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Alpha Adrenergic Antagonist

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161. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD

, in patients with glucose intolerance and diabetes. 35 Short-acting beta adrenergic agonists (SABAs) and short-acting muscarinic antagonists (SAMAs) are established treatments to relieve dyspnea and improve airflow obstruction during ECOPD, but the benefits of combining SABAs and SAMAs compared with using SABAs or SAMAs alone are unclear. 36 Long-acting bronchodilators and inhaled corticosteroids have historically only be used in stable COPD, but there is emerging evidence that an increase in dosage (...) Table 13. Comparison of oral mucolytics versus control, additional outcomes 24 Table 14. Comparison of inhaled corticosteroids with or without inhaled short- and long-acting bronchodilators versus placebo, critical outcomes 25 Table 15. Comparison of inhaled corticosteroids with or without inhaled short- and long-acting bronchodilators versus placebo, additional outcomes 25 Table 16. Comparison of inhaled antibiotics versus placebo 26 Table 17. Long-acting muscarinic antagonists versus placebo 26

2019 Effective Health Care Program (AHRQ)

164. Male Sexual Dysfunction

Hypertens, 2004. 17: 1135. 199. Kloner, R.A., et al. Interaction between the phosphodiesterase 5 inhibitor, tadalafil and 2 alpha-blockers, doxazosin and tamsulosin in healthy normotensive men. J Urol, 2004. 172: 1935. 200. McCullough, A.R., et al. Achieving treatment optimization with sildenafil citrate (Viagra) in patients with erectile dysfunction. Urology, 2002. 60: 28. 201. Forgue, S.T., et al. Tadalafil pharmacokinetics in healthy subjects. Br J Clin Pharmacol, 2006. 61: 280. 202. Nichols, D.J (...) with injection therapy: long-term dropout parameters. J Urol, 2000. 163: 467. 251. Buvat, J., et al. Double-blind multicenter study comparing alprostadil alpha-cyclodextrin with moxisylyte chlorhydrate in patients with chronic erectile dysfunction. J Urol, 1998. 159: 116. 252. Mulhall, J.P., et al. Intracavernosal forskolin: role in management of vasculogenic impotence resistant to standard 3-agent pharmacotherapy. J Urol, 1997. 158: 1752. 253. Bechara, A., et al. Comparative study of papaverine plus

2019 European Association of Urology

165. 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

2019 European Association of Urology

166. 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

2019 European Association of Urology

168. Treatment of Hypertension in Association With Left Ventricular Hypertrophy

with a decrease in left ventricular mass index of 13.3% (95%CI, 9.9%–16.8%), calcium channel blockers (CCBs) 9.3% (95%CI, 5.5%–13.1%), diuretics 6.8% (95%CI, 3.0%–10.7%) and beta-adrenergic antagonists (β-blockers) 5.5% (95%CI, 2.3%–8.6%) . However, this meta-analysis was small (1200 patients received active treatment; 189 received placebo), and mean duration of therapy was only 25 weeks. Subsequent studies have shown similar degrees of LVH regression with other agents, including alpha-blockers (ɑ-blockers (...) . Langenfeld MR, Gatzka CD, Weidinger G, Schobel HP. Impact of alpha- versus beta-blockers on hypertensive target organ damage: results of a double-blind, randomized, controlled clinical trial. Am J Hypertens 1997;10:985-91. Thurmann PA, Kenedi P, Schmidt H, Rietbrock N. Influence of the Angiotensin II antagonist valsartan on left ventricular hypertrophy in patients with essential hypertension. Circulation 1998;98:2037-42. Tedesco MA, Ratti G, Aquino D, et al. Effects of losartan on hypertension and left

