Ipsen Pharma · 小分子 · 小分子
doxazosin 是一种小分子，由Ipsen Pharma研发。该药已获批，用于治疗相关适应症，给药途径：Oral (PO)。
| 商品名 | Cardura XL, doxazosin, GITS, Cardura CR |
| 公司 | Ipsen Pharma |
| 药物类别 | 小分子 |
| 给药途径 | Oral (PO) |
| 状态 | Approved |
doxazosin 针对 2 个适应症，涉及 2 个治疗领域。
| 治疗领域 | 疾病/病症 | 分期 |
|---|---|---|
| Vascular disorders | Hypertension | ✓ Approved |
| Reproductive system and breast disorders | Benign prostatic hyperplasia | ✓ Approved |
Anwar Imran I, Zafar Nadiah N, Mahmood Asif A, Zulcaif
[This corrects the article DOI: 10.15171/bi.30257.].
Bhalla Jaideep Singh JS, Saraswati Ushasi U, Bansal Agam A, Abou Hassan Ossama O et al.
Cardiac paragangliomas are rare neoplasms, comprising only 1%-3% of primary cardiac tumours, and often pose a diagnostic challenge. A 56-year-old male presented with persistent chest pressure, palpitations and diaphoresis. Cardiac catheterization and further imaging revealed the presence of a fluorodeoxyglucose-avid enhancing epicardial mass accompanied by elevated serum catecholamines. Treatment with doxazosin followed by surgical resection was performed, confirming the diagnosis of cardiac paraganglioma on pathology. Whilst rare, cardiac paragangliomas can be hormonally active and symptomatic, necessitating operative management. Accurate differentiation from similar masses on imaging aids in guiding preoperative hormonal evaluations and medical management, as well as in conducting genetic testing to identify causative mutations and assess heritability.
Szwarkowska Maria M, Petela Tymoteusz T, Zeliaś Aleksander A, Skowerski Tomasz T et al.
Background: Resistant hypertension poses a significant therapeutic challenge, often leading to severe polypharmacy. Renal denervation (RDN) has re-emerged as a valuable adjunctive intervention for blood pressure control. Case Presentation: We report the case of a 64-year-old man (body mass index [BMI] 34 kg/m2) with long-standing resistant hypertension (RH), after previous percutaneous coronary intervention (PCI) to the left anterior descending artery, heart failure with preserved ejection fraction (HFpEF), and prior nephron-sparing surgery for clear cell renal carcinoma. Despite treatment with an extensive antihypertensive regimen encompassing nine pharmacological classes including diuretic therapy (angiotensin-converting enzyme inhibitor; calcium channel blocker, thiazide diuretic, β-blocker, α1-blocker, central α2-agonist, mineralocorticoid receptor antagonist, loop diuretic, long-acting nitrates), blood pressure remained severely uncontrolled on both home and office measurements. Persistent hypertension was accompanied by exertional dyspnoea and episodes of exertional chest discomfort. Following comprehensive evaluation and exclusion of secondary causes of hypertension, the patient underwent catheter-based renal denervation using the SymplicitySpyral™ (Medtronic) multi-electrode radiofrequency system. The procedure was associated with substantial and sustained improvement in blood pressure control, with mean 24 h ambulatory blood pressure measurements decreasing to 130/80 mmHg at six-month follow-up. Importantly, successful blood pressure reduction enabled major simplification of pharmacotherapy, including complete discontinuation of clonidine, loop diuretic therapy, and long-acting nitrates, together with marked dose reduction in doxazosin. Conclusions: This case illustrates the potential clinical utility of renal denervation in carefully selected patients with true resistant hypertension and pronounced sympathetic overactivity. Beyond achieving satisfactory blood pressure control, RDN may facilitate meaningful reduction in medication burden, potentially improving treatment adherence, quality of life, and long-term cardiovascular risk. Written informed consent was obtained from the patient for both the procedure and the publication of this case report.
