about Atenolol class, uses, side effects contraindications
Atenolol
Short Description
. This medicine is used to contribute to the treatment of problems of the heart and circulatory system.
Atenolol does not cure?heart disease,??but rather treats the symptoms. There may be a need to take atenolol regularly for a long time, perhaps even for life. Compared to other beta-blocker drugs, atenolol has a greater effect on the heart, in contrast, a small effect on other parts of the body.
Uses of atenolol
Atenolol is used to treat the following health problems:
Angina pectoris.
High blood pressure.
Irregular heartbeat (Arrhythmia).
Myocardial infraction.
Category
Chemical class: Beta-adrenergic blocker (beta1and at high doses beta2)
Therapeutic class: Antianginal, antihypertensive
Pregnancy category: D
Indications
To treat angina pectoris and control hypertension
Adults.50 mg daily increased, p.r.n., after 1 to 2 wk to 100 mg daily. To treat acute MI atenolol 106 ,
IV:
Adults. Initial: 5 mg I.V. over 5 min followed by 5 mg I.V. 10 min later. After another 10 min, 50 mg given and followed by another 50 mg in 12 hr. Maintenance: 50 mg P.O. b.i.d. or 100 mg P.O. daily for 6 to 9 days or until discharged from hospital.
DOSAGE ADJUSTMENT Dosage reduced to 50 mg daily P.O. for renally impaired patients and for elderly, renally impaired patients with creatinine clearance of 15 to 35 ml/min/1.73 m2. Dosage reduced to 25 mg daily P.O. for renally impaired patients and for elderly, renally impaired patients with creatinine clearance less than 15 ml/min/1.73 m2. Route Onset Peak Duration P.O. 1 hr 2–4 hr 24 hr I.V. Immediate 5 min 12 hr
Mechanism of Action
Inhibits stimulation of beta1-receptor sites, located mainly in the heart, decreasing cardiac excitability, cardiac output, and myocardial oxygen demand. Atenolol also acts to decrease release of renin from the kidneys, aiding in reducing blood pressure. At high doses, it inhibits stimulation of beta2 receptors in the lungs, which may cause bronchoconstriction.
Contraindications
