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Alpha Adrenergic Antagonist

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181. Management of Non-neurogenic Male LUTS

-adrenoceptors in the urinary bladder, urethra and prostate. Br J Pharmacol, 2006. 147 Suppl 2: S88. 132. Kortmann, B.B., et al. Urodynamic effects of alpha-adrenoceptor blockers: a review of clinical trials. Urology, 2003. 62: 1. 133. Barendrecht, M.M., et al. Do alpha1-adrenoceptor antagonists improve lower urinary tract symptoms by reducing bladder outlet resistance? Neurourol Urodyn, 2008. 27: 226. 134. Djavan, B., et al. State of the art on the efficacy and tolerability of alpha1-adrenoceptor (...) enlargement: 2-year results from the CombAT study. J Urol, 2008. 179: 616. 140. Roehrborn, C.G., et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol, 2010. 57: 123. 141. Nickel, J.C., et al. A meta-analysis of the vascular-related safety profile and efficacy of alpha-adrenergic blockers for symptoms related to benign prostatic hyperplasia. Int J Clin Pract, 2008

2018 European Association of Urology

182. Chronic Pelvic Pain

urinary tract. J Urol, 1998. 159: 2185. 170. Parsons, C.L., et al. Cyto-injury factors in urine: a possible mechanism for the development of interstitial cystitis. J Urol, 2000. 164: 1381. 171. Chelimsky, G., et al. Autonomic Testing in Women with Chronic Pelvic Pain. J Urol, 2016. 196: 429. 172. Charrua, A., et al. Can the adrenergic system be implicated in the pathophysiology of bladder pain syndrome/interstitial cystitis? A clinical and experimental study. Neurourol Urodyn, 2015. 34: 489. 173

2018 European Association of Urology

183. British guideline on the management of asthma

and Table 10 Categorisation of inhaled corticosteroids by dose - children, 7.3.5 Maintenance and reliever therapy, 7.4 Additional add-on therapies, 7.4.2 Leukotriene receptor antagonists, 7.4.3 Tiotropium bromide, Figure 2 Summary of management in adults, Figure 3 Summary of management in children, 7.7.2 Anti-IL-5 monoclonal antibody Updated: 7.1 Intermittent reliever therapy, 7.3.2 Inhaled long-acting ß 2 agonist, 7.5 High-dose therapies, 7.7.1 Anti-IgE monoclonal antibody, 7.7.3 Other agents Minor

2016 SIGN

184. CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis

to the site, and start the inflammatory reaction. No antibodies are involved. This type of reaction is seen in contact dermatitis, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. [2] Describe 5 mechanism of epinephrine in anaphylaxis Epinephrine derives its therapeutic value from its combined alpha-adrenergic and beta-adrenergic actions: Receptor Stimulation Physiologic Response Alpha-1 ● Vasoconstriction ● Increased PVR ● Decreased mucosal edema Beta-1 ● (+) Inotropy (...) , but it is believed to be non-immunologic (non-IgE). Clinically, the risk for severe adverse reaction with ionic and nonionic contrast materials is less than 1%. Standard Treatment Protocol for Patients with Hx of RCI Anaphylaxis Prednisone 50 mg by mouth given 13 hours, 7 hours, and 1 hour before the procedure Consider an H2 antagonist, such as ranitidine 150 mg by mouth given 3 hours before the procedure Diphenhydramine 50 mg PO given 1 hour before the procedure Consider ephedrine 25 mg by mouth given 1 hour

2017 CandiEM

185. Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease

, PubMed/MEDLINE, Google Scholar and Embase, using the following key terms: type 1 diabetes, type 2 diabetes, hypertension, albuminuria, microalbuminuria, microvascular complications, nephropathy, chronic kidney disease, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and mineralocorticoid antagonists. Table 1 Differentiating renal disease in diabetes Diabetic nephropathy (DN) Damage to the glomerular capillaries in patients with diabetes mellitus resulting in albuminuria (...) % of patients on losartan developed microalbuminuria compared with 6% on a placebo and 4% on enalapril over 5 years. It has been suggested that aldosterone escape during long-term RAAS blockade may be a mechanism by which ACE inhibition fails to prevent progressive renal disease in patients with type 1 diabetes. 61 Thus the use of aldosterone antagonists in such patients may be useful. Spironolactone has been investigated in a small study of patients with type 1 diabetes and microalbuminuria. 62

