Alpha1-Adrenergic Blockers
PREGNANCY CATEGORY C
Therapeutic actions
Alpha1-adrenergic blockers selectively block postsynaptic alpha1-adrenergic receptors, decreasing sympathetic tone on the vasculature, dilating arterioles and veins, and lowering both supine and standing BP; unlike conventional alpha-adrenergic blockers (phentolamine), they do not also block alpha2 presynaptic receptors, so they do not cause reflex tachycardia. They also relax smooth muscle of bladder and prostate.
Indications
Treatment of hypertension (alone or with other drugs)
Treatment of BPH (alfuzosin, doxazosin, terazosin, tamsulosin)
Unlabeled uses: Symptomatic treatment of chronic abacterial prostatitis (terazosin), Raynaud’s syndrome
Contraindications and Cautions
Contraindicated with hypersensitivity to any alpha1-adrenergic blocker, lactation.
Use cautiously with heart failure, renal failure, pregnancy.
Adverse Effects
CNS: Dizziness, headache, drowsiness, lack of energy, weakness, nervousness, vertigo, depression, paresthesia
CV: Palpitations, sodium and water retention, increased plasma volume, edema, dyspnea, syncope, tachycardia, orthostatic hypotension
Dermatologic: Rash, pruritus, lichen planus
EENT: Blurred vision, reddened sclera, epistaxis, tinnitus, dry mouth, nasal congestion
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