Lecture Notes: Alpha-1 Blockers and BPH Medications

Overview

• Focus on Alpha-1 blockers used to treat Benign Prostatic Hyperplasia (BPH) and hypertension.
• Key drugs: Doxazosin, Terazosin, Tamsulosin.

Alpha Receptors

• Two types: Alpha 1 and Alpha 2.
• Focus on Alpha-1 receptors:
  • Located on vascular smooth muscles: blood vessels, pupils, urinary sphincter, prostate.
  • Activation leads to smooth muscle contraction (e.g., constriction of blood vessels).

Alpha-1 Blockers

• Suffix: "osin" (e.g., Doxazosin, Terazosin, Tamsulosin).
• Indications:
  • BPH: All mentioned drugs.
  • Hypertension: Doxazosin, Prazosin, Terazosin.
• Branding Tips:
  • Flomax (Maximize flow in BPH).
  • Hytrin (Terazosin, hint at hypertension).
  • Minipress (Prazosin, minimize blood pressure).

Mechanism of Action

• BPH:
  • Blocks alpha-1 adrenergic receptors in prostate and bladder neck tissues.
  • Results in relaxation of smooth muscles, alleviating urinary symptoms.
• Hypertension:
  • Inhibits Alpha adrenergic receptors in blood vessels, causing vasodilation.
  • Leads to decreased blood pressure.

Side Effects

• Mnemonic: My Head Feels Weak
  • H: Headache
  • E: Edema (fluid retention)
  • A: Abnormal Erection (priapism)
  • D: Decreased Blood Pressure (hypotension)
  • W: Weakness or Fatigue
• Risks:
  • Orthostatic hypotension and syncope, especially with first dose.
  • Intraoperative floppy iris syndrome in cataract surgery.

Patient Counseling Points

• Take medication at bedtime to minimize side effects.
• Rise slowly from sitting or lying position due to orthostatic hypotension.
• Avoid abrupt discontinuation to prevent rebound hypertension.
• Report persistent erections (priapism) to healthcare provider.

Visual Anchors

• Smug looking alpha-1 receptor saying "Oh sun".
• Imagine number one alpha feeling sad due to hypertension and BPH.

Final Tips

• Repetition is key for memorization.
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