antihistamines, phenothiazines, tricyclic antidepressants, anticholinergic antispasmodics, Read more [...]

Alpha Blockers

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Overview Hyperplasia of the stromal tissue may or may not lead to significant enlargement of the prostate, but it usually leads to dynamic benign prostatic hyperplasia by increasing prostatic smooth muscle, which triggers increased smooth-muscle tension and resistance to urine flow. (The dynamic and static components of benign prostatic hyperplasia are discussed in the "Etiology and Pathophysiology" section.) Alpha1-adrenergic receptors in the bladder neck and prostatic capsule mediate tension in these muscles. Although the alpha1-adrenergic antagonists, or alpha blockers, currently used to block these receptors (e.g., doxazosin [Pfizer/AstraZeneca's Cardura/Cardura XL, generics] and terazosin [Abbott's Hytrin, generics]) reduce benign prostatic hyperplasia symptoms and resistance to urine flow, some of them also cause cardiovascular side effects. The latest entrants in this field (e.g., tamsulosin [Astel-las/Boehringer Ingelheim/Abbott's Harnal/Flomax/Omnic, others] and alfuzosin [Sanofi-Aventis's Xatral/Xatral SR/Uroxatral, others]) are prostate-specific or uroselective alpha blockers that reduce Read more [...]

Benign Prostatic Hyperplasia: Alpha Blockers

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Overview Numerous alpha blockers have been approved for the treatment of benign prostatic hyperplasia in the major pharmaceutical markets (United States, France, Germany, Italy, Spain, United Kingdom, and Japan), largely replacing the need for surgical treatment in the past ten years. Alpha blockers, with tamsulosin as the leading agent, currently constitute the largest segment of the benign prostatic hyperplasia drug market. Alpha-blocker drugs may differ in terms of their relative inhibitory potency and specificity for alpha1-adrenergic receptors, but most seem to exhibit the same degree of efficacy in benign prostatic hyperplasia patients . However, the propensity for inducing side effects, such as orthostatic hypotension and retrograde ejaculation, often distinguishes one alpha blocker from another. Nevertheless, alpha-blocker activity is sustained over several years of therapy, thereby eliminating the need for dose increases that could increase side effects. Mechanism Of Action Alpha blockers inhibit the activity of adrenergic receptors (also known as adrenoceptors), which cause smooth-muscle Read more [...]

Benign Prostatic Hyperplasia:Current Therapies

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Treatment of benign prostatic hyperplasia (benign prostatic hyperplasia) is directed primarily toward managing symptoms and improving patients' quality of life (QoL). The two dominating classes of pharmacological agents used to treat benign prostatic hyperplasia are alpha Mockers and 5-alpha-reductase inhibitors (5-ARIs). Both drug classes are effective in alleviating lower urinary tract symptoms (lower urinary tract symptoms ) associated with benign prostatic hyperplasia, thereby improving patients' comfort level. Alpha blockers are most useful in alleviating symptoms related to dynamic benign prostatic hyperplasia; 5-ARIs are used for the treatment of static benign prostatic hyperplasia. The dynamic and static forms of benign prostatic hyperplasia are discussed in the "Etiology and Pathophysiology" section. Alpha blockers work by relaxing prostatic muscle involved in dynamic benign prostatic hyperplasia; they cannot stop further growth of the prostate. 5-ARIs and gonadotropin modulators (used only in Japan) reduce the cellular growth seen in static benign prostatic hyperplasia. lower Read more [...]

Alfuzosin Hydrochloride

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Drug Approvals (British Approved Name Modified, US Adopted Name, rINN) International Nonproprietary Names (INNs) in main languages (French, Latin, and Spanish): Alfutsosiinihydrokloridi; Alfuzosin Hidroklorur; Alfuzosine, chlorhydrate d' Alfuzosin-hydrochlorid; Alfuzosinhydroklorid; Alfuzosini hydrochloridum; Alfuzozin-hidroklorid; Alfuzozino hidrochloridas; Hidrocloruro de alfuzosina; SL-77499-10; SL-77499 (alfuzosin). Pharmacopoeias. In Europe. European Pharmacopoeia, 6th ed. (Alfuzosin Hydrochloride). Awhite or almost white, slightly hygroscopic, crystalline powder. Freely soluble in water sparingly soluble in alcohol practically insoluble in dichlo-romethane. A 2% solution in water has apH of 4.0 to 5.5. Store in airtight containers. Protect from light. Adverse Effects, Treatment, and Precautions As for Prazosin Hydrochloride. Alfuzosin may be more selective for the urinary tract and vasodilator effects may be less frequent. It should be avoided in severe hepatic impairment, and doses may need to be reduced in mild to moderate hepatic impairment and in renal impairment (see below). Incidence Read more [...]

ALFUZOSIN

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ALFUZOSIN (al-FOO-zoe-sin) Other Names for this Medication: US - Uroxatral, Canada - Xatral Appearance White and yellow 3 layered round (10 mg) tablets Why this Medication is Used Alfuzosin is used in the treatment of benign prostatic hyperplasia or BPH (enlargement of the prostate gland) by relaxing muscles in the prostate and bladder, resulting in improved urine flow and reduced BPH symptoms. How do you take this Medication The usual dose is 1 0mg once per day. Alfuzosin may be taken 30 minutes after the same meal every day. Do not take Alfuzosin tablets on an empty stomach. If you interrupt your treatment for several days or more, resume treatment at one tablet daily, after consulting your doctor. Avoid drinking grapefruit juice and eating grapefruits while being treated with Alfuzosin. Precautions • Make sure to schedule regular check-ups with your doctor while taking Alfuzosin. • Do not crush or chew tablets of Alfuzosin, as the tablets are specially made to regulate the release of Alfuzosin into the blood stream. Swallow the tablets whole. • Avoid driving or operating Read more [...]

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 [...]