Zhang Di D, Huang Qi-Fang QF, Li Yan Y, Wang Ji-Guang JG
We performed a post hoc exploratory secondary analysis to investigate whether baseline circadian blood pressure (BP) pattern was associated with changes in serum uric acid (SUA) during 8-week antihypertensive therapy. Of the 494 hypertensive patients who received amlodipine (5-10 mg) or nifedipine GITS (30-60 mg) for 8 weeks, 369 patients with available laboratory data and valid follow-up ambulatory BP monitoring data were included in the present analysis, including 221 dippers (nocturnal systolic BP decline ≥ 10%) and 148 non-dippers (nocturnal systolic BP decline < 10%). Analysis of covariance was used to estimate least square mean changes in SUA according to baseline dipping pattern. After 8-week antihypertensive treatment, SUA decreased significantly in dippers (-12.4 ± 3.4 µmol/L, p = 0.0004) but not in non-dippers (-3.3 ± 4.2 µmol/L, p = 0.44). In the repeated-measures analysis, SUA levels decreased significantly over time (p = 0.002), whereas no significant time-by-dipping interaction was observed (p = 0.23). Baseline BP dipping pattern may be modestly associated with short-term SUA changes during antihypertensive therapy. However, the absence of a significant time-by-dipping interaction suggests that these findings should be interpreted cautiously and require further confirmation.
Javed Tauram T, Shafique Mehwish M, Saleem Huma H, Iqbal Almas A et al.
This is a classic and complete representation of the multiple endocrine neoplasia type 2A (MEN2A) syndrome, involving primary hyperparathyroidism, medullary thyroid carcinoma, and pheochromocytomas. This case is particularly noteworthy for the recurrent, contralateral presentation of the pheochromocytoma, which emerged years after the initial surgical management. Recurrent and contralateral pheochromocytomas present unique anesthetic, surgical, and postoperative problems due to excess catecholamines and severe, potentially life-threatening hemodynamic instability in the perioperative phase. We report an unusual case of a 29-year-old female with MEN2A who had a right adrenalectomy, subsequently total thyroidectomy and parathyroidectomy, and was under follow-up with an endocrinologist. During follow-up, she was found to have very high plasma normetanephrine levels (>760 pg/mL), and radiological imaging revealed an avid adrenal nodule in the left adrenal gland, which was consistent with the diagnosis of recurrent contralateral pheochromocytoma. She was managed preoperatively on doxazosin and metoprolol. During the anesthetic evaluation, she had orthostatic hypotension, but no other symptoms related to pheochromocytomas. Elective open left adrenalectomy was carried out under general anesthesia, aiming to blunt stress responses. Hemodynamics were monitored invasively and managed with vasodilator and vasopressor infusions. After the removal of the adrenal tumor, the noradrenaline infusion was stopped as she maintained her stable hemodynamic parameters. She had an uneventful recovery and an orderly discharge from the post-anesthesia recovery unit. This case highlights the importance of meticulous preoperative optimization, vigilant intraoperative monitoring, and readiness with vasoactive agents in managing pheochromocytomas in patients with MEN2A. A multidisciplinary approach is essential to achieve a safe anesthetic course and a favorable outcome in such high-risk scenarios.
Hananias Fady Elias FE, Vera Gonzalo G, Fernández Valeria V, Quevedo Iván I
Pheochromocytoma is an uncommon neuroendocrine tumor that may present with highly variable and misleading clinical manifestations. We report the case of a 64-year-old woman with a history of hypertension who presented with acute chest pain, electrocardiographic changes, and marked elevation of cardiac biomarkers, initially suggestive of an acute coronary syndrome. Coronary angiography revealed no obstructive coronary disease. During hospitalization, the patient developed severe hemodynamic instability with alternating hypertensive crises and hypotension. Imaging studies identified a large heterogeneous right adrenal mass with high attenuation and associated hemoperitoneum. Biochemical evaluation demonstrated markedly elevated urinary metanephrines and normetanephrines, confirming the diagnosis of pheochromocytoma. The patient was stabilized medically and treated with preoperative α-adrenergic blockade using doxazosin, followed by successful surgical resection. Histopathological examination revealed extensive tumor necrosis with minimal viable tissue. Postoperatively, the patient had an uneventful recovery, with normalization of blood pressure and no recurrence of symptoms during follow-up. This case highlights the diagnostic and therapeutic challenges posed by pheochromocytoma presenting as acute myocardial injury and complicated by spontaneous tumor rupture with hemoperitoneum.
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