The drug that causes first dose phenomenon in elderly patients -
The side effect postural hypotension also known as "First Dose Hypotension" is observed with drugs ending with 'zosin' eg. Prazosin, Terazosin,Doxazosin These drugs cause blocking of a1 receptors, leading to vasodilation, that can cause Postural Hypotension. Acarbose - Inhibition of intestinal absorption of carbohydrates. S/E - flatulence, abdominal discomfo, loose stool. Metformin - S/E - Abdominal Pain, Anorexia, bloating, nausea, metallic taste mild diarrhea & tiredness. Noradrenaline (Pressor agent)- stimulates a1 and a2 receptors, thus increases peripheral vascular resistance and result in increase BP. It acts on b1 adrenergic receptors, causing increase In hea rate and cardiac output. S/E = Transient restlessness, headache, palpitations, Anxiety, tremor.
Metformin
Prazosin
Acarbose
Noradrenaline
Sympathetic System