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PEBC: What You Need to Know: Alpha Blockers

Examples:

Non-selective: terazosin, doxazosin, prazosin

Prostate-selective: tamsulosin, silodosin, alfuzosin

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Indication:

-Benign prostatic hypertrophy

-Hypertension (non-selective ones, second-line)

-Nightmares (prazosin)

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Dosing:

-most agents can be dosed once daily

-non-selective ones taken at bedtime to reduce orthostatic hypotension

-alfuzosin and silodosin taking after a meal

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Adverse Effects:

-drowsiness

-dizziness, postural hypotension (especially non-selective ones)

-nasal congestion

-priapism

-rare: intraoperative floppy iris syndrome

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Drug Interactions:

-antihypertensives: additive hypotension or dizziness

-PDE5 inhibitors such as sildenafil, vardenafil, tadalafil: additive hypotension

-most are metabolized through CYP 3A4, so caution with strong inhibitors

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