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Cardura

Cardura is a high-quality medication which is taken in treatment of symptoms of benign prostatic hyperplasia or enlarged prostate, hypertension. Cardura acts by relaxing the blood vessels and muscles of bladder and prostate.

Other names for this medication:

Similar Products:
Doxazosin, Tamsulosin, Alfuzosin

 

Also known as:  Doxazosin.

Description

Cardura is a perfect remedy in struggle against hypertension, symptoms of benign prostatic hyperplasia or enlarged prostate.

Cardura acts by relaxing the blood vessels and muscles of bladder and prostate.

Cardura is also known as Doxazosin, Carduran, Cascor, Doxadura, Doxacard.

Generic name of Cardura is Doxazosin.

Brand names of Cardura are Cardura, XL Cardura.

Dosage

Take Cardura tablets orally once a day with or without food in the morning or in the evening, extended-release tablets take once a day with a breakfast.

Do not crush or chew it.

If you want to achieve most effective results do not stop taking Cardura suddenly.

Overdose

If you overdose Cardura and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature below 30 degrees C (86 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Cardura are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Cardura if you are allergic to Cardura components.

Do not take Cardura if you're pregnant or you plan to have a baby, or you are a nursing mother.

Be careful using Cardura if you take HIV/AIDS medicines (nelfinavir (such as Viracept), atazanavir (such as Reyataz), indinavir (such as Crixivan), saquinavir (such as Invirase, Fortovase), ritonavir (such as Kaletra, Norvir)); clarithromycin (such as Prevpac, Biaxin); ipratropium (such as Atrovent); nefazodone; telithromycin (such as Ketek); voriconazole (such as Vfend); antihistamines; itraconazole (such as Sporanox); ketoconazole (such as Nizoral); ED medicines (vardenafil (such as Levitra); sildenafil (such as Viagra), tadalafil (such as Cialis); high blood pressure medicines; ulcers, irritable bowel disease medicines, urinary medicines, Parkinson's disease, motion sickness medicines.

It can be dangerous to use Cardura if you suffer from or have a history of prostate cancer, chest pain (angina), intestines narrowing or blockage, liver disease, short bowel syndrome, hypertension.

Avoid alcohol.

Do not stop taking Cardura suddenly.

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Elevated levels of endothelin-1 (ET-1) and von Willebrand factor (vWF), both markers indicative of endothelial function, are associated with hypertension. In a randomized open study we investigated the effect of antihypertensive treatment with the alpha-blocker doxazosin (n = 23) or the beta-blocker atenolol (n = 22) for 22 weeks on circulating levels of ET-1 and vWF in middle-aged men with essential hypertension. Blood pressure reduction was satisfactorily achieved with both drugs, although the decrease in the atenolol group was larger than that in the doxazosin group. A reduction in the levels of vWF occurred in both groups, being more pronounced in the alpha-blocker group compared with the decrease on beta blockers, p = 0.004 and p = 0.056, respectively. In the alpha-blocker group, there was a significant correlation (r = 0.50, p = 0.022) between the reduction in diastolic blood pressure and the decline in vWF. A highly significant decrease in plasma ET-1 was obtained during beta blockade (p = 0.007), whereas no significant change occurred within the alpha-blocker group. There was, however, no correlation between the decrease in blood pressure and the reduction in ET-1. The different favorable effects of alpha and beta blockers on endothelial function expressed as vWF and ET-1, could indicate that the effects are probably related not only to the blood pressure per se, but also to the different pharmacologic mechanisms of the drugs.

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In these patients, drug therapy may resolve the pathology, or allow the use of minimally invasive surgery (i.e. lasertherapy, transuretheral incision, etc.).

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The newly established method can be used in research and development of the enantiomers of three new drugs.

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The proposed method is simple, rapid, reproducible, and reliable with high measurement accuracy, which can be useful to estimate lipid-water partition coefficients of pharmaceuticals.

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In the 15 batches of different phytotherapeutic agents tested no interference secondary to contamination with alpha-blockers or 5alpha-reductase inhibitors was observed.

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The efficacy and safety of doxazosin (mean dosage 6.9 mg, range 1 to 16) in the treatment of essential hypertension were compared in a double-blind study with those of hydrochlorothiazide (HCTZ) (mean dosage, 84.6 mg, range 25 to 100) in 104 hypertensive patients treated once daily for 6 months. Thirty-five patients were also assessed for comparative effects of the 2 agents on serum lipid parameters. Doxazosin produced potentially favorable changes from baseline in the concentrations of serum lipid fractions (total triglycerides, total cholesterol, high density lipoprotein [HDL] cholesterol and the derived HDL/total cholesterol ratio) compared with HCTZ. The decreases in total triglyceride and total cholesterol concentrations and an increase in the HDL/total cholesterol ratio were significantly different (p less than 0.006) from the opposite changes observed with HCTZ. Clinically relevant decreases from baseline in supine and standing blood pressures at 24 hours after administration did not significantly differ between the 2 agents. The incidence and severity of side effects were similar for both drugs. Three patients receiving doxazosin and 6 receiving HCTZ were withdrawn due to drug-related clinical side effects including 2 patients receiving HCTZ who were withdrawn because of laboratory test abnormalities. Eight HCTZ- and 1 doxazosin-treated patients developed hypokalemia and 6 HCTZ-treated patients developed hyperuricemia. These findings indicate that doxazosin and HCTZ provide comparable antihypertensive efficacy after 6 months of treatment using a once-daily regimen, but doxazosin produces a beneficial effect on the serum lipid profile as well as fewer biochemical aberrations.

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To test the hypothesis that the spinal control of micturition involves alpha 1-adrenoceptors, the urodynamic effects of intrathecal and intraarterial alpha 1-adrenoceptor blockade on apomorphine-induced bladder activity in rats were studied. Continuous cystometry was performed in conscious female Sprague-Dawley rats with and without bladder outflow obstruction. In normal rats, subcutaneous apomorphine, 30 micrograms/kg, induced bladder activity that was abolished or attenuated by the alpha 1-adrenoceptor antagonists indoramin and doxazosin given intrathecally or intra-arterially. In rats with outlet obstruction, apomorphine 30 micrograms/kg caused no change in cystometric parameters. However, at a dose of 100 micrograms/kg the drug induced bladder activity, which was attenuated by intrathecal indoramin or doxazosin. These results suggest that the bladder activity evoked by apomorphine-stimulation of bulbospinal pathways can be influenced by alpha 1-adrenoceptors at the spinal and peripheral levels, both in normal rats and in rats with bladder hypertrophy secondary to outlet obstruction.

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Patients prescribed an alpha-blocker were significantly more likely to experience AUR (hazard ratio 2.32, 95%CI 1.37, 3.94) or surgery (hazard ratio 1.78, 95%CI 1.30, 2.44) than patients prescribed a 5ARI. These differences were sustained with sensitivity analyses.

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The aims of this study were to examine the effects of doxazosin on contractile responses to 5-hydroxytryptamine (5-HT), carbachol, and histamine, and to compare them with those of prazosin, alfuzosin, and terazosin, and then characterize a pharmacological profile of the 5-HT-induced contractile response using preparations of isolated longitudinal muscle strips from the rabbit gastric body. The results from these preparations showed that the contraction response to 5-HT, but not to carbachol or histamine, was found to be dose-dependently potentiated by doxazosin and its enantiomers. The specific potentiation effect on 5-HT was not observed in the preparations that were treated with prazosin, terazosin, or alfuzosin. The contractile response to 5-HT and its potentiation by doxazosin were not affected by treatment with phenoxybenzamine. However, 5-HT-induced contraction was competitively antagonized by nefazodone (with pA₂ value of 8.64 ± 0.17), and was almost completely inhibited by treatment with indomethacin. In conclusion, doxazosin, but not prazosin, alfuzosin, or terazosin, selectively potentiates 5-HT-induced contraction in the rabbit gastric body strips via an α₁-adrenoceptor-independent mechanism, without chiral recognition of its enantiomers. Additionally, the contraction to 5-HT was found to be mediated via 5-HT(₂) receptors, and was similar to PGs synthesis in the preparations.

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This report deals with perioperative treatment for a very rare disease called ectopic ACTH-producing pheochromocytoma in a 55-year-old woman. She showed high norepinephrine, cortisol, and ACTH levels, and diagnosed as ectopic ACTH-producing pheochromocytoma, by MIBG scintigraphy. An alpha-blocker and fluid loading for pheochromocytoma, and an adrenal cortex hormone synthesis inhibitor for Cushing's syndrome, were given simultaneously as a preoperative treatment. Propofol with nitrous oxide-oxygen-sevoflurane and epidural anesthesia were used for excision of the tumor, and the procedure was performed without any marked changes in hemodynamics. Although ectopic ACTH-producing pheochromocytoma is a very rare disease, it can be managed safely by appropriate preoperative treatment for pheochromocytoma and Cushing's syndrome.

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Doxazosin gastrointestinal therapeutic system (GITS) or placebo was added to the antihypertensive therapy of uncontrolled hypertensive patients in a prospective, randomized, double-blind trial. Patients received doxazosin GITS 4 mg/d (n=89) or placebo (n=86) for 6 weeks in addition to entry antihypertensive medication. Doxazosin GITS was increased to 8 mg/d after 2 or 4 weeks if patients did not respond (sitting blood pressure <140/90 mm Hg and 10/10-mm Hg decrease from baseline). Reductions from baseline in sitting and standing blood pressures were greater with doxazosin GITS than placebo at all time points (p

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Essential hypertension is characterized by an insulin-resistance state that may be responsible for the increased atherogenesis typical of this disease. To investigate the effect on glucose and insulin metabolism of doxazosin, an antihypertensive drug whose favorable impact on lipid metabolism is well known, 10 newly diagnosed essential hypertensive patients of the same age and body mass index (BMI) were selected for our study. They underwent an oral glucose tolerance test (OGTT) with measurement of plasma insulin levels before and after a 6-month treatment period with doxazosin. In this period of time, they took no other drugs and followed no diets, nor did their weights vary. The daily dose of doxazosin was increased (maximum, 8 mg) to achieve a normotensive blood pressure (< 140/90). At the end of treatment, total and low-density lipoprotein (LDL) cholesterol levels (225 +/- 18 v 200 +/- 16 and 177 +/- 8 v 150 +/- 7 mg/dL, respectively; P < .05) were decreased, confirming the lipid-lowering effect of the drug. The OGTT showed a significant decrease of plasma insulin (16.04 +/- 1.8 v 10.99 +/- 0.9 mU/mL.min, P < .05) and blood glucose (22.54 +/- 1.6 v 20.83 +/- 1.6 g/dL.min, P < .05) areas. The glucose to insulin ratio, also known as the insulin sensitivity index, increased (1.56 +/- 0.15 v 1.95 +/- 0.12, P < .05). These findings seem to provide evidence of a favorable effect of doxazosin on insulin action.

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Spironolactone was the most effective add-on drug for the treatment of resistant hypertension. The superiority of spironolactone supports a primary role of sodium retention in this condition.

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After 12 weeks of treatment, both groups showed significant improvements in IPSS scores (total, obstructive and irritative subscores, QoL score) from baseline (p < 0.0001). However, the doxazosin-GITS group showed significantly greater improvements in total IPSS and obstructive subscore than the tamsulosin group in the early period (p < 0.05). Improvements in irritative subscore (within 4 weeks) and QoL score (during 12 weeks) were not significantly different between the groups. The incidences of AEs were similar between the groups.

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The purpose of this study was to compare prescriber monitoring for safety and efficacy of medication classes used to treat benign prostatic hyperplasia (BPH).

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The efficacy and tolerability of doxazosin and atenolol in the management of mild and moderate hypertension were compared in a multicentre, parallel study, the first year of which was randomized and double-blind. Patients who completed this first year were invited to enter a two-year extension phase; the results after the first year are presented. A total of 228 patients entered the double-blind phase (118 received atenolol). A reduction in dose was required by 4% in each group; eight patients on doxazosin and 11 on atenolol were withdrawn due to adverse effects. Ninety-three of the 100 doxazosin patients and 88 of the 104 atenolol patients who completed the double-blind phase agreed to participate in the open extension study. At 24 months, the mean dose of doxazosin was 5.2 mg/day, and of atenolol 66.7 mg/day. From baseline levels of BP of 158/104 mmHg in the doxazosin group and 161/103 mmHg in the atenolol group, average reductions at 24 months were -16/-14 and -19/-15 mmHg respectively. Neither drug had a significant effect on total cholesterol levels. At all four points of measurement over the two years, doxazosin decreased blood triglyceride levels and increased high density lipoprotein (HDL) cholesterol and the HDL: total cholesterol ratio. Atenolol had the opposite effect on each of these lipid values with the differences between the treatment groups being significant. Doxazosin was well tolerated and was shown to be effective as monotherapy in mild and moderate hypertension. Its effect on blood lipids was potentially favourable, and it should therefore be regarded as an alternative first-line drug in hypertensive patients.

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The effect of the drugs on albumin and total protein excretion, beta-2-microglobulin, proximal tubular enzyme markers and renal haemodynamics.

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These findings suggest that the treatment of BPH with finasteride is cost-effective compared to placebo in the Brazilian public health system perspective.

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In Protocol 1, a significant relationship was observed between the following: trait anxiety and plasma norepinephrine (r = 0.32, P < .01); plasma norepinephrine and ROS formation by MNC (r = 0.36, P < .01); and plasma norepinephrine and systolic, diastolic, and mean BP (r = 0.17, P = .04; r = 0.26, P = .02; r = 0.23, P < .01, respectively). In Protocol 2, subtherapeutic doxazosin treatment (1 mg/day) had no significant effect on BP. However doxazosin significantly decreased ROS formation by MNC compared with placebo (P < .01).

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Fifteen male Wistar rats were treated subcutaneously with 10 mg/Kg doxazosin during 15 days and fifteen controls were treated with the vehicle only. After the treatment period, prostate was removed to obtain soluble and membrane-bound fractions. Soluble and membrane-bound IRAP specific activities were assayed fluorometrically using leucyl-ß-naphthylamide as substrate. Prostate OT content was assayed by enzyme immunoassay.

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We conducted ambulatory BP monitoring three times (twice at baseline and after nighttime dosing of the alpha1-blocker doxazosin) in 98 elderly hypertensive patients in whom the presence of silent cerebral infarcts (SCI) was assessed by brain magnetic resonance imaging. The morning BP surge (MBPS) was calculated as the mean systolic BP during the 2 h after waking minus the mean systolic BP during 1 h that included the lowest sleep BP. The alpha-adrenergic MBPS was calculated as the reduction of MBPS by doxazosin.

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The acute effects of selective alpha 1 inhibition with doxazosin (0.5-0.7 mg intravenously) and beta 1-blockade with atenolol (0.1 mg/kg body weight, intravenously) on smoking-induced peripheral vasoconstriction were investigated in 24 hypertensive habitual smokers. Forearm blood flow was measured by venous occlusion plethysmography and skin blood flow was estimated by thermography and laser doppler flowmetry. After the patients had smoked two cigarettes, plasma adrenaline elevations were similar under basal conditions and after drug administration; plasma noradrenaline remained unchanged. The smoking-induced increase in the heart rate was attenuated by atenolol compared with basal values. The smoking-induced increase in systolic blood pressure was more marked after atenolol and doxazosin (P less than 0.05) than before the drug administration. The smoking-induced increase in diastolic blood pressure was enhanced by atenolol (P less than 0.05) but unchanged by doxazosin. Smoking increased forearm vascular resistance under basal conditions (P less than 0.05) and after atenolol (P less than 0.01) but not after doxazosin. Similarly, skin temperature was significantly reduced by smoking under basal conditions and after the administration of atenolol (P less than 0.001) but not doxazosin. The smoking-induced reduction in skin blood flow was attenuated by doxazosin compared with atenolol (P less than 0.05). Thus, smoking-induced muscular and cutaneous vasoconstriction was inhibited by doxazosin as opposed to atenolol in hypertensive habitual smokers. This may reflect unmasked beta-adrenoceptor mediated vasodilation in addition to attenuated alpha 1-adrenoceptor mediated vasoconstriction.

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Randomised controlled trials of at least one anti-hypertensive treatment against placebo, or two anti-hypertensive medications against each other, with interventions lasting at least one month. Trials had to include patients with symptomatic PAD.

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Clinical trials of alpha-blockers in men with enlarged prostate have reported improvements in total symptom scores of 10% to 20% compared with placebo; however, these agents were not shown to reduce the risk of long-term complications or disease progression. Studies of the 5ARIs have reported significant reductions compared with placebo in the relative risk for AUR and enlarged prostate-related surgery, slowing of disease progression, and relief of symptoms. In studies of dutasteride, improvements in symptom scores were greater after 4 years of therapy compared with 2 years (-6.4 vs -4.3 points, respectively) and flow rates were better (2.6 vs 2.3 mL/sec). Six-year data for finasteride showed maintenance of the decreased risk for AUR and enlarged prostate-related surgery. Use of combination therapy with an alpha-blocker and a 5ARI may be of benefit in patients who require immediate relief of symptoms, with discontinuation of the alpha-blocker after several months of therapy. 5ARIs were generally well tolerated, with sexual dysfunction the most frequently reported adverse effect, although in only a small proportion of men (1%-8%).

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1. The effects of the alpha(1)-adrenoceptor antagonists doxazosin (0.1 -- 2 mg kg(-1)), RS-100329 (alpha(1A); 0.01 -- 1 mg kg(-1)), RS-513815 (Ro 151-3815, alpha(1B); 0.3 -- 3 mg kg(-1)) and BMY 7378 (alpha(1D); 0.1 -- 1 mg kg(-1)), the 5-HT(1A) receptor agonist, 8-OH-DPAT (0.03 -- 0.3 mg kg(-1)) and antagonist WAY-100635 (0.03 -- 0.3 mg kg(-1)) were investigated (i.v.) on the 'micturition reflex' in the urethane anaesthetized male rat. 2. Reflex-evoked urethra contractions were most sensitive to the inhibitory action of RS-100329, followed by doxazosin, BMY 7378 and WAY-100635 and then RS-513815. The maximum inhibition was 66, 63, 54, 46 and 22% at doses of 0.3, 0.5, 0.3, 0.3 and 3 mg kg(-1) respectively. 3. BMY 7378 and 8-OH-DPAT decreased, while WAY-100635 increased, the pressure threshold to induce bladder contraction. WAY-100635 (0.01 mg kg(-1)) blocked the effects of BMY 7378 (1 mg kg(-1)) on bladder pressure and volume threshold. 4. Doxazosin, RS-100329 and BMY 7378 had a similar potency in inducing a fall in arterial blood pressure while WAY-100635 only caused a fall at the highest dose. 5. Therefore, reflex-evoked urethral contraction involves the activation of alpha(1A/1D)-adrenoceptors, as BMY 7378 and RS-100329 are similarly potent in attenuating this effect. The ability of WAY-100635 to attenuate this contraction may suggest that 5-HT(1A) receptors are also involved. However, as this inhibition occurred at the highest dose of WAY-100635, which also caused a fall in arterial blood pressure; this effect is considered to be due to blockade of alpha(1)-adrenoceptors not 5-HT(1A) receptors. Nevertheless the initiation of the 'micturition reflex' involves the activation of 5-HT(1A) receptors.

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The attenuation of cyclic guanosine 5'-monophosphate (cGMP) production due to inactivation of guanylate cyclase by increased superoxide has been reported as a mechanism of nitrate tolerance. Carvedilol has been known to combine alpha/beta-blockade with antioxidant properties.

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Benign prostatic hyperplasia (BPH) is highly prevalent in the male population beyond the age of 60. Impairment of urinary flow due to prostate enlargement gives rise to symptoms of 'prostatism' that have a detrimental impact on the quality of life. The current trend in the management of symptomatic BPH favours pharmacotherapy as a first line option, while the number of surgical procedures being performed has experienced a steady decline during the last ten years. Among the pharmacological treatments, the use of alpha1-adrenoceptor blockers has demonstrated to be an effective treatment option for BPH. These agents reduce the adrenergic tone to the prostate and increase urinary flow, with a concomitant reduction of lower urinary tract symptoms. The alpha1-blockers currently approved include compounds such as alfuzosin, terazosin and doxazosin, originally developed for the treatment of hypertension, and more recently tamsulosin, an alpha1-subtype selective drug. The blockade of alpha1-adrenoceptors present in vascular smooth muscle is largely responsible for the most prominent side effects of current drugs, which can be severe and require patients dose titration. The limitation imposed by side effects naturally raises the possibility that complete blockade of prostatic alpha1 receptors is not attained at the maximum tolerated dose. The extensive efforts by the pharmaceutical industry towards the development of uroselective alpha1-blockers, is the subject of this review. Advances in the molecular cloning of genes encoding three alpha1-adrenoceptors led to the identification of the alpha1A-subtype as the predominant receptor responsible for the contraction of prostate smooth muscle. In preclinical animal models, selective alpha1A-antagonists have consistently been found to have minimal cardiovascular effects, thus providing a pharmacological rationale for uroselectivity. It has also become apparent, however, that uroselectivity can emerge in a poorly understood manner from the pharmacodynamic properties of compounds without alpha1A-subtype selectivity. Clinical experience with tamsulosin, an alpha1A/alpha1D selective drug, has failed to demonstrate a significant improvement in efficacy beyond that demonstrated for non-subtype selective alpha1-blockers, and gives support to the notion that alpha1A-selective antagonists might achieve greater efficacy for the treatment of BPH. Given the demonstrated uroselectivity of alpha1A-selective antagonists in preclinical models, it is anticipated that third generation alpha1-blockers will exhibit improved urinary flow efficacy and be better tolerated than tamsulosin. The extent to which the improvement in urinary flow will translate to the relief of symptoms of prostatism, however, remains to be demonstrated in randomised placebo-controlled clinical trials of alpha1A-selective antagonists.

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Data were extracted by one author (DAL) and checked by the other (GYHL). Potentially eligible studies were excluded when the results presentation prevented adequate extraction of data and enquiries to authors did not yield raw data.

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These data show that the low subdepressor dose ACE inhibitor with an alpha- or beta-adrenergic receptor antagonist provides beneficial cardiovascular effects in SHR.

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A study was conducted to determine whether sympathetic nerve activity, one of the main regulators of blood pressure, is involved in high blood pressure in the night-time and morning. Twenty-seven untreated hypertensive subjects, in whom hypertension was diagnosed by ambulatory blood pressure (ABP) measurement, who showed a 24 h systolic ABP value over 140 mmHg and/or 24 h diastolic ABP over 90 mmHg were recruited. They also showed a night-time systolic ABP value of over 130 mmHg and/or a night-time diastolic ABP of over 80 mmHg. They were divided into two groups: "dippers (D)" whose night-time ambulatory blood pressure fell by more than 10% of the day-time blood pressure, and "non-dippers (ND)" in whom this phenomenon was absent. We examined the effect of a long-acting alpha 1-blocker (doxazosin) on diurnal blood pressure variation in these subjects with essential hypertension. Baseline casual blood pressure and 24 h systolic ABP were not significantly different between the two groups. However, both night-time and morning ABP in ND were higher than those in D. Administration of doxazosin (mean 73 +/- 13 (SE) d) significantly decreased casual blood pressure, and 24 h, day-time, night-time and morning systolic ABP in the whole cohort. When subjects were divided into D and ND, the day-time and morning systolic ABP decreased significantly after doxazosin treatment in both groups, whereas the night-time systolic ABP decreased significantly only in ND but not in D. These results suggest that sympathetic nerve activity involved in elevating blood pressure during the night may differ between D and ND.

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82.5% of the patients (33/40) could urinate after removal of the catheter. 84.8% (28/33) were treated with doxazosin (21 with 4 mg and 7 with 8 mg). In the first attempt at removal, 60% of the patients (12/20) treated with 4 mg of doxazosin could spontaneously buy cardura urinate, while only 25% (5/20) of those not treated, p=0.02. Similarly, 60% of the patients (9/15) treated with 4 mg of doxazosin in the second attempt could spontaneously urinate. Fifty per cent (7/14) of the patients still with a catheter, after the treatment with 4 mg of doxazosin, could urinate with 8 mg. In the logistic regression analysis, none of the variables analyzed allowed us to predict the response to the treatment.

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The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Experimental groups included (1) a control group, (2) a surgical delay (4-day and 7-day delay) group, and (3) a combined surgical and chemical (doxazosin mesylate, nitroglycerine patch) delay group. These groups buy cardura were further divided into subgroups (n = 10) depending on the delay period and the chemical agents. An arterialized venous flap was created on one ear of each rabbit. In the arterialized venous flap, arterial inflow was provided by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. In the control group, the arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. In the surgical delay group, the mean percentage survival of arterialized venous flaps was 36.6 percent in the 4-day delay group and 59.7 percent in the 7-day delay group. In the combined surgical and chemical delay group, a 3-day chemical delay followed by a 4-day simultaneous surgical and chemical delay resulted in mean percentage survival of the arterialized venous flaps of 81.1 percent in the doxazosin mesylate group, 72.8 percent in the nitroglycerine patch group, and 92.9 percent in a combination group of doxazosin mesylate and nitroglycerine patch. A 3-day chemical delay followed by a 7-day simultaneous surgical and chemical delay resulted in mean percentage survival of the arterialized venous flaps of 94 percent in the doxazosin mesylate group, 90.2 percent in the nitroglycerine patch group, and 99 percent in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increased the percentage survival of the arterialized venous flaps in proportion to the delay period. The combination group of surgical and chemical delay procedures had a significantly greater percentage survival than that of the surgical delay group (p < 0.001), and the delay period could be shortened.

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The hemodynamic interaction between tadalafil (5 mg/d) and doxazosin or tamsulosin was investigated in 2 randomized, double-blind, crossover phase 1 studies. Healthy men (n = 45) received tadalafil or placebo for 28 days and increasing doses of doxazosin (1, 2, and 4 mg/d) for the last 21 days of treatment. In the second study, participants (n = 39) received tadalafil or placebo for 14 days and tamsulosin ( Ivermectin Stromectol Buy 0.4 mg/d) for the last 7 days of treatment. Similar mean maximum postbaseline changes in standing systolic blood pressure were observed in subjects given tadalafil or placebo with 4 mg of doxazosin (-0.5 mm Hg; 95% confidence interval, -4 to 3.1 mm Hg) or with tamsulosin (0.9 mm Hg; 95% confidence interval, -1.4 to 3.2 mm Hg). Standing systolic blood pressure less than 85 mm Hg (blood pressure outlier) occurred in 1 subject treated with 4 mg of doxazosin plus tadalafil but was not reported in subjects treated with tamsulosin and tadalafil. Three subjects experienced moderate hypotensive events lasting less than 2 hours, 2 with syncope (after tadalafil alone or with 4 mg of doxazosin) and 1 without (after 4 mg of doxazosin with placebo). The incidence of hypotension was low in healthy men given increasing doses of doxazosin with chronically dosed tadalafil or placebo. Administration of tadalafil with tamsulosin was well tolerated in healthy men.

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Lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), and sexual dysfunction such as erectile dysfunction (ED), are highly prevalent in men over the age of 50. LUTS and ED have a negative impact on sexual function and when comorbid, result in reduced quality of life. The goal of this article is to discuss the relationship between ED and LUTS, describe the diagnostic workup of these disorders, explore the current treatment options, and examine how treatments may affect this population. Medline (1980-2006), Cochrane reviews, and the American Urological Association 2006 General Meeting abstracts were searched for relevant clinical trials and reviews with the terms: benign prostatic hyperplasia, lower urinary tract symptoms, erectile dysfunction, sexual dysfunction, alpha-adrenergic receptor antagonists, alpha-blockers, 5alpha-reductase inhibitors, phosphodiesterase type-5 inhibitors, transurethral resection of the prostate, transurethral microwave thermotherapy, transurethral needle ablation, adverse events, alfuzosin, doxazosin, tamsulosin, terazosin, dutasteride, finasteride, sildenafil, tadalafil, vardenafil. However, because of the volume of literature, this article is not a systematic review. Topamax Generic Pill Identifier

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alpha1-Adrenergic receptors mediate mitogenic responses and increase intracellular free Ca2+ ([Ca2+]i) in vascular smooth muscle cells. Induction of c-fos is a critical early event in cell growth; expression of this gene is regulated by a number of signaling pathways including Ca2+. We wondered whether Ca2+ signaling plays a critical role in the induction of c-fos gene by alpha1-adrenergic receptors. Using stably transfected rat-1 fibroblasts, we confirmed that PE induced c-fos mRNA expression in a time- and dose-dependent manner, and also increased [Ca2+]i (measured with Fura-2 AM). These responses were blocked by the alpha1-adrenergic receptor antagonist doxazosin. Both intracellular Ca2+ chelation (using BAPTA/AM) and extracellular Ca2+ depletion (using EGTA) significantly inhibited PE-induced c-fos expression by alpha1A and alpha1B receptors. Brief (1-min) Cymbalta Drug Info stimulation of alpha1A and alpha1B receptors with PE did not maximally induce c-fos expression, suggesting that a sustained increase in [Ca2+]i due to Ca2+ influx is required. The calmodulin (CaM) antagonists, R24571, W7, and trifluoperazine, but not the CaM-dependent protein kinases inhibitor KN-62, significantly inhibited c-fos induction by alpha1A and alpha1B receptors. Neither inhibition of protein kinase C nor inhibition of adenylyl cyclase modified c-fos induction by PE. These results suggest that alpha1-adrenergic receptor-induced c-fos expression in rat-1 cells is dependent on a Ca2+/CaM-associated pathway.

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The goal of this Avelox Dose Pneumonia study was to investigate the effect of a combination therapy with finasteride and doxazosin on IPP in BPU/LUTS patients.

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The antihypertensive effect of doxazosin 1-16 mg once-daily was compared with that of atenolol 50-100 mg once-daily, and placebo, utilizing a double-blind Nexium Generic Add Topic parallel group (12 patients each) design. Blood pressure (BP) and pulse rate were determined in out-patients who returned for clinic visits every 2 weeks for 14 weeks. During the first 4 weeks, all patients received single-blind placebo therapy. During the subsequent 10 weeks, patients were randomized to placebo, atenolol or doxazosin treatment. After 2 weeks of doxazosin therapy 16 mg daily, there was a significant decrease from baseline (single-blind placebo period) in supine diastolic BP (P less than 0.01) and standing diastolic BP (P less than 0.001). The decreases in supine and standing diastolic BPs in the doxazosin 16 mg daily group were significantly (P less than 0.01) different from the corresponding BPs of the placebo group. At weeks 12 and 14, heart rates in the doxazosin group were not significantly different from baseline or from those in the placebo group. After 4 and 6 weeks of atenolol 100 mg daily, there was a significant decrease from baseline in both supine (P less than 0.001 and P less than 0.05) and standing (P less than 0.05) diastolic BPs and heart rates (P less than 0.05). However, when the atenolol group was compared with the placebo group, a significant decrease occurred only with supine diastolic BP at week 12 (P less than 0.01) and not at week 14; but significant decreases occurred in supine and standing heart rates at weeks 12 and 14 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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The left coronary artery was hypoperfused by means Viagra Online Canadian of a clamped shunt line. Sequential selective postjunctional alpha 1 (doxazosin) and alpha 2 (SK&F 104078) adrenergic antagonism was established following beta adrenergic antagonism with propranolol. Regional myocardial blood flow was measured with radiolabelled microspheres during equal coronary perfusion pressures. Experimental subjects were nine pentobarbitone anaesthetised open chest cats.

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Treatment with doxazosin resulted in sustained benefits for BPH patients over the whole study period, with significant improvements in the severity (12.2%, P < 0. Buy Viagra Pills Online Uk 001) and bothersomeness (13.2%, P < 0.001) of BPH symptoms, and in the maximum urinary flow rate (26.6%, P < 0.05) from baseline to the end of the 4-year period. There was also a significant and sustained reduction in diastolic blood pressure. The efficacy of doxazosin treatment for both BPH and hypertension was maintained over the 4-year period, despite the tendency of these conditions to worsen with time. Comparison of adverse events in patients with long- and short-term hypertension and BPH demonstrates that the safety of doxazosin is not altered during long-term therapy.

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Both doxazosin formulations reduced clinic diastolic and systolic blood pressure from baseline (P < 0.0001). Doxazosin GITS and doxazosin 4 mg had similar blood pressure-lowering effects. Doxazosin GITS reduced sitting Cymbalta Dosage Rxlist diastolic and systolic blood pressure compared with doxazosin 2 mg (P < 0.01 for both). A greater proportion of the doxazosin GITS group reached goal blood pressure (< or = 140/90 mm Hg) after 9 weeks compared with the doxazosin 2-mg group. All doses of doxazosin reduced 24-h and daytime (7:00 am to 10:00 pm) ambulatory blood pressure from baseline (all P < 0.01). Doxazosin GITS significantly reduced nighttime (10:00 pm to 7:00 am) ambulatory blood pressure from baseline. A neutral effect on serum lipids was observed with doxazosin.

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It is now widely recognized that a rigid stepped-care approach to antihypertensive therapy is not universally appropriate. Individualized treatment may result in good or better blood pressure control and a simpler regimen without troublesome side effects. Successful development of such a strategy depends on accurate characterization of a dose-response relation and quantitative assessment of the response in each individual. In the past such relations have proved to be hard to identify for antihypertensive drugs, often because of inappropriate study design during drug development. Despite failure of earlier studies to identify drug concentration-antihypertensive response relations, use of concentration-effect modeling, which recognizes and characterizes the temporal discrepancy between drug concentration and effect, has proved more successful. By using such approach, it has been possible to characterize the concentration-effect relations after acute and steady-state antihypertensive therapy with prazosin, doxazosin, nifedipine, verapamil, and enalapril. With enalapril and nifedipine, it has been demonstrated that the mathematical parameters of effect derived from the first dose can predict the response to these drugs after 4-6 weeks of treatment. These findings suggest that the definition of individual concentration-effect relations may be of value in the rational choice of antihypertensive drug therapy and optimization of dose and dose frequency. In particular, the approach can provide valuable information on dose-effect relations and should optimize choice of dose intervals in drug development and practice.

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To evaluate the effectiveness of the monotherapy of Cardura and the combination therapy of Cardura and Tolterodine L-Tartrate Tablets for II° ? benign prostate hyperplasia (BPH) with overactive bladder (OAB).

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The combination of muscarinic receptor and alpha(1)-adrenoceptor antagonists is increasingly used for benign prostatic hyperplasia related lower urinary tract symptoms. In addition to the well established peripheral site of action, little is known about the central effects of muscarinic receptor antagonists and muscarinic receptor/alpha(1)-adrenoceptor antagonist combinations on bladder function, partly due to poor brain penetration after systemic administration. We assessed the effects of intrathecal 5-hydroxymethyl tolterodine, an active metabolite of fesoterodine, in obstructed and nonobstructed rats, and of combined intrathecal 5-hydroxymethyl tolterodine/doxazosin in a rat model of partial urethral obstruction.

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PubMed and DOAJ were searched for papers related to prostate, apoptosis, and stem cell death. The following key words were used: prostate, benign prostate hyperplasia, programmed cell death, apoptosis, cell death, α1-adrenoreceptor antagonist, α-blockade, prostate epithelium, prostate stroma, stem cells, progenitors, and in vitro models.

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Pupillometry can be used to characterize autonomic drug effects.

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We report the case of a 59-year-old man with a pheochromocytoma in which erectile dysfunction was the main symptom. Erectile function was related to the amount of noradrenaline secreted by the tumor, as was determined when recurrence of the malignancy was diagnosed twice. Erectile function could be restored by lowering the level of noradrenaline excretion, either by removal of the noradrenaline-producing tumor or by treatment with doxazosin. By stimulating alpha-1-adrenoceptors, high levels of noradrenaline are likely to result in excessive contraction of the corpus cavernosum and penile vessels and, thereby, cause erectile dysfunction.

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Autonomic dysreflexia is a clinical emergency that occurs in individuals with spinal cord injury at level T-6 and above. We present a 58-year-old male patient with paraplegia who developed a severe, recurrent, throbbing headache during the night, which was relieved by emptying the urinary bladder by intermittent catheterisation. As this person continued to get episodes of severe headache for more than 6 months, computed tomography (CT) of the brain was performed. CT revealed an infarct measuring 1.2 cm in the right basal ganglia. In order to control involuntary detrusor contractions, the patient was prescribed propiverine hydrochloride 15 mg four times a day. The alpha-adrenoceptor blocking drug doxazosin was used to reduce the severity of autonomic dysreflexia. Following 4 weeks of treatment with propiverine and doxazosin, the headache subsided completely. We learned from this case that bladder spasms in individuals with spinal cord injury can lead to severe, recurrent episodes of autonomic dysreflexia that, in turn, can predispose to vascular complications in the brain. Therefore, it is important to take appropriate steps to control bladder spasms and thereby prevent recurrent episodes of autonomic dysreflexia. Intermittent catheterisations along with an alpha-adrenoceptor blocking drug (doxazosin) and an antimuscarinic drug (propiverine hydrochloride) helped this individual to control autonomic dysreflexia, triggered by bladder spasms during the night.

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Most alpha-receptor blocking drugs require divided daily administration because of a short plasma half-life. This multicenter study examined the effectiveness and safety of once-daily administration with doxazosin, a quinazoline analog alpha 1-receptor blocking drug with a plasma half-life of 19 hours. Patients with diastolic blood pressure (BP) of 90 to 115 mm Hg entered 4 weeks of single-blind placebo therapy and then were randomized to double-blind treatment with doxazosin (63 patients) or placebo (67 patients). After 10 weeks of titration, standing arterial BP was lowered by 14/11 mm Hg with doxazosin and by 0.5/0.9 mm Hg with placebo (p less than 0.001). Measured hourly for 12 hours after the dose, all standing and supine arterial BP values were significantly lower in the doxazosin group at each hour. Pulse rate increased slightly in both groups int he double-blind phase, but the increase with doxazosin never significantly exceeded that of placebo. Dizziness was the most common complaint with doxazosin, but syncope did not occur. Side effects were mild and transient and did not necessitate withdrawing any participants from the study. Body weight increased by 1.5 kg in the doxazosin group and decreased by 0.2 kg in the placebo group (p less than 0.01). Safe and effective in once-daily administration, doxazosin is suitable for initial therapy in mild and moderate hypertension.

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- Multicenter, randomized, double-blind, parallel-group clinical trial.

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Our study clearly showed the effects of finasteride on prostate tissue, and from a histomorphometric perspective, it was not able to detect any advantage of the combined treatment over the use of finasteride alone.

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To determine the sensitivity of drug-resistant prostate cancer cell lines to doxazosin-mediated cell death, and the effects of combining doxazosin and chemotherapeutic agents on these cell lines. Materials and methods The cytotoxic effect of doxazosin was initially evaluated in the prostate carcinoma cell lines DU145 and PC-3. Doxazosin was combined either with adriamycin, etoposide or paclitaxel after its cytotoxic effects were detected in these cell lines. The tetrazolium dye (MTT) assay and trypan blue dye-exclusion tests were used to determine drug-mediated cytotoxicity. Experiments were performed at least three times and representative data are presented.

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Taken together, these results suggest that the decrease in collagen type I following treatment with doxazosin or carvedilol is achieved by decreasing the profibrotic activities of TGF-β via the blockage of α1- and β-adrenergic receptor. Consequently, a diminution of fibrotic tissue in the CCl4-induced model of cirrhosis is achieved.

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The efficacy and safety of doxazosin (DOX) for the treatment of hypertension was investigated. A multicenter, double-blind, placebo-controlled, parallel design was employed. A 4-week placebo runin period was followed by a 9-week double-blind period during which patients were randomly assigned to placebo or 2, 4, or 8 mg doxazosin. Blood pressures (BP) and heart rates (HR) were measured 24 hours postdose. The mean changes in standing BP (mmHg) were -6.2/-6.9 (2-mg regimen), -5.7/-5.8 (4-mg regimen), -8.5/-7.7 (8-mg regimen) for DOX patients and 0.7/-2.9 for placebo patients. The mean changes in supine BP (mmHg) were -3.2/-4.7 (2-mg regimen), -4.0/-5.1 (4-mg regimen), -4.6/-5.6 (8-mg regimen) for DOX patients and -0.5/-3.3 for placebo patients. There was no evidence of a dose-response relationship for DOX; however, DOX serum levels were linearly related to the dose. Responder rate for the combined DOX patients was 38% (32/84) and for the placebo patients 27% (8/30). HR (24 hours postdose) was not modified by DOX. Patients in the 8-mg regimen had a significantly higher gain in mean body weight (+ 1.3 +/- 0.3 kg; P less than 0.05) compared to the 2-mg regimen, 4-mg regimen, and placebo groups. Plasma norepinephrine was not significantly modified by DOX. DOX had a favorable effect on plasma lipids. DOX lowered LDL cholesterol (P less than 0.05), total cholesterol, and apoprotein B and increased HDL/(LDL + VLDL) ratio (0.05 less than or equal to P less than 0.1) compared to placebo. Dropout rate and treatment-related side effects were equally distributed among the DOX and placebo groups. No patients had the dose of medication reduced because of side effects. Three DOX patients were withdrawn because of postural dizziness.

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The aim of the study was to describe our diagnostic and therapeutic logarithm based on functional classification in children with enuresis, and effects of therapy based on this classification.

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Anti-hypertensive treatment is much less successful at reducing coronary artery disease than at reducing mortality from stroke and congestive heart failure. The effects of the alpha-adrenergic antagonist doxazosin on progression of atheromatous lesions and functional responses of isolated coronary arteries from cholesterol-fed rabbits have been investigated. Normotensive rabbits were fed either a standard chow (control, n = 8) or a 1% cholesterol-rich diet (n = 16) for 20 weeks. After 3 weeks the cholesterol-fed animals were assigned randomly to two groups either given placebo capsules (n = 8) or treated with doxazosin (5 mg kg-1 day-1; n = 8). Doxazosin reduced the mean arterial blood pressure by 10% that of the control and placebo-treated cholesterol-fed rabbits, but did not affect the plasma cholesterol, triacylglycerol and phospholipid levels, which were, after 20 weeks, severalfold increased in the cholesterol-fed rabbits compared with controls. Histological examination showed atheromatous lesions in proximal (but not distal) coronary arteries from both groups of cholesterol-fed rabbits. Doxazosin either had no effect on reduced contractions to 125 mmol L-1 potassium saline solution or increased contractions to 5-hydroxytryptamine in proximal isolated coronary arteries from the cholesterol-fed rabbits. It did, however, abolish the hyper-responsiveness of the large atheromatous coronary arteries to noradrenaline. In both vehicle-and doxazosin-treated cholesterol-fed rabbits the maximum relaxation and sensitivity to acetylcholine were significantly reduced in proximal segments compared with the control group, whereas responses to acetylcholine in distal coronary segments were not significantly different. The relaxation to sodium nitroprusside, adenosine diphosphate and isoprenaline in proximal and distal coronary arteries were similar in the three experimental groups. These results indicate that treatment of normotensive cholesterol-fed rabbits with doxazosin prevents the hyper-responsiveness to noradrenaline of proximal coronary arteries, although it does not prevent the progression of other functional alterations observed in the coronary circulation.

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During examination of 165 children aged 5 to 15 years (primarily identified during planned monitoring in Petrozavodsk children's institutions) with dysfunctional urination and encopresis without organic lesion of the central nervous system, autonomic dysfunction syndrome (ADS) was revealed. According to the results of urological examination, which was supplemented with the registration of spontaneous voiding rate and counting the radial pulse, overactive bladder syndrome and insufficient relaxation of the pelvic floor muscles during urination and defecation were detected; relationship between the number of heart rate (as a marker of sympathetic nervous system activity) and the effective volume was identified. It was revealed that the children with ADS in the presence of tachycardia show intermittent decrease of effective amounts of urination, and have residual urine. The standard course of treatment using colon hydrotherapy and biofeedback to activate cystic and obturator reflex caused a positive but short-term therapeutic effect; clinically and statistically significant increase in the effective volume of the bladder was not achieved, despite the reduction in residual urine volume. During the course of treatment using methods of biofeedback, bladder volume remained almost unchanged and tachycardia persisted, indicating the continued oppression of the sympathetic activity. The course of treatment using nootropic drug picamilon and alpha-adrenoblocker doxazosin with peripheral actions allowed to restore the reservoir and evacuation functions of the bladder, to achieve a regular bowel movement without encopresis. It was revealed that the combined dysfunction of pelvic organs occur in children with high activity of the sympathetic division of the ANS, which has a direct impact on the accumulation phase of voiding cycle and relaxation of the pelvic floor muscles.

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The evidence indicates that doxazosin is effective and generally well tolerated for improving LUTS and PUF in men with symptomatic BPO. Combined therapy was better than doxazosin alone in reducing the risk of clinical progression of BPO and other long-term complications related to BPO.

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The development of therapeutic strategies for the treatment of cirrhosis has become an important focus for basic and clinical researchers. Adrenergic receptor antagonists have been evaluated as antifibrotic drugs in rodent models of carbon tetrachloride (CCl4)-induced cirrhosis. The aim of the present study was to evaluate the effects of carvedilol and doxazosin on fibrosis/cirrhosis in a hamster animal model.

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To assess differences in pupil diameter between men taking systemic α(1)-adrenoreceptor antagonists and controls.