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Updated: 4/28/2022

Alpha-Blockers

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  • α-Blockers
      • Nonselective α-Blockers
      • Clinical Applications
      • Toxicity
      • Phenoxybenzamine (irreversible, preferred)
      • Pheochromocytoma
      • High catecholamine states
      • Orthostatic hypotension
      • Reflex tachycardia
      • Phentolamine (reversible)
      • Pheochromocytoma
      • High catecholamine states
      • Orthostatic hypotension
      • Reflex tachycardia
      • Selective α1-blockers (-zosin)
      • Drug
      • Clinical Applications
      • Toxicity
      • Prazosin
      • Hypertension
      • Urinary retention in benign prostatic hyperplasia (tamulosin is the most specific for urinary symptoms)
      • First dose orthostatic hypotension
      • Headache and dizziness
      • Doxazosin
      • Hypertension
      • Urinary retention in benign prostatic hyperplasia (tamulosin is the most specific for urinary symptoms)
      • First dose orthostatic hypotension
      • Headache and dizziness
      • Terazosin
      • Hypertension
      • Urinary retention in benign prostatic hyperplasia (tamulosin is the most specific for urinary symptoms)
      • First dose orthostatic hypotension
      • Headache and dizziness
      • Tamulosin
      • Hypertension
      • Urinary retention in benign prostatic hyperplasia (tamulosin is the most specific for urinary symptoms)
      • First dose orthostatic hypotension 
      • Headache and dizziness
      • Selective α2 blockers
      • Drug
      • Clinical Applications
      • Toxicity
      • Mirtazapine
      • Depression
      • Sedation
      • Xerostomia
      • ↑ serum cholesterol
      • ↑ appetite
      • Yohimbine
      • Male erectile dysfunction
      • Hypotension
      • Anxiety
  • α-Blockers + Sympathomimetics effects
    • Epi + α-blocker
      • before non selective α-blocker is given, epi's net effect is to increase heart rate, contractility, and vasoconstriction leading a net pressor effect on blood pressure
      • after α-blocker is given, epi's α response is blocked while its β2 response remains leading to net depressor effect on blood pressure (top of image)
        • β2 is Gs coupled, increases cAMP, causes vasodilation
        • α is Gq coupled, increases calcium causes vasoconstriction
    • Epi + β-blocker
      • before nonselective α-blocker is given, epi's net effect is to increase heart rate, contractility, and vasoconstriction leading a net pressor effect on blood pressure
      • after β-blocker given, epi's β response is blocked, while α response remains leading to net pressor effect (bottom of image)
    • Phenylephrine + α-blocker
      • phenylephrine (α1 > α2 agonist) leads to a net pressor effect on blood pressure
      • administration of a nonselective α-blocker leads a net zero effect on blood pressure

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