Patho Pharm Drug List - Alpha-Adrenergic Antagonists

Prazosin [Minipress]

action: selective competitive a1 blocker, vasodilates arteries/veins, approved for hypertension and may imporve BPH symptoms
major adverse effects: first-dose syncope/orthostatic hypotension, reflex tachycardia, nasal congestion
nursing priorities: give the first dose at bedtime, monitor BP and dizziness

Terazosin [Hytrin]

action: selective a1 blocker for hypertension and BPH (bladder control); once-daily dosing
Major adverse effects: first-dose orthostasis, reflex tachycardia, nasalcongestion, headache
nursing priorities: begin at bedtime, monitor BP and BPH symptoms

Doxazosin [Cardura]

action: selective a1 blocker for hypertension and BPH; long half-life/ once-daily dosing
major adverse effects: first-dose orthostasis, reflex tachycardia, nasal congestion
nursing priorities: take the first dose at bedtime and use fall precautions

Tamsulosin [Flomax]

action: a1 blocker selective for prostate.bladder-neck receptors, BPH only, with weak vascular blockade
major adverse effects: headache, dizziness, rhinitis, abnormal ejaculation
nursing priorities: monitor urinary symptoms and dizziness

Alfuzosin [Uroxatral]

action: prostate/urinary-selective a1 blocker for BPH, extended release, CYP3A4 metabolism
major adverse effects: dizziness, QT prolongation concern
nursing priorities: swallow ER tablet intact, monitor dizziness and QT risk

Silodosin [Rapaflo]

action: a1 blocker selective for prostate, bladder, and urethra, BPH only
major adverse effects: reduced/absent semen release, dizziness, lightheadedness, nasal congestion
nursing priorities: use orthostatic precautions, explain possible ejaculatory changes

Phentolamine

action: competitive a1 + a2 blocker, treats pheochromocytoma-related hypertension and prevents necrosis after vasopressor extravasation
major adverse effects: orthostatic hypotension, reflex tachycardia, nasal congestion, inhibited ejacualtion
nursing priorities: use for vasopressor extravasation, monitor BP and the affected site

Phenoxybenzamine

action: noncompetitive, irreversible a1 + a2 blocker used for pheochromocytoma, long-lasting effect
major adverse effects: orthostatic hypotension, reflex tachycardia, nasal congestion, inhibited ejaculation
nursing priorities: monitor closely for prolonged orthostatic hypotension