Prazosin and Hydrallazine in the Treatment of Hypertension

Kincaid‐Smith, Priscilla; Hua, A. S. P.; Myers, Jonny; Macdonald, Ileene M.; Fang, Peter

doi:10.1042/cs051617s

Cited by 8 publications

(5 citation statements)

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“…51 While introduced primarily as an antihypertensive agent, 71 it has been used orally to treat psychogenic erectile dysfunction. 72 Prazosin has also been used, in combination with alprostadil (PGE1), as an intraurethral agent for treatment of erectile dysfunction.…”

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 99%

Role of alpha adrenergic receptors in erectile function

et al. 2000

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Penile erection is a complex physiological process in which the regulation of penile hemodynamics depends on signal input from central and peripheral nervous systems, and on the balance and interplay between several local physiological mediators (neurotransmitters, vasoactive agents and endocrine factors). A role for the sympathetic nervous system in attaining or maintaining penile¯accidity and detumescence is well recognized. However, the exact mechanisms of alpha-adrenergic receptor mediated erectile function remain poorly de®ned. The objective of this review is to summarize data presented in the literature and from our laboratory on alpha-adrenergic receptors, and to discuss the conceptual framework by which the alphaadrenergic receptor pathway modulates penile corpus cavernosum smooth muscle contractility. We will integrate the current state of knowledge of penile erection into one framework encompassing the biochemical and physiological pathways responsible for trabecular smooth muscle relaxation (erection) and contraction (detumescence). We will focus our discussion on local control mechanisms of alpha-adrenergic receptors and explore the following topics: (1) functional activity of alpha-1 and alpha-2 adrenergic receptors in the physiology of human penile erection; (2) identi®cation, classi®cation and characterization of alpha-1 and alpha-2 adrenergic receptor subtypes in human penile erectile tissue; (3) molecular mechanism of action of alpha-1 and alpha-2 adrenergic receptors in human penile erectile tissue; (4) blockade of alpha-1 and alpha-2 adrenergic receptor action by selective and non-selective alpha-1 and alpha-2 adrenergic receptor antagonists (blockers); (5) physiologic (functional) antagonism of alpha-1 and alpha-2 adrenergic receptor activity by vasodilators mediating smooth muscle relaxation; and (6) key areas of consensus, as well as critical gaps in the existing scienti®c knowledge concerning the rationale and the potential use of alpha-blockers in erectile function.

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Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 99%

Role of alpha adrenergic receptors in erectile function

et al. 2000

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“…Con respecto al uso de prazosin existe una gran controversia que va desde quienes afirman su utilidad en el manejo crónico y ambulatorio de la hipertensión arterial (38)(39)(40) hasta los que sostienen que su efecto antinipertensivo es de poco valor (41)(42)(43)(44)(45)(46)(47). Esto se ha complicado últimamente (48) cuando se describió-una taquifilaxia progresiva que comien za a demostrarse ya entre las 12 y 24 horas de la administración de la droga.…”

Section: Discussionunclassified

Utilidad del prazosin en el tratamiento de los hipertensos con bajo gasto cardiaco

Pujadas¹,

Baglivo²,

Rı́o³

1980

Cardiology

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Un grupo de 36 hipertensos con bajo volumen minuto que no normalizó o mejoró significativamente su presión arterial con la administración de digoxina y diuréticos, fue tratado con prazosin. Estos hipertensos no tenían signos clínicos de insuficiencia cardiaca; solo presentaban manifestaciones de falla de bomba durante la prueba ergométrica axaduáda y el radiocardioerama (PEG y RCG) que denotaban volumen minuto disminuido. El seguimiento de los parámetros hemodinámicos de estos enfermos mediante radiocardiografía demostró al cabo de cuatro meses. de comenzado el tratamiento, un descenso de la presión arterial sistólica y diastólica de 171/107 ± 6/2.5 a 163/95 ± 2.7/2.8 mmHg, debido fundamentalmente al descenso de la resistencia vascular periférica, de 2.480 ± 195 a 1.522 ± 57 din/cm^-5/seg, mientras que el índice cardiaco aumentó un 60.7 ± 13.2% con relaciónal valor testigo (2.268 ± 0.10 1/min/m²), sin modiñcaciones significativas de la frecuencia cardiaca. Estos resultados favorables se mantuvieron en seis pacientes estudiados a los siete meses de comenzado el tratamiento. El prazosin está indicado no solo en los hipertensos con aumento de la resistencia vascular periférica y signos de insuficiencia cardiaca clínicamente manifiesta, sino también cuando este trastorno es subclínico y solo es demostrable mediante la ergometría o la radiocardiografía. La asociación de digitálicos y diuréticos evita cambios en la frecuencia cardiaca y el aumento de volumen sanguíneo secundario a la retención de sodio preducido por todas las drogas vasodilatadoras.

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“…gle doses of hydralazine in hypertensive patients persist for 8 hr 12 and even longer after long-term maintenance therapy. 24, 31.…”

mentioning

confidence: 99%

Hemodynamic evaluation of hydralazine dosage in refractory heart failure

Packer

Meller

Medina

et al. 1980

Clin Pharmacol Ther

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Hemodynamic responses to different doses of hydralazine were evaluated in 18 patients with severe refractory resistant heart failure. There were no significant overall hemodynamic effects after 50 mg hydralazine. After 75 mg, CI increased slightly (+0.36 l/min/m2) with a 19% decrease in SVR. After 100 mg, there were substantial increases in CI (+0.60 l/min/m2) and decreases in SVR (31%) changes which were greater than those after 75 mg, but the decrease in MAP with 100 mg (-6.6 mm Hg) was of the same order as that after 75 mg (-5.0 mm Hg). LVFP and SWI improved significantly only with 100-mg doses. Seven patients in whom 100 mg hydralazine induced no hemodynamic effects all responded to single doses of 150 to 200 mg. The duration of action of hydralazine was longer (p less than 0.001) in patients with a CCr less than 35 ml/min (14.3 +/- 1.4 hr) than in patients with adequate renal function (7.9 +/- 0.5 hr). Thus, the dose and dosing interval of hydralazine needed to induce hemodynamic improvement in patients with severe heart failure are variable and require individualization.

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Prazosin and Hydrallazine in the Treatment of Hypertension

Cited by 8 publications

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Role of alpha adrenergic receptors in erectile function

Role of alpha adrenergic receptors in erectile function

Utilidad del prazosin en el tratamiento de los hipertensos con bajo gasto cardiaco

Hemodynamic evaluation of hydralazine dosage in refractory heart failure

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