Page 186 - Basic _ Clinical Pharmacology ( PDFDrive )

172 SECTION II Autonomic Drugs

Fitzgerald JD: Do partial agonist beta-blockers have improved clinical utility? Nickerson M: The pharmacology of adrenergic blockade. Pharmacol Rev
Cardiovasc Drugs Ther 1993;7:303. 1949;1:27.
Freemantle N et al: Beta blockade after myocardial infarction: Systematic review Okamoto LE et al: Nebivolol, but not metoprolol lowers blood pressure in nitric
and meta regression analysis. BMJ 1999;318:1730. oxide-sensitive human hypertension. Hypertension 2014;64:1241.
Hogeling M, Adams S, Wargon O: A randomized controlled trial of propranolol Perez DM: Structure-function of alpha1-adrenergic receptors. Biochem Pharmacol
for infantile hemangiomas. Pediatrics 2011;128:e259. 2007;73:1051.
Jacobs DS: Open-angle glaucoma: Treatment. UpToDate.com 2013, topic 15695. Pojoga L et al: Beta-2 adrenergic receptor diplotype defines a subset of salt-sensitive
Kamp O et al: Nebivolol: Haemodynamic effects and clinical significance of hypertension. Hypertension 2006;48:892.
combined β-blockade and nitric oxide release. Drugs 2010;70:41. Raj SR et al: Propranolol decreases tachycardia and improves symptoms in the
Kaplan SA et al: Combination therapy using oral β-blockers and intracavernosal postural tachycardia syndrome: Less is more. Circulation 2009;120:725.
injection in men with erectile dysfunction. Urology 1998;52:739. Robertson D et al: Primer on the Autonomic Nervous System, 3rd ed. Cambridge,
Kyprianou N: Doxazosin and terazosin suppress prostate growth by inducing MA: Academic Press, 2012.
apoptosis: Clinical significance. J Urol 2003;169:1520. Roehrborn CG, Schwinn DA: Alpha1-adrenergic receptors and their inhibitors
Lanfear DE et al: β2-Adrenergic receptor genotype and survival among patients in lower urinary tract symptoms and benign prostatic hyperplasia. J Urol
receiving β-blocker therapy after an acute coronary syndrome. JAMA 2004;171:1029.
2005;294:1526. Schwinn DA, Roehrborn CG: Alpha1-adrenoceptor subtypes and lower urinary
Lepor H et al: The efficacy of terazosin, finasteride, or both in benign prostate tract symptoms. Int J Urol 2008;15:193.
hyperplasia. N Engl J Med 1996;335:533. Shibao C et al: Comparative efficacy of yohimbine against pyridostigmine for the
Maggio PM, Taheri PA: Perioperative issues: Myocardial ischemia and protection– treatment of orthostatic hypotension in autonomic failure. Hypertension
beta-blockade. Surg Clin North Am 2005;85:1091. 2010;56:847.
McVary KT: Alfuzosin for symptomatic benign prostatic hyperplasia: Long-term Tank J et al: Yohimbine attenuates baroreflex-mediated bradycardia in humans.
experience. J Urol 2006;175:35. Hypertension 2007;50:899.
Nickel JC, Sander S, Moon TD: A meta-analysis of the vascular-related safety Wilt TJ, MacDonald R, Rutks I: Tamsulosin for benign prostatic hyperplasia.
profile and efficacy of alpha-adrenergic blockers for symptoms related to Cochrane Database Syst Rev 2003;1:CD002081.
benign prostatic hyperplasia. Int J Clin Pract 2008;62:1547.

C ASE STUD Y ANSWER

The patient had a pheochromocytoma. This tumor secretes cat- rate increase, producing a typical episode during the examina-
echolamines, especially norepinephrine and epinephrine, result- tion, perhaps set off in this case by external pressure as the phy-
ing in increases in blood pressure (via α receptors) and heart sician palpated the abdomen. His profuse sweating was typical
1
rate (via β receptors). The pheochromocytoma was in the left and partly due to α receptors, although the large magnitude of
1
1
adrenal gland and was identified by meta-iodobenzylguanidine drenching sweats in pheochromocytoma has never been fully
(MIBG) imaging, which labels tissues that have norepinephrine explained. Treatment would consist of preoperative pharma-
transporters on their cell surface (see text). In addition, he had cologic control of blood pressure and normalization of blood
elevated plasma and urinary norepinephrine, epinephrine, and volume if reduced, followed by surgical resection of the tumor.
their metabolites, normetanephrine and metanephrine. The Control of blood pressure extremes might be necessary during
catecholamines made the blood pressure surge and the heart surgery, probably with nitroprusside.