2017 Association of British Clinical Diabetologists

186. CrackCAST E129 – Bacteria

about 4 days after the onset of disease. Long-acting nondepolarizing agents are preferred. Progress to IV NDMR (pancuronium) Consider for early Tracheostomy Autonomic instability requires monitoring and aggressive treatment. Sympathetic hyperactivity can be treated with combined alpha- and beta-adrenergic antagonists, such as labetalol and propranolol. Esmolol is ideal. Consider morphine and magnesium infusions. Try to avoid catecholamines. Elimination of unbound tetanospasmin Passive immunization (...) alpha (TNF-α), and interleukins at a rate and magnitude many fold greater than with the normal antigen presentation, which begin the cascade of systemic vasculitis and the multisystem manifestations of the disease. Anything that puts you at risk for developing Staph. Aureus infections! Orifices packed with foreign bodies, concurrent infections, comorbidities Non-menstrual staphylococcal TSS is associated with superinfection of various skin lesions, including burns, surgical sites, dialysis catheters

2017 CandiEM

187. CRACKCast E099 – Urological Disorders

of the catheter [3] What are two medication classes of drugs for prostatic enlargement? ALPHA-ADRENERGIC RECEPTOR ANTAGONIST Alfuzosin 10 mg once daily Doxazosin 1 mg once daily Tamsulosin 0.4 mg once daily Terazosin 1 mg once daily or at bedtime 5-ALPHA-REDUCTASE INHIBITORS Dutasteride 0.5 mg once daily Finasteride 5 mg once daily [4] Describe the testicular salvage rates (Fig. 89.9) Any delay beyond 6 hrs is associated with testicular loss and infertility (>60% after 6 hrs). By 24 hrs there is a 50% salvage (...) by dropping GRF to the obstructed kidney) Fentanyl prn ondansetron prn Fluids (although no evidence for this) What is medical expulsive therapy? When can it be used? Useful for distal ureteral stones less than 10 mm. Alpha1-antagonists Tamsulosin 0.4 mg po daily OR Calcium channel blockers Nifedipine xr 30 mg po daily Thought to facilitate distal stone expulsion, decrease time to stone passage, and block ureteral smooth muscle contraction More evidence for alpha blockers, but there are notable side

2017 CandiEM

188. Tadalafil Medical Expulsive Therapy in Ureteral Calculi: A New Kid on the Block?

a high ureteral stone expulsion rate as well as significant pain control. You wonder how it might compare to α-receptor blockers, such as tamsulosin or silodosin. Search Strategy Medline 1966-11/15 using OVID interface, Cochrane Library (2015), and Embase (exp ureteral obstruction/ or exp ureteral calculi/ or exp renal colic) AND [(exp adrenergic alpha-antagonists/ or tamsulosin.mp or silodosin.mp) AND (exp phosphodiesterase-5 inhibitors/ or tadalafil.mp)]. Limit to human, English language Search (...) Episodes Group B had a lower mean number of colic episodes than Group A (0.45 vs. 1.60, p Mean Number of Hospital Visits Group B had a lower mean number of hospital visits than Group A (2.2 vs. 2.85, p=0.001). Adverse Effects There was no statistically significant difference in rates of adverse effects, but there was a trend towards increased rates of adverse effects in Group B compared to Group A. Comment(s) α-adrenergic antagonists such as tamsulosin have been used to treat patients with renal colic

