Antihypertensives: Peripheral Alpha1 blockers

1. may activate baroreceptors and cause increase in heart rate (less w/ selective b/c don't block alpha 2 which decreases central sympathetic output

2. prazosin

2.1. shorter half life; BID dosing

3. doxazocin

3.1. qhs dosing

4. terazocin

4.1. qhs dosing

5. MOA: selective alpha 1 blockade-> vasodilation-> decreased PVR

6. AE

6.1. first dose phenomenom

6.1.1. postural hypotention and syncompe w/in 30-90 min of first dose -> give low dose at bedtime, increase slowly

6.1.2. HA, dizz, weakness, palpatations, dry mouth

6.1.3. ALLHAT study-> why we don't use alpha 1 blockers as much

6.1.3.1. doxazocin arm was stopped early d/t increased strokes, CHF and all cause cardiovascular events

6.1.3.2. may be used in males w/ prostatic hypertrophy