PMID: 20134112Feb 6, 2010Paper

The forefront for novel therapeutic agents based on the pathophysiology of lower urinary tract dysfunction: alpha-blockers in the treatment of male voiding dysfunction - how do they work and why do they differ in tolerability?

Journal of Pharmacological Sciences
Martin C Michel

Abstract

alpha(1)-Adrenoceptor antagonists are the mainstay of medical treatment of male voiding dysfunction which typically is attributed to benign prostatic hyperplasia. While original concepts have assumed that they relieve voiding dysfunction by relaxing prostatic smooth muscle, newer data indicate that their therapeutic effects at least partly occur independent of prostatic relaxation, perhaps involving direct effects on blood vessels, urothelium, afferent nerves, and/or smooth muscle of the urinary bladder. The adverse event profiles differ among alpha(1)-adrenoceptor antagonists, with tamsulosin having a particularly good cardiovascular tolerability. While this was originally attributed to its selectivity for alpha(1A)-adrenoceptors, it appears that alfuzosin which lacks subtype-selectivity, has a very similar tolerability. In contrast, doxazosin and terazosin, which are chemically and pharmacologically more closely related to alfuzosin than to tamsulosin, appear to have more side effects attributable to the cardiovascular system. More recent data indicate that tolerability differences between alpha(1)-adrenoceptor antagonists may at least partly relate to pharmacokinetic rather than to pharmacodynamic differences. Taken together...Continue Reading

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Citations

Apr 20, 2014·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Martin HennenbergChristian Gratzke
Nov 28, 2015·Naunyn-Schmiedeberg's Archives of Pharmacology·Ursula KösterMartin C Michel
Sep 29, 2012·Advances in Urology·Andrew J MacnabBabak Shadgan
Jan 4, 2017·Therapeutic Advances in Urology·Karl-Erik AnderssonAxel Forman
Jun 3, 2014·Therapeutic Advances in Urology·Karl-Erik AnderssonOsamu Yamaguchi
Sep 17, 2013·Neurourology and Urodynamics·Martin HennenbergChristian Gratzke
Jul 10, 2019·The Journal of Pharmacology and Experimental Therapeutics·Bruna Maria Castro Salomão QuaresmaFrançois Noël
May 14, 2011·British Journal of Clinical Pharmacology·Martin C Michel
Oct 24, 2014·International Journal of Urology : Official Journal of the Japanese Urological Association·Masanori NomiyaOsamu Yamaguchi
Dec 4, 2010·Current Opinion in Urology

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