2017 BestBETS

189. Pharmacological Management of Hypertension

controlled with triple therapy (i.e., thiazide-type diuretics, ACEI or ARB, and CCBs). Drug classes to consider include aldosterone receptor antagonists (e.g., spironolactone); peripherally acting antiadrenergic agents (e.g., reserpine); direct vasodilators (e.g., hydralazine); dual alpha-beta adrenergic blockers (e.g., carvedilol); and centrally acting antiadrenergic drugs (e.g., clonidine). The ACP/AAFP guideline does not address pharmacologic treatment of refractory hypertension. Areas of Difference (...) diuretics, ACEI or ARB, and CCBs] described in Recommendation 43) or as supplementary therapy in some clinical indications. Drug classes for consideration can include (not in priority order): Aldosterone/mineralocorticoid receptor antagonists (e.g., spironolactone, eplerenone) Other potassium-sparing diuretic (i.e., amiloride) Alpha-adrenergic blockers Beta-adrenergic blockers Non-dihydropyridine CCBs Combined alpha-beta adrenergic blockers Peripherally acting antiadrenergic agents (reserpine, pending

2017 National Guideline Clearinghouse (partial archive)

191. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

; alcohol intake; ambulatory care; antihypertensive: agents, drug, medication, therapy; beta adrenergic blockers; blood pressure: arterial, control, determination, devices, goal, high, improve, measurement, monitoring, ambulatory; calcium channel blockers; diet; diuretic agent; drug therapy; heart failure: diastolic, systolic; hypertension: white coat, masked, ambulatory, isolated ambulatory, isolated clinic, diagnosis, reverse white coat, prevention, therapy, treatment, control; intervention; lifestyle

2017 American Heart Association

193. Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

–q26.2, Xq26 Desmin, myotilin, LIM domain binding protein 3, crystallin alpha B, filamin C gamma, BCL2-associated athanogene 3, four-and-a-half LIM domains 1 AD Common Rare (late; AF) Rare (AVB) AD indicates autosomal dominant; AF, atrial fibrillation; AFL, atrial flutter; AR, autosomal recessive; AT, atrial tachycardia; AVB, atrioventricular block; DCM, dilated cardiomyopathy; HCM, hypertrophic cardiomyopathy; LGMD, limb-girdle muscular dystrophy; LVNC, left ventricular noncompaction; RCM (...) associated with MFM, and mutations in these genes account for ≈50% of all cases of MFM: DES (encoding desmin), MYOT (encoding myotilin), LDB3 / ZASP (encoding LIM domain binding 3), CRYAB (encoding crystallin alpha B), FLNC (encoding filamin C, gamma) and BAG3 (encoding BCL2-associated athanogene 3). Recently, mutations in FHL1 (encoding four-and-a-half LIM domains 1), DNAJB6 (encoding a DNAJ protein family member), and TTN (encoding titin) have also been linked to MFM, and the list of genes causing MFM

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2017 American Heart Association

194. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary

relevant to this guideline, was conducted between February and August 2015. Key search words included but were not limited to the following: adherence; aerobic; alcohol intake; ambulatory care; antihypertensive: agents, drug, medication, therapy; beta adrenergic blockers; blood pressure: arterial, control, determination, devices, goal, high, improve, measurement, monitoring, ambulatory; calcium channel blockers; diet; diuretic agent; drug therapy; heart failure: diastolic, systolic; hypertension: white

2017 American Heart Association

196. Atrial Fibrillation

with atrial fibrillation 32 8.4 Structured follow-up 32 8.5 Defining goals of atrial fibrillation management 32 9 Stroke prevention therapy in atrial fibrillation patients 33 9.1 Prediction of stroke and bleeding risk 34 9.1.1 Clinical risk scores for stroke and systemic embolism 34 9.1.2 Anticoagulation in patients with a CHA 2 DS 2 -VASc score of 1 in men and 2 in women 35 9.1.3 Clinical risk scores for bleeding 35 9.2 Stroke prevention 36 9.2.1 Vitamin K antagonists 36 9.2.2 Non-vitamin K antagonist (...) oral anticoagulants 37 9.2.3 Non-vitamin K antagonist oral anticoagulants or vitamin K antagonists 41 9.2.4 Oral anticoagulation in atrial fibrillation patients with chronic kidney disease 41 9.2.5 Oral anticoagulation in atrial fibrillation patients on dialysis 42 9.2.6 Patients with atrial fibrillation requiring kidney transplantation 42 9.2.7 Antiplatelet therapy as an alternative to oral anticoagulants 42 9.3 Left atrial appendage occlusion and exclusion 43 9.3.1 Left atrial appendage occlusion

