Tamsulosin is a alpha blocker indicated for the treatment of Benign Prostatic Hyperplasia (BPH) and few of the precautions should be considered while using this drug.
Hi everyone today in this video we are going to discuss about precautions and side effects of tamsulosin. what is this drug tamsulosin? the suffix -osin indicates it is an alpha blocker and this tamsulosin is indicated for the treatment of benign prostatic hyperplasia or hypertrophy, we can observe enlargement of the
Prostate so this is the normal prostate gland which prostate gland, the urine output is normal years we can observe some prostate enlargement particularly this prostate enlargement is more observed in the patients with age greater than prostate enlargement the urethral pathway is somewhat constricted so
That even by constriction of the bladder urine cannot be emptied completely patients we can observe increased urinary frequency as well as urgency because the urine is not cleared from the bladder even by constriction of the bladder and there is decreased urinary flow these two conditions result in the incomplete
Emptying of bladder so even urinary frequency is increased but bladder is not completely emptied in such patients we can observe increased urinary frequency as well as urgency but urinary output is somewhat reduced. in those patients tamsulosin can be used which increase the urinary flow by relaxing the prostate tissue
As well as bladder neck muscles so that urinary flow can be increased. but when this drug is used for bph what are the important precautions that should be considered and what are the side effects that can be observed with this drug so these things we will discuss in this video. first of all let the important
Precaution of tamsulosin is that this drug can act on the vascular smooth muscle which is expressed with alpha-1 receptors. acts as alpha 1 blocker so that it blocks the now this vasodilation produce some hypotension and decrease in the blood pressure which leads to so many side effects. particularly this hypotension
Changes with the posture that’s why it’s also hypotension is the one of the important side effect of tamsulosin. in this condition the blood pressure is not changed with the gravitational pressure and change in the posture leading to some hypotension that’s why this postural hypotension is also called as orthostatic
Hypotension. so with the tamsulosin we can observe decrease in the blood pressure particularly the systolic blood pressure is reduced at least 20 mm of mercury and diastolic blood pressure is going to be reduced by at least 10 millimeter of mercury. so when there is a drop in the blood pressure by 20 of systolic
Blood pressure and 10 of diastolic blood pressure hypotension which changes with the posture. so tamsulosin produces a postural hypotension resulting in the various symptoms in the patients. of postural hypotension and dizziness, some reeling sensation even vertigo can be produced. patient may have some confused
State and all the falling sensation within the patients. hypotension is significantly observed in those patients who are driving the vehicles otherwise those patients working with machinery, caution should be taken to monitor any symptoms of can produce one of the condition priapism which is a
Very rare condition which is observed only in one patient’s out of 50 000 patients. corpus cavernosa. in this condition there greater than four hours without any relation with time of intercourse or sexual interaction and because of this prolonged erection it may result in some painful erection in the patients.
With the tamsulosin but if it is observed untreated it may lead to some impotence in the patients. similarly tamsulosin can be converted into metabolites by cytochrome p450 system one of the major metabolic pathways is the cyp3a4 enzyme. so many of the drugs are there which are instance, ketoconazole is a strong
Inhibitor of cyp3a4 enzyme thereby inhibits the metabolism of tamsulosin. when its metabolism is inhibited its serum levels are increased resulting in the increased toxic reactions such as significant ketoconazole is contraindicated with tamsulosin. similarly few of the drugs such as erythromycin can also
Inhibit the cyp3a4 enzyme activity but erythromycin caution should be taken to monitor any significant hypotension or toxic reactions of tamsulosin is mediated by cyp2d6 enzyme. this is the minor metabolic pathway compared with the cyp3a4 enzyme. so few of the drugs such as paroxetine, terbinafine all these drugs
Are going to inhibit this enzyme activity. so again these drugs can increase the levels of tamsulosin that’s why these drugs should be carefully combined with tamsulosin. particularly because of these interactions when these drugs are co-prescribed with tamsulosin the low dose of the tamsulosin should be used and it
Should be used at 0.4 mg in order to minimize these drug interactions. another important drug interaction is observed have the drugs like sildenafil ,tadalafil, phosphodiesterase type 5 inhibitors. they are used for treatment of erectile dysfunction as well as pulmonary hypertension. these drugs mainly
Produce hypotension as an important side effect. so when these drugs are combined with tamsulosin resulting in severe hypotension, collapse, even coma and death in the patients. so again care should be taken when this tamsulosin inhibitors. similarly this drug can produce intraoperative floppy iris syndrome
Ifis during the cataract surgery. this is not observed in all the patients those patients who are undergoing cataract surgery and who are administered with tamsulosin before the surgery they may have one of the syndrome intraoperative floppy iris syndrome. by a micro incision. so after the incision the lens is
Going to be incorporated and this method is known as phacoemulsification. but for this process the pupil should be dilated. so proper dilatation of the eye is required. now in presence of tamsulosin we can observe poor pupil dilatation and even miosis, pupillary constriction, flaccid iris all these conditions can be
Observed which are collectively known as intraoperative floppy iris syndrome. so in such patients the tamsulosin should be carefully used because it interacts with cataract surgery. what are the side effects? mainly related with its vasodilatory reactions. because of cranial vasodilation and it can produce
Some dizziness, lightheadedness, blurred vision, somnolence, drowsiness as well as it can also produce some disturbance in the sleep resulting in insomnia. all these side effects can be observed with the tamsulosin. similarly by acting on the urogenital system it can produce some abnormal ejaculation. so prolonged
Erection can be observed which may lead to some abnormal ejaculation in the patients. it can also affect the respiratory system resulting in rhinitis, pharyngitis but apart from these side effects one of the important side effect of tamsulosin is the hypotension, particularly postural hypotension and because
Of this hypotension it can produce some syncope in the patients as well as it can also increase the as less chest pain but these side effects can be controlled with low dose of tamsulosin. so that’s about the precautions, interactions tamsulosin is indicated for the treatment of bph initially started at low dose
Such as 0.4 mg but when this drug is given it can produce some postural hypotension or orthostatic hypotension resulting in the syncope as well as fainting. so caution should be taken to monitor any symptoms carefully combined with cyp3a4 inhibitors combined with phosphodiesterase type 5 inhibitors
During the cataract surgery it can interact intraoperative floppy iris syndrome and erection of penis resulting in the priapism. so with these precautions, tamsulosin can be used in the treatment of bph. so that’s for today. hope you have enjoyed this video if you like this video please subscribe to our channel
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Transcribed from video
Tamsulosin for BPH – Precautions & side effects By egpat