2018 Hypertension Canada

169. Choice of therapy for Adults With Hypertension Without Compelling Indications for Specific Agents

supporting use of beta-adrenergic antagonists (β-blockers) in this age group consists of four trials including the placebo-controlled Medical Research Council on Mild Hypertension trial , comparing thiazides with β-blockers, which failed cumulatively to detect any significant difference in occurrence of cardiovascular endpoints (RR, 0.95; 95%CI, 0.82 to 1.11), although number of events in these trials was insufficient to prove equivalence, thus justifying a Grade B rating . Additionally, β-blockers may (...) be noted that LIFE used a control regimen with suboptimal efficacy in older patients with hypertension (i.e., β-blockers) . However, data from the ONTARGET Trial supports the equivalence of ARBs to ACE inhibitors in high-risk patients and is the basis of the caution not to combine ACE and ARB therapy given the unfavourable risk benefit profile demonstrated . Alpha-blockers Alpha-blockers were inferior to diuretics in the ALLHAT trial and this resulted in early termination of the alpha-blocker arm

2018 Hypertension Canada

170. Diagnosis & Assessment of Hypertension - Endocrine Hypertension

these conversion values with their local laboratories. Uncorrected hypokalemia (K + <3.3mmol/L), severe sodium restriction, and administration of renin-angiotensin inhibitors, diuretics and DHP-calcium channel antagonists may cause false-negative ratios and beta-blockers can cause a false positive . Other factors that can interfere with interpretation include renal dysfunction, oral contraceptives, NSAIDs, and in particular mineralocorticoid receptor antagonists. If possible, alpha blockers, hydralazine (...) adrenal adenoma, idiopathic hyperaldosteronism/bilateral adrenal hyperplasia, unilateral hyperplasia, and less commonly adrenal carcinoma and familial hyperaldosteronism (glucocorticoid remediable or non-remediable). Differentiation between unilateral and bilateral forms of aldosterone hypersecretion has important treatment implications. Unilateral forms might be amenable to improvement or even cure with adrenalectomy. In contrast, mineralocorticoid receptor antagonists are the treatment of choice

2018 Hypertension Canada

171. Canadian Cardiovascular Society Guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery

-bloqueurs dans les 24 heures qui pr ecèdent l’in- tervention chirurgicale; 5) la suspension des inhibiteurs de l’enzyme de conversion de l’angiotensine et des antagonistes des r ecepteurs 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’in- terventionchirurgicalechezlespatientsquiavaientunemesure elev ee desNT-proBNP

2017 CPG Infobase

172. Management of specific situations in polycythaemia vera and secondary erythrocytosis

(Landolfi et al , ). Low‐dose aspirin, which describes various doses (e.g. 75, 81 or 100 mg) used in different countries, is the only dose to have been assessed in recent clinical trials. The risk of major bleeding, particularly gastro‐intestinal, increases with age, and proton pump inhibitors should be given to patients over 75 years of age as well as to those a with high bleeding risk. The role of the ADP‐receptor antagonist, clopidogrel, in the long‐term prevention of MPN‐related thrombosis has (...) should be undertaken if it is not controlled at the time of acute thrombosis. For arterial thrombosis, low dose aspirin should be offered to all patients, and specialist advice should be sought. For venous thromboembolism (VTE), anticoagulation should be commenced. Low molecular weight heparin (LMWH) remains the first choice in the acute setting, followed by vitamin K antagonists (VKA) as per guidelines (NICE, ). Direct oral anticoagulants (DOACs) are increasingly used in the non‐MPN population

2018 British Committee for Standards in Haematology

173. Heart Failure

congestion on physical examination to decrease mortality and decrease hospitalisation. a Specifically, bisoprolol, carvedilol, metoprolol (controlled release or extended release) or nebivolol Weak FOR Low Mineralocorticoid receptor antagonists (MRAs) An MRA is recommended in all patients with HFrEF associated with a moderate or severe reduction in LVEF (LVEF less than or equal to 40%) unless contraindicated or not tolerated, to decrease mortality and decrease hospitalisation for heart failure. Strong (...) FOR High Mineralocorticoid receptor antagonists (MRAs) An MRA may be considered in patients with HFrEF associated with a mild reduction in LVEF (LVEF 41–49%) unless contraindicated or not tolerated, to decrease mortality and decrease hospitalisation for heart failure. Weak FOR Low Diuretics A diuretic should be considered in patients with heart failure and clinical symptoms, or signs of congestion, to improve symptoms and manage congestion. Strong FOR Very low Angiotensin receptor blockers (ARBs