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2016 European Society of Cardiology

197. Management of Cancer Pain in Adult Patients: ESMO Clinical Practice Guidelines

and tolerability of morphine administered orally or by epidural [159, 160]. An improvement in pain control as well as in adverse effects was shown by switching from oral to epidural infusion of mor- phine [159]. However, Kalso et al. showed no signi?cant bene?ts, either in ef?cacy or in adverse effects, by administering morphine via the epidural route compared with the s.c. route. The authors concluded that the co-administration of local anaesthetic agents, alpha-2-adrenergic agonists or NMDA antagonists may (...) strontium, samarium or rhenium has been investigated in a sys- tematic review [138]. The results showed only a small bene?cial ef- fect on pain control in the short and medium term (1–6 months), with no modi?cation of the analgesics used but relatively frequent adverse effects including leukopaenia and thrombocytopaenia. A randomised trial has evaluated the effect of radium-223 (an alpha emitter releasing short-range radiation, with little bone mar- row toxicity) in patients with castrate-resistant

2018 European Society for Medical Oncology

198. CCS guidelines on perioperative cardiac risk assessment and management for patients undergoing noncardiac surgery

l’intervention chirurgicale ; 5) la suspension des inhibiteurs de l’enzyme de conversion de l’angiotensine et des antagonistes des récepteurs de l’angiotensine II 24 heures avant l’intervention chirurgicale ; 6) la facilitation de l’abandon du tabac avant l’intervention chirurgicale ; 7) la mesure quotidienne de la troponine de 48 à 72 heures après l’intervention chirurgicale chez les patients qui avaient une mesure élevée des NT-proBNP/BNP avant l’intervention chirurgicale ou s’il n’y avait eu aucune mesure

2016 Canadian Cardiovascular Society

199. Drugs That May Cause or Exacerbate Heart Failure

Like amiodarone, dronedarone inhibits the calcium, sodium, and potassium channels and is both an α-and a β-adrenergic receptor antagonist. Dronedarone therapy reduced death and cardiovascular hospitalizations significantly in ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death From Any Cause in Patients With Atrial Fibrillation/Atrial Flutter). A post hoc analysis of a subset (...) with higher mortality. The consistent effectiveness of β-adrenergic receptor antagonists in reversing myocardial remodeling and in improving mortality in patients with HF and reduced LVEF stimulated an interest in other mechanisms of decreasing sympathetic activity as a treatment for HF. Centrally acting α 2 -adrenergic agonists such as clonidine and moxonidine decrease sympathetic outflow and thus decrease plasma norepinephrine concentrations and blood pressure. In an animal model of HF, clonidine

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2016 American Heart Association

200. Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

to toxicity even in the setting of normal serum di- goxin levels. 56 Similarly, calcium antagonists bind to am- yloid fibrils, which can result in exaggerated hypotensive and negative inotropic responses. 57 Ultimately, judicious diuresis remains the mainstay of HF therapy in these pa- tients. ACE inhibitors, or angiotensin receptor blockers (ARBs) if the patient is intolerant of ACE inhibitors, should be used with caution in patients with amyloidosis and probably should be avoided because of hypotension (...) ag- gregation, and deceased fibrinolysis by cocaine predis- pose to coronary and microvascular disease. 97 Treatment Other than abstinence, very little is known about treat- ment of cocaine-induced cardiac dysfunction. Indeed, there are case reports of reversibility of cardiac function after cessation of drug use. 99 Early reports of cocaine- induced hypertension and myocardial ischemia caused by unopposed a-effects of ß 1 -adrenergic blocking agents in cocaine-related chest pain resulted

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2016 American Heart Association

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