Articles: adrenergic-alpha-antagonists-therapeutic-use.
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Recent studies suggest that alpha-blockade with tamsulosin may be useful in the treatment of ureterolithiasis by increasing the success of, and decreasing the time to, stone passage. ⋯ Patients with ureterolithiasis discharged from our ED and given tamsulosin by prescription had moderately high ureteral stone passage success rates in our non-randomized retrospective cohort study. Compared to non-recipients of tamsulosin, patients receiving tamsulosin seemed to have greater success in stone passage.
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Randomized Controlled Trial Comparative Study
A double-blind, crossover study of Doxazosin and Enalapril on peripheral vascular tone and nocturnal blood pressure in sleep apnea patients.
Pulse wave attenuation, which occurs in association with obstructive sleep apnea (OSA), is sympathetically mediated. We compared the effect of Doxazosin (DO, a peripheral alpha-receptor inhibitor) and Enalapril (EN, an ACE inhibitor) on digital vasoconstriction and nocturnal blood pressure (BP) in hypertensive OSA patients. ⋯ Digital vasoconstrictions associated with apneic events are alpha-receptor mediated. DO compared to EN has a proportionally poor effect on nocturnal BP control in OSA patients, which may be due to the enhanced sympathetic nervous system activity characteristic of this condition.
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The Journal of urology · Feb 2010
Comparative StudyMedical expulsive therapy for ureteral calculi in the real world: targeted education increases use and improves patient outcome.
In controlled trials medical expulsive therapy has improved outcomes in patients with ureteral stones but its real-world use and effectiveness outside a clinical trial have not been thoroughly examined. We studied the impact of targeted education of emergency department physicians about medical expulsive therapy and analyzed its impact on patient outcomes and cost. ⋯ Targeted educational intervention can increase the use of preferred medical expulsive therapy (alpha-blockers) in the emergency department. Medical expulsive therapy decreases the incidence of adverse events by 29% and decreases the total cost associated with ureteral stones by 24%.
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Pheochromocytoma is a catecholamine-secreting tumor, for which the treatment of choice is complete surgical resection, when possible. Some form of preoperative pharmacological preparation is indicated. ⋯ The authors report three different cases in which doxazosin was used: as preoperative preparation of a patient with pheochromocytoma, as preparation for therapy in I-131-MIBG of a patient with a malignant pheochromocytoma, and as a pre-cesarean preparation in a pregnant woman with multiple endocrine neoplasia type 2A (MEN-2A). Doxazosin provided a safe alternative to phenoxybenzamine in the three cases described, with some advantages that the authors summarize.
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Urologia internationalis · Jan 2010
Review Randomized Controlled Trial Meta AnalysisTreatment of ureteral lithiasis with tamsulosin: literature review and meta-analysis.
Ninety percent of ureteral calculi <4 mm are expelled over a period of 3 months; if they are >6 mm the elimination possibilities are reduced to 30%. Presently, investigations in the treatment of ureteral lithiasis have the objective of modifying ureter contractibility with the aid of calcium antagonist and alpha-blocking drugs. The objective of this study is to analyze the effect of tamsulosin in the treatment of the distal ureter lithiasis and to make a systematic analysis of the literature. ⋯ Tamsulosin increases the elimination of distal ureter lithiasis of <10 mm.