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Atenolol

Atenolol

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Published by: api-3797941 on Oct 17, 2008
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atenolol
(ate n' o lole)
Apo-Atenolol (CAN), Gen-Atenolol (CAN), Novo-Atenol (CAN), Tenolin
(CAN), Tenormin
Pregnancy Category D
Drug classes

Beta1-selective adrenergic blocking agent
Antianginal
Antihypertensive

Therapeutic actions

Blocks beta-adrenergic receptors of the sympathetic nervous system in the heart and
juxtaglomerular apparatus (kidney), thus decreasing the excitability of the heart,
decreasing cardiac output and oxygen consumption, decreasing the release of renin from
the kidney, and lowering blood pressure.

Indications
\u2022
Treatment of angina pectoris due to coronary atherosclerosis
\u2022
Hypertension, as a step 1 agent, alone or with other drugs, especially diuretics
\u2022
Treatment of myocardial infarction
\u2022
Unlabeled uses: Prevention of migraine headaches; alcohol withdrawal syndrome,
treatment of ventricular and supraventricular arrhythmias
Contraindications and cautions
\u2022
Contraindicated with sinus bradycardia, second- or third-degree heart block,
cardiogenic shock, CHF.
\u2022

Use cautiously with renal failure, diabetes or thyrotoxicosis (atenolol can mask
the usual cardiac signs of hypoglycemia and thyrotoxicosis), lactation, respiratory
disease.

Available forms
Tablets\u201425, 50, 100 mg; injection\u20145 mg/10 mL
Dosages
ADULTS
\u2022
Hypertension: Initially, 50 mg PO once a day; after 1\u20132 wk, dose may be
increased to 100 mg/day
\u2022
Angina pectoris: Initially, 50 mg PO daily. If optimal response is not achieved in
1 wk, increase to 100 mg daily; up to 200 mg/day may be needed.
\u2022
Acute MI: Initially, 5 mg IV given over 5 min as soon as possible after diagnosis;

follow with IV injection of 5 mg 10 min later. Switch to 50 mg PO 10 min after
the last IV dose; follow with 50 mg PO 12 hr later. Thereafter, administer 100 mg
PO daily or 50 mg PO bid for 6\u20139 days or until discharge from the hospital.

PEDIATRIC PATIENTS
Safety and efficacy not established.
GERIATRIC PATIENTS OR PATIENTS WITH RENAL IMPAIRMENT
Dosage reduction is required because atenolol is excreted through the kidneys. The
following dosage is suggested:
Creatinine Clearance
mL/min
Half-life (hr)
Maximum Dosage
15\u201335
16\u201327
50 mg/day
< 15
> 27
25 mg/day
For patients on hemodialysis, give 50 mg after each dialysis; give only in hospital setting;
severe hypotension can occur.
Pharmacokinetics
Route
Onset
Peak
Duration
Oral
Varies
2\u20134 hr
24 hr
IV
Immediate
5 min
24 hr

Metabolism: T1/2: 6\u20137 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Urine (40%\u201350%) and bile and feces (50%\u201360%)

IV facts
Preparation: May be diluted in dextrose injection, sodium chloride injection, or sodium
chloride and dextrose injection. Stable for 48 hr after mixing.
Infusion: Initiate treatment as soon as possible after admission to the hospital; inject
5 mg over 5 min; follow with another 5-mg IV injection 10 min later.
Adverse effects
\u2022
Allergic reactions: Pharyngitis, erythematous rash, fever, sore throat,
laryngospasm, respiratory distress
\u2022
CNS: Dizziness, vertigo, tinnitus, fatigue, emotional depression, paresthesias,
sleep disturbances, hallucinations, disorientation, memory loss, slurred speech
\u2022
C V:Bradycardia, CHF, cardiac arrhythmias, sinoatrial or AV nodal block,
tachycardia, peripheral vascular insufficiency, claudication, CVA, pulmonary
edema, hypotension
\u2022
Dermatologic: Rash, pruritus, sweating, dry skin
\u2022
EENT: Eye irritation, dry eyes, conjunctivitis, blurred vision
\u2022
GI: Gastric pain, flatulence, constipation, diarrhea, nausea, vomiting,anorex ia,
ischemic colitis, renal and mesenteric arterial thrombosis, retroperitoneal fibrosis,
hepatomegaly, acute pancreatitis
\u2022
GU: Impotence, decreased libido, Peyronie's disease, dysuria, nocturia, frequent
urination
\u2022
Musculoskeletal: Joint pain, arthralgia, muscle cramp
\u2022
Respiratory: Bronchospasm, dyspnea, cough, bronchial obstruction, nasal
stuffiness, rhinitis, pharyngitis (less likely than with propranolol)

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