Unexpected bradycardia after a first dose of doxazosin

An 89-year-old man with a medical history of hypertension, prostate cancer and postural hypotension presented to the emergency department with worsening headache and fatigue. His general practitioner had recently stopped his daily 10 mg of amlodipine due to symptoms of postural hypotension. On initial assessment, his heart rate was 67 beats per minute, blood pressure 219/104 mm Hg, respiratory rate 16 breaths per minute and oxygen saturations 98% on room air. He did not have any chest pain, signs of heart failure, acute kidney injury or new confusion. An ECG showed first-degree atrioventricular block. The patient was given 4 mg of modified-release doxazosin for his hypertension. There was no documentation in the emergency department notes about why this had been chosen as the first-line intervention. Two hours later, he complained to nursing staff that he was about to pass out. Repeat observations showed a blood pressure of 60/30 mm Hg and...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Open access Adverse drug reactions Source Type: research