A client with BPH is being treated with terazosin (Hytrin) 2 mg at bedtime. The nurse should monitor the client’s:
A. Urinary nitrites
B. White blood cell count
C. Blood pressure
D. Pulse
Correct Answer: C. Blood pressure
Terazosin (Hytrin) is an antihypertensive drug that is also used in the treatment of BPH. Blood pressure must be monitored to ensure that the client does not develop hypotension, syncope, or postural hypotension. The client should be instructed to change positions slowly. Statistically significant adverse effects associated with terazosin detected in placebo-controlled trials listed in the FDA database include dizziness, headache, weakness, postural hypotension, and nasal congestion.
Option A: If used for lower urinary tract symptoms associated with benign prostatic hyperplasia, standard clinical assessment of patients may be used to determine efficacy. According to the FDA, post-marketing surveys also found priapism, atrial fibrillation, anaphylaxis, intraoperative floppy iris syndrome to be associated with terazosin use, though instances of such occurrences were extremely rare.
Option B: The use of terazosin does not require plasma/blood drug level monitoring. Orthostatic vital signs should be obtained after the first dose to exclude postural hypotension. Overdose of terazosin may lead to hypotension, and standard life-support protocols should be in place for instances of hemodynamic instability.
Option D: If used for hypertension, orthostatic blood pressures may be checked regularly during the titration interval to confirm efficacy. First-dose syncope is rare and may be mitigated by bedtime use. Orthostatic hypotension is common and should merit strong consideration when prescribing terazosin.
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