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Prostatic alpha 1-adrenoceptors and uroselectivity
K E Andersson1, H Lepor, M G Wyllie
1Department of Clinical Pharmacology, Lund University Hospital, Sweden.
The Prostate
|February 15, 1997
Summary
Alpha 1-adrenoceptor antagonists are used for lower urinary tract obstruction. This review examines claims of uroselectivity and prostate selectivity for newer agents like tamsulosin.
Area of Science:
- Pharmacology
- Urology
Background:
- Alpha 1-adrenoceptor antagonists are used to treat lower urinary tract obstruction symptoms.
- Early treatments used non-selective alpha 1- and alpha 2-adrenoceptor antagonists like phenoxybenzamine.
- Development of selective alpha 1-antagonists (e.g., prazosin) aimed to reduce side effects.
Purpose of the Study:
- To critically evaluate claims of uroselectivity and prostate selectivity for newer alpha 1-adrenoceptor antagonists.
- To provide a comprehensive analysis of pre-clinical and clinical data regarding these agents.
- To define selectivity at different levels: in vitro, in vivo, and clinical.
Main Methods:
- Comprehensive literature review of pre-clinical and clinical data.
- Inclusion of studies from international sources, including Japanese literature.
- Analysis of drug selectivity across various biological systems.
Main Results:
- Newer alpha 1-adrenoceptor antagonists (alfuzosin, doxazosin, terazosin, tamsulosin) have emerged with claims of enhanced selectivity.
- The concept of "uroselectivity" and "prostate" selectivity requires careful definition and validation.
- Selectivity varies depending on the specific alpha 1-adrenoceptor subtype involved.
Conclusions:
- Conclusions are drawn within the framework of alpha 1-adrenoceptor subtypes (alpha 1A, 1B, 1D).
- The clinical relevance of reported selectivity needs further investigation.
- Understanding subtype selectivity is crucial for optimizing treatment of lower urinary tract obstruction.