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Primary adrenal malignancy
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Ayshea Hameeduddin, Anju Sahdev, Rodney H Reznek
Surgical resection of the primary tumour is the definitive treatment where possible. Laparoscopic surgery is advocated for tumours up to 9 cm and cortical-sparing adrenalectomy can be done for patients with hereditary tumours (77). A transabdominal approach is mandated for malignant tumours where debulking surgery and/or adrenalectomy is advised (72). Surgery reduction of tumour bulk may relieve symptoms and may increase the efficacy of other therapeutic modalities; 131I-MIBG (meta-iodobenzylguanidine) can be used as a therapeutic option in cases of incomplete removal or metastatic disease. Medical management with alpha- and beta-blockade using phenoxybenzamine is effective in controlling symptoms.
The twentieth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
Giles Brindley (1983) reported that the injection of phenoxybenzamine had relatively similar effects. Lechtenberg and Ohl (1994) wrote: ‘The effectiveness of phenoxybenzamine in inducing erection was underscored by the same Doctor Brindley at the American Urological Association Meeting in 1983. At the end of his lecture on the physiology of erection he informed the audience that he had self-administered phenoxybenzamine just prior to his lecture and then proceeded to display the result of his injection. Following this spectacular demonstration of the effectiveness of phenoxybenzamine, Doctor Brindley retired to less public settings, where he tested several intracavernosal agents on himself to find out whether or not they would induce erection’.
Pituitary and adrenal disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Expert anaesthetic care is essential and both fetal and maternal mortality rates have improved significantly since the advent of α-blockade, which should be given for at least 3 days prior to surgery. Phenoxybenzamine (i.v.) must be available for caesarean section. In an emergency if i.v. α-blockade is not available, then i.v. labetalol is an appropriate choice.
Preoperative adrenal artery embolization followed by surgical excision of giant hypervascular adrenal masses: report of three cases
Published in Acta Chirurgica Belgica, 2018
Ismail Cem Sormaz, Fatih Tunca, Arzu Poyanlı, Yasemin Giles Şenyürek
Preoperative management included medical treatment with α- and β-adrenergic blockers for blood pressure control. Three weeks before surgery, the patient was started on phenoxybenzamine 10 mg per day by mouth, which was gradually titrated up to 60 mg per day. The patient was also put on β-adrenergic blocker agent (propranolol-HCL) 40 mg per day concordant with gradual increasing doses of phenoxybenzamine. Preoperative adrenal artery embolization was planned for the right-sided adrenal mass in this patient. The main aim of the arterial embolization was to reduce hypervascularity and decrease troublesome bleeding during surgery. We also thought that TAE might help to prevent severe perioperative hypertensive attacks. The day before angiography and embolization, the average blood pressure and heart rate of the patient were 123/62 mm Hg and 65 bpm, respectively. Equipment for close hemodynamic monitoring and management of possible hypertensive attacks during angiography and embolization was maintained.
Perspectives on the pharmacological management of complex regional pain syndrome
Published in Expert Opinion on Pharmacotherapy, 2023
Kyle F. Norton, Timothy J. Furnish
NSAIDs; muscle relaxants; botulin toxin; calcitonin; topical NAC, DMSO and capsaicin; and IVIG all have either very limited or conflicting evidence of efficacy. Topical ISDN provides no significant relief of symptoms. Mannitol is no more effective than placebo in reducing CRPS-related symptoms, but there may be some benefit in patients with acute, warm CRPS-I of the upper extremity. Tadalafil may provide pain relief but does not affect skin temperature or overall functionality. Phenoxybenzamine appears to be most effective in the early phases of CRPS, and only in small studies.
Adrenergic receptor behaviors of mesenchymal stem cells obtained from different tissue sources and the effect of the receptor blockade on differentiation
Published in Journal of Receptors and Signal Transduction, 2022
Erkan Maytalman, Arash Alizadeh Yegani, Ilknur Kozanoglu, Fazilet Aksu
Given MTT test results, phenoxybenzamine was studied at dose of 1 µM in order to ensure use at the same concentration with propranolol and to prevent adverse effect on proliferation. In the literature search, we found no study using phenoxybenzamine in stem cell cultures. However, dose of 1 µM was used in addition to another active substance in a study using cancer cell lines [26].