2018 Cardiac Society of Australia and New Zealand

174. Dutasteride, tamsulosin, alfuzosin and dutasteride/tamsulosin combination for benign prostatic hyperplasia

Alfuzosin and tamsulosin are alpha-1-adrenergic antagonists (alpha blockers) used for the relief of lower urinary tract symptoms (LUTS) associated with BPH. The use of alpha-blockers for bothersome moderate to severe LUTS is supported by local and international clinical guidelines and constitutes routine clinical practice. The Committee acknowledged that an alpha-blocker (terazosin) is already listed on SDL for the treatment LUTS. 2.2 Dutasteride is a 5-alpha-reductase inhibitor which is used in line (...) the 5-alpha-reductase inhibitors, dutasteride is typically preferred for its longer half-life (5 weeks versus 8 hours for finasteride) which the clinicians suggested could improve treatment compliance. For the alpha-blockers, terazosin requires dose titration and close clinical monitoring, and therefore is often the least preferred agent within the class. Clinical effectiveness and safety Point Item 3.1 On the basis of the available clinical evidence, the Committee agreed that all alpha-blockers

2018 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

175. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia

). Traditionally, the primary goal of treatment has been to alleviate bothersome LUTS that result from BPO. More recently, treatment has also been focused on the alteration of disease progression and prevention of complications that can be associated with BPH/LUTS, such as acute urinary retention. 16 A variety of pharmacologic classes of medications are employed to treat LUTS attributed to BPH, including alpha- adrenergic antagonists (alpha-blockers), beta adrenergic agonists, 5-alpha- reductase inhibitors (5

2018 American Urological Association

177. Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update

of Pharmacological Treatments 75 Detailed Synthesis: Placebo-Controlled Trials of Alpha-Blockers 76 Detailed Synthesis: Placebo-Controlled Trials of Anticonvulsants/Mood Stabilizers 77 Detailed Synthesis: Placebo-Controlled Trials of Atypical Antipsychotics 78 Detailed Synthesis: Placebo-Controlled Trials of Benzodiazepines 82 Detailed Synthesis: Selective Serotonin Reuptake Inhibitors 82 Detailed Synthesis: Serotonin and Norepinephrine Reuptake Inhibitors 87 Detailed Synthesis: Placebo-Controlled Trials (...) interventions 59 Table 16. Characteristics of included studies that compared efficacy or comparative effectiveness between patients having different characteristics or specific trauma types 71 Table 17. Summary of efficacy and strength of evidence of PTSD pharmacological treatments 73 Table 18. Characteristics of included placebo-controlled trials of alpha-blockers 76 Table 19. Characteristics of included placebo-controlled trials of anticonvulsants, by drug 77 Table 20. Characteristics of included placebo

2018 Effective Health Care Program (AHRQ)

178. Gastroesophageal Reflux Disease (GERD) - Guidelines for Prescribing H2RAs and PPIs

, hypercalcemia Use of medications which reduce lower esophageal pressure can induce or worsen GERD – alpha-adrenergic antagonists, anticholinergics, beta-agonists, benzodiazepines (diazepam), calcium channel blockers (nifedipine, felodipine, amlodipine), nicotine, progesterone, theophylline For more information go to: CTC - Gastroesophageal Reflux - Available at . American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease. Available online at GERD (...) -The-Counter Drug Options Antacids, alginates; over-the-counter dose H2 receptor antagonists (H2RAs); OTC-dose H2RAs/alginate combination mild, infrequent symptoms Esomeprazole 20 mg or omeprazole 20 mg (14 days) mild and frequent symptoms (if daily treatment is preferred) or moderate symptoms. PPIs are considered first line. Grade A recommendation (consistent high-quality evidence) on-demand therapy for recurrent symptoms appearing 3 months after resolution of last episode esomeprazole or omeprazole

2018 medSask

179. 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

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