A 62-year-old man with benign prostatic hyperplasia presents with a 6-month history of urinary hesitancy, weak urinary stream, and incomplete bladder emptying. His blood pressure is 138/82 mmHg with a heart rate of 76/min. Digital rectal examination reveals a smooth, symmetrically enlarged prostate without nodules. Post-void residual urine is 180 mL. His current medications include lisinopril for hypertension. Laboratory studies show serum PSA of 2.1 ng/mL and normal renal function. The patient is counseled that some alpha-1 adrenergic antagonists used to treat BPH can cause orthostatic hypotension and syncope due to vasodilation, which would be particularly concerning given his existing hypertension treatment. His urologist selects a medication with selective affinity for alpha-1A receptors in the prostate while minimizing vascular alpha-1B receptor blockade. Which of the following drugs is most appropriate?
- A)Doxazosin
- B)Phenoxybenzamine
- C)Prazosin
- D)Silodosin
- E)TamsulosinGABARITO
Explicação
Tamsulosin is a selective alpha-1A adrenergic antagonist with approximately 13-fold selectivity for alpha-1A receptors (found in prostate smooth muscle) compared to alpha-1B receptors (found in vascular smooth muscle). This selectivity translates to minimal ef... Ver explicação completa e trilha adaptativa →