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Blockers

All articles from this key word are listed below.

Volume 7, Supplement 4 Review Articles

Long-Term Efficacy and Safety of Tamsulosin for Benign Prostatic Hyperplasia

Perinchery Narayan Hari Siva Gurunadha Rao Tunuguntla

Benign prostatic hyperplasia Tamsulosin Blockers AUA symptom score

Volume 8, Supplement 4 Review Articles

The Evolution of Alpha-Blockers for the Treatment of Benign Prostatic Hyperplasia

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

Alpha-blockers have been evaluated for the treatment of benign prostatic hyperplasia (BPH) for 30 years, from early trials with the nonselective a-inhibitor phenoxybenzamine to short-acting (prazosin) then long-acting (terazosin, doxazosin, tamsulosin, alfuzosin) selective a1-antagonists. All of the a-blockers evaluated have demonstrated comparable effectiveness, and the evolution of a-blocker therapy for BPH has therefore focused primarily on improving convenience and tolerability. Although all of the long-acting a1-blockers are well tolerated, only tamsulosin and alfuzosin SR are administered without the requirement for dose titration. Alfuzosin has the additional advantage over tamsulosin of a lower incidence of ejaculatory dysfunction. Studies of subtype-selective a1-antagonists have not demonstrated superior efficacy or improved tolerability over the existing long-acting a1-blockers. [Rev Urol. 2006;8(suppl 4):S3-S9]

Benign prostatic hyperplasia Blockers Lower urinary

Volume 8, Supplement 4 Review Articles

Alpha-Blockers for the Treatment of Prostatitis-Like Syndromes

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

J Curtis Nickel

Prostatitis is a common medical diagnosis. The etiology of this symptomatic syndrome can be an acute or chronic bacterial infection, a noninfectious initiator (the most common cause), or iatrogenic heat or radiation; the syndrome may coexist with benign prostatic hyperplasia. Alpha-blockers have a role in the treatment of the prostatitis syndromes. In Category I, acute bacterial prostatitis, a-blockers have been shown to possibly ameliorate obstructive and irritative voiding symptoms. In Category II, chronic bacterial prostatitis, a-blockers seem to reduce the risk of clinical and bacteriological recurrence. In Category III, chronic pelvic pain syndrome, a-blockers improve symptoms and quality of life. Alpha-blockers also seem to ameliorate the symptoms and reduce the risk of acute urinary retention in patients who suffer from either heat- or radiation-induced prostatic inflammation. Alpha-blockers improve lower urinary tract symptoms, including pain, in patients who are diagnosed with both prostatitis and benign prostatic hyperplasia. Evidence has proven there is definitely a role for a-blockers in the management of the prostatitis syndromes. [Rev Urol. 2006;8(suppl 4):S26-S34]

Benign prostatic hyperplasia Lower urinary tract symptoms Blockers Prostatitis syndromes CP/CPPS

Volume 8, Supplement 4 Review Articles

The Use of Alpha-Blockers for the Treatment of Nephrolithiasis

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

Michael Lipkin Ojas D Shah

Medical expulsion therapy has been shown to be a useful adjunct to observation in the management of ureteral stones. Alpha-1-adrenergic receptor antagonists have been studied in this role. Alpha-1 receptors are located in the human ureter, especially the distal ureter. Alpha-blockers have been demonstrated to increase expulsion rates of distal ureteral stones, decrease time to expulsion, and decrease need for analgesia during stone passage. Alphablockers promote stone passage in patients receiving shock wave lithotripsy, and may be able to relieve ureteral stent–related symptoms. In the appropriate clinical scenario, the use of a-blockers is recommended in the conservative management of distal ureteral stones. [Rev Urol. 2006;8(suppl 4):S35-S42]

Kidney stones Blockers Ureteral stones

Volume 8, Number 4 Review Articles

The Role of Gonadotropin- Releasing Hormone Antagonists for the Treatment of Benign Prostatic Hyperplasia

Treatment Update

Medical therapy is the preferred first-line approach in the management of lower urinary tract symptoms in men with benign prostatic hyperplasia. The magnitude of the improvement in lower urinary tract symptoms observed in response to combination therapy (-blocker plus 5- reductase inhibitors) does not approach that achieved with prostatectomy. Various drugs have been under consideration, including BXL628, lonidamine, and phosphodiesterase inhibitors, all of which have had unacceptable side effects. The gonadotropinreleasing hormone antagonist cetrorelix is associated with dose-dependent symptom improvement and reduction of prostate volume. Elucidating the mechanism for cetrorelix-mediated improvement in lower urinary tract symptoms will likely contribute to unraveling the pathophysiology of lower urinary tract symptoms in men. [Rev Urol. 2006;8(4):183-189]

Benign prostatic hyperplasia Blockers 5-reductase inhibitors LH-RH antagonists Cetrorelix

Volume 10, Number 2 Review Articles

The QT Interval and Selection of Alpha-Blockers for Benign Prostatic Hyperplasia

Treatment Update

Richard G Trohman Lawrence A Hill Norman E Lepor Herbert Lepor

The QT interval is the electrocardiographic manifestation of ventricular depolarization and repolarization. Drug-induced long QT syndrome is characterized by acquired, corrected QT (QTc) interval prolongation that is associated with increased risk of torsade de pointes. Every physician must recognize if the drugs he or she prescribes prolongs the QTc interval, especially if the drug is prescribed for a chronic condition in older patients who are on polypharmacy. The evolution of alpha-blockers for the treatment of benign prostatic hyperplasia has allowed the development of drugs that are easier to administer and better tolerated. Because alpha-blockers generally have equivalent efficacy, this class of drugs is typically differentiated by safety and side effects. Studies suggest that alpha-blockers may vary in regard to their effect on the QT interval, and, therefore, on their predisposition to cause potentially life-threatening ventricular arrhythmias. [Rev Urol. 2008;10(2):85-91]

Blockers Benign prostatichyperplasia Drug-induced long QT syndrome Torsade de pointes

Volume 11, Supplement 1 Review Articles

Medical Management of Lower Urinary Tract Symptoms

Advances in the Pharmacologic Treatment of BPH

Kevin T McVary Eric E Laborde

Lower urinary tract symptoms (LUTS) are a common complaint among aging men and are often caused by benign prostatic hyperplasia (BPH). A number of medical treatments for LUTS/BPH exist, such as α-blockers, 5α-reductase inhibitors, anticholinergics, phosphodiesterase type 5 (PDE5) inhibitors, and combination therapies. Agonist binding of the α1A-adrenergic receptor (AR), causing prostatic smooth muscle contraction, has been attributed to cause some LUTS. Therefore, medical therapy has aimed to block the α1A-AR and improve LUTS. Determining which therapy to choose must take into account individual patient factors as well as cost and patient choice.[Rev Urol. 2009;11(suppl 1):S19–S25 doi: 10.3909/riu11S1S0004]© 2009 MedReviews®, LLC

Lower urinary tract symptoms Phosphodiesterase Combination therapy Blockers 5-reductase inhibitors Anticholinergics Benign prostatichyperplasia

Volume 11, Supplement 1 Review Articles

Efficacy of a-Adrenergic Receptor Blockers in the Treatment of Male Lower Urinary Tract Symptoms

Advances in the Pharmacologic Treatment of BPH

Claus G Roehrborn

Male lower urinary tract symptoms (LUTS) are one of the most common causes for a consultation with a health care provider, and one of the most common causes of male LUTS is benign prostatic hyperplasia (BPH). In recent decades, medical therapy has established itself as viable and cost effective for the majority of men. For the treatment of male LUTS in the United States, the 5 currently available α-adrenergic receptor blockers are alfuzosin, doxazosin, silodosin, terazosin, and tamsulosin. α-Blockers remain one of the mainstays in the treatment of male LUTS and clinical BPH. They exhibit an early onset of efficacy (within less than 1 week) with regard to both symptoms and flow rate improvement, maintain such improvements in open-label and controlled trials for up to 5 years, and have been shown to prevent symptomatic progression.[Rev Urol. 2009;11(suppl 1):S1–S8 doi: 10.3909/riu11S1S0003]© 2009 MedReviews®, LLC

Benign prostatic hyperplasia Lower urinary tract symptoms Blockers

Volume 11, Supplement 1 Review Articles

Side Effects of a-Blocker Use: Retrograde Ejaculation

Advances in the Pharmacologic Treatment of BPH

Steven A Kaplan

There are currently 5 α-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all α-blockers are equally effective. However, α-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available α-blockers being used to treat men with LUTS due to benign prostatic hyperplasia.[Rev Urol. 2009;11(suppl 1):S14–S18 doi: 10.3909/riu11S1S0001]© 2009 MedReviews®, LLC

Benign prostatic hyperplasia Lower urinary tract symptoms Blockers