Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The new alpha 1-blocker alfuzosin was compared with propranolol as monotherapy for hypertension in a double-blind, parallel group study of 8-week duration in 40 patients with essential hypertension. The patients (11 males, 29 females; mean age 47.8 +/- 2.2 years in the alfuzosin group and 46.6 +/- 2.4 years in the propranolol group) randomly received either alfuzosin from 2.5 mg b.i.d. up to 10 mg b.i.d. or propranolol from 40 mg b.i.d. up to 160 mg b.i.d. according to an individualized dose-titration schedule. The two groups were comparable with respect to disease history, cardiovascular risk factors, concomitant diseases, previous treatments and end-placebo blood pressure and heart rate values. Four patients did not complete the study, two patients in the alfuzosin group: one patient because of postural hypotension and the second one because of breast cancer; and two patients in the propranolol group: one patient for inefficacy and the second one lost to follow-up. At the end of the 8-week trial the mean daily doses were 12.2 +/- 0.61 mg and 196 +/- 9.82 mg for alfuzosin and propranolol, respectively. The antihypertensive effects of the two drugs were comparable. Upright and supine blood pressures decreased significantly with both treatments from the second week on (P less than 0.001 for all BP values). At the end of the 8-week double-blind trial, 83% of alfuzosin patients and 67% of propranolol patients were normalized. The two treatments differed significantly with respect to their effect on heart rate. Alfuzosin did not induce marked changes in heart rate: only a slight increase was observed. In contrast, propranolol caused bradycardia, more marked in the upright position. Palpitations, headache, asthenia and orthostatic hypotension were reported in the alfuzosin group. Asthenia and decreased libido were reported in the propranolol group. These data prove that alfuzosin has antihypertensive effects equivalent to propranolol and it is an interesting agent for the therapy of essential hypertension. It can be used as a first agent at doses between 5 and 20 mg/day with satisfactory therapeutic response and without relevant side-effects.
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PMID:Comparison of the new alpha 1-blocker alfuzosin with propranolol as first-line therapy in hypertension. 168 5

The safety profile of alfuzosin, a selective alpha 1-adrenergic antagonist, was assessed in a total of 13,389 patients (mean age 66.9 +/- 8.5 years) with symptomatic benign prostatic hypertrophy in two open, noncontrolled, multicentre, post-marketing surveillance studies, both conducted in France. Alfuzosin was prescribed at the recommended dose of 2.5 mg t.i.d., according to the current labelling recommendations, for a 3-month period. Clinical safety was assessed using spontaneous reporting of adverse events leading to discontinuation of treatment. Overall, 89.7% of the patients completed the treatment period. Drop outs were recorded in 10.3% of patients: 3.7% for intolerance; 1.5% for resolution of urinary symptoms; 2.1% for lack of efficacy, and 3.0% for loss to follow-up, noncompliance, and miscellaneous reasons. Two thirds of the adverse events leading to discontinuation were vasodilatory and occurred in 2.7% of the patients: vertigo/dizziness (1.4%); malaise (0.6%); hypotension (0.4%), and headache (0.4%). Other adverse events (predominantly gastrointestinal disorders) were recorded in < 1.2% of the patients. Three quarters of the adverse events occurred during the first week of therapy. As expected, adverse events were more frequent in the elderly (aged over 75 years) and in patients taking cardiovascular drugs or with concomitant cardiovascular disease. Overall, alfuzosin was very well tolerated and the adverse event profile was consistent with the cumulative experience of the drug. No unexpected or serious adverse events considered to be related to alfuzosin were recorded. Particular care must be taken when prescribing for very elderly patients and/or those with concomitant cardiovascular disease for which they are receiving therapy.
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PMID:Safety profile of 3 months' therapy with alfuzosin in 13,389 patients suffering from benign prostatic hypertrophy. 882 87

Approximately 25% of men over 40 or 50 suffer from lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). The bothersomeness of the symptoms varies considerably from one individual to the other and can fluctuate with time. Symptoms tend to gradually worsen as time goes on through. Surprisingly, there appears to be no particular relationship between symptoms and the overall prostate size and weight. Symptoms of BPH are divided in obstructive (voiding) and irritative (storage) symptoms, of which the irritative are the most bothersome. Until recently, surgery (open or transurethral resection) was the only treatment option. Nowadays, a range of less invasive treatments and pharmacological therapies are available to relieve BPH symptoms. Finasteride, for instance, reduces the prostate size by blocking 5-alpha-reductase, the enzyme which plays a role in the growth of the prostate. It takes however a long time before a clinically significant effect is noticed: +/- 6 to 12 months. Then, there are alpha 1-blockers. These agents result in relaxation of prostatic and bladder neck smooth muscle. alpha 1-blockers act relatively fast. Most alpha 1-blockers used in the treatment of symptomatic BPH were originally developed to treat hypertension. The adverse events most commonly associated with alpha 1-blockers, such as dizziness, headache, asthenia, tachycardia/palpitation, postural hypotension and syncope are possibly related to the blood pressure lowering effect. This stimulated the search for more selective alpha-blockers which act predominantly on the prostate and have less effect on the blood levels (afluzosin: Xatral and tamsulosin: Omic). Presently, alpha-blockers have become the first-line drugs in the medical treatment of symptomatic BPH. Surgery (open or TURP) is limited to patients with recurrent infections, large residue (> 200 ml), recurrent hematuria, bladder stones. New alternative and minimally invasive treatment such as TUNA generate necrotic lesions within the prostate through needle introduced endoscopically. This leads also to marked improvement in patients symptomatology.
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PMID:[Benign hypertrophy of the prostate: which treatment, for whom?]. 1052 95