Drugs online research references
Int J Radiat Oncol Biol Phys. 1999 Oct 1;45(3):567-70.
Efficacy of selective alpha-1 blocker therapy in the treatment of acute urinary symptoms during radiotherapy for localized prostate cancer.
Zelefsky MJ, Ginor RX, Fuks Z, Leibel SA.
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
PURPOSE: To determine the efficacy of an alpha-1 adrenoreceptor blocking agent for acute urinary symptoms in patients treated with radiotherapy for localized prostate cancer. METHODS AND MATERIALS: Between 1987 and 1995, 743 patients with clinically localized prostate cancer were treated with 3D-CRT. A total of 275 (37%) patients developed Grade 2 acute urinary symptoms as defined by the RTOG morbidity scoring system. Terazosin hydrochloride (THC), a selective alpha-1 adrenoceptor blocking agent, was given to 119 (43%) patients for treatment of their urinary symptoms, whereas nonsteroidal anti-inflammatory medications (NSAID) were administered to 71 patients (26%). Thirty-one patients (11%) were treated with other medications, and 54 (20%) did not seek pharmacologic intervention for their urinary symptoms. Patients were monitored weekly to assess changes in urinary urgency, frequency, and nocturia. RESULTS: Treatment with THC resulted in a significant resolution of urinary symptoms in 79 of 119 patients (66%), while 26 (22%) had moderate improvement, and 14 (12%) had minimal to no response to this drug. In contrast, only 11 of 71 (16%) of the patients treated with NSAIDs experienced significant symptom relief, 20 (28%) had moderate improvement, and 40 (56%) had minimal to no response. The difference in the significant symptomatic improvement between THC and NSAID therapy (66% vs. 16%) was highly significant (p < 0.001). For patients treated with THC, a higher likelihood of significant symptom relief was observed in patients who did not receive neoadjuvant androgen ablation (p = 0.04) and in those who were younger than 65 years of age (p = 0.02). CONCLUSION: Alpha-1 selective adrenoceptor blocking agents are effective in ameliorating the acute urinary symptoms in patients receiving radiotherapy for localized prostate cancer. Although this was not a randomized prospective study, the data suggest that NSAIDs were less effective in relieving radiation-induced urinary symptoms.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10524407&dopt=Abstract
Nippon Yakurigaku Zasshi. 1987 Apr;89(4):225-33.
[Effects of intravenous and intracerebroventricular terazosin, prazosin and clonidine on spontaneous sympathetic outflow in rats]
[Article in Japanese]
Yuki S, Hanazuka M, Watanabe T, Nishi H.
The hypotensive activity of terazosin has been attributed to inhibition of postsynaptic alpha-1 adrenoceptors. The present study examined the influence of terazosin on spontaneous sympathetic outflow in anesthetize and immobilized rats. The effects on blood pressure and heart rate were also evaluated. Intravenously (i.v.) injected terazosin 0.3 mg/kg and prazosin 0.1 mg/kg increased a sympathetic outflow by 15.4 and 21.6%, respectively. These drugs produced a significant and long-lasting fall in blood pressure with slight heart rate change. On the contrary, clonidine 0.1 mg/kg, i.v. significantly inhibited the sympathetic outflow by 69.2%. The intracerebroventricularly administered 10 micrograms/kg clonidine also showed the sympathoinhibitory effect. However 3 micrograms/kg, i.c.v. of terazosin and prazosin increased the sympathetic tone by 16 and 7.2%. During these periods, in both drugs slightly decreased the blood pressure. These changes in hemodynamic parameters and nerve activities were obtained at 2 approximately 3 min after the i.c.v. administration. The 10 micrograms/kg, i.c.v. of terazosin and prazosin significantly inhibited the pressor response by phenylephrine 1 micrograms/kg, i.v. These results indicate the peripheral effect of terazosin and prazosin through the penetration of the drugs from the brain. The results provide evidence that terazosin, like prazosin, dose not affect cardiovascular regulation by a central action.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2886411&dopt=Abstract
Am Heart J. 1988 Mar;115(3):576-87.
Hemodynamic recovery during simulated ventricular tachycardia: role of adrenergic receptor activation.
Feldman T, Carroll JD, Munkenbeck F, Alibali P, Feldman M, Coggins DL, Gray KR, Bump T.
Department of Medicine, University of Chicago, IL.
Ventricular tachycardia (VT) produces a wide variety of hemodynamic outcomes. Variations in autonomic nervous system response were studied in an animal model of VT. In 18 dogs anesthetized with chloralose VT was simulated by ventricular pacing (rate 240 bpm). Dynamic changes in left ventricular (LV) function were assessed during sinus rhythm and after VT was initiated, under variable autonomic conditions: ganglionic blockade with hexamethonium (n = 5), alpha-adrenergic blockade with terazosin (n = 7; 0.3 mg/kg), and beta-adrenergic blockade with propranolol (n = 6; 2 mg/kg). Micromanometers were used to measure LV pressure, and endocardial piezo crystals assessed changes in cavity size. Sinus interval, an index of autonomic tone, was determined immediately after tachycardia was terminated. Under control conditions the onset of simulated VT was accompanied by severe hypotension, with a decline in LV systolic pressure from 113 +/- 5 to 67 +/- 4 mm Hg within 10 seconds (p less than 0.05). Subsequently, during persistent tachycardia peak LV pressure recovered to sinus values, and maximum +dP/dt exceeded sinus values by 20 seconds (2604 +/- 413 vs 2112 +/- 184 mm Hg/sec; 20 seconds for VT vs sinus rhythm). Diastolic pressures were unchanged, and sinus rate accelerated. Ganglionic blockade with hexamethonium resulted in persistent hypotension, blunted +dP/dt, no change in diastolic pressures, and failure of the sinus rate to accelerate after the tachycardia. After beta blockade there was sustained hypotension (LV systolic pressure 78 +/- 4 vs 120 +/- 5 mm Hg; 20 seconds for VT vs sinus rhythm), maximum +dP/dt was blunted, and minimum diastolic ventricular pressure rose. This was due to an upward shift in the diastolic pressure-dimension relationship associated with prolongation of the time constant of LV relaxation. The sinus interval did not change. In contrast, tachycardia during alpha blockade produced a sustained fall in peak LV pressure; however, maximum +dP/dt recovered (2194 +/- 328 vs 2154 +/- 153 mm Hg/sec; 20 seconds for VT vs sinus rhythm), minimum diastolic LV pressure remained low, and sinus rate accelerated after ventricular tachycardia. Hemodynamic recovery during ventricular tachycardia is mediated by the response of the autonomic nervous system and requires both alpha-adrenergic vasoconstriction and beta-adrenergic augmentation of contraction and relaxation.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2894148&dopt=Abstract
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