Home Nonfiction 10 • John D. McConnell (auth.), Reginald C. Bruskewitz MD (eds.)'s Atlas of the Prostate PDF

John D. McConnell (auth.), Reginald C. Bruskewitz MD (eds.)'s Atlas of the Prostate PDF

By John D. McConnell (auth.), Reginald C. Bruskewitz MD (eds.)

ISBN-10: 1461565057

ISBN-13: 9781461565055

ISBN-10: 1461565073

ISBN-13: 9781461565079

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L. 4 1 13 Stud~ Abram t I. 17 I L par et al. 5 mLis and to decrease symptom scores by about 35% [74-76]. The side effect profile appears similar to that of other long-acting agents such as terazosin or doxazosin. Longer term clinical trials are pending. NR-not reported; PVR-postvoid residual volume; ~ax-maximum urine flow. • FIGURE 3-20. Randomized, placebo-controlled, double-blind phase III clinical trials of tamsulosin. Pharmacokinetic studies have demonstrated tamsulosin to be a long-acting a-blocker with selectivity for the al a-adrenoreceptor [72].

Xl d-aor nor ptor eptor t FIGURE 3-16. Distribution of a-adrenoreceptor subtypes in the lower urinary tract [54]. ala-Receptors predominate in the prostatic epithelial tissue, bladder trigone, and the urethra. aId-Receptors predominate in the bladder. ala-Receptors also predominate in the prostatic vascular smooth muscle. However, with aging alb-receptors are expressed and ultimately predominate. This transition occurs around age 50 years. T hus blockade of ala-receptors is believed to improve obstructive symptoms by decreasing the prostatic obstruction, while blockade of a I d-receptors is believed to relieve irritative symptoms by reducing bladder tone.

FIGURE 3-25. Overview of phytotherapy. Botanicals remain the lifeblood of modern pharmacology. The most famous is probably the foxglove plant, but serenoa repens has been used for the prostate for over 300 years [87]. Despite the fact that Americans use more and more alternative medicine [88], and that the use of botanicals in Europe far exceeds that for a-blockers and Sa-reductase inhibitors [89], the plant extracts have been poorly evaluated. This is primarily due to their sale as food supplements and not pharmaceuticals that may be patented.

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Atlas of the Prostate by John D. McConnell (auth.), Reginald C. Bruskewitz MD (eds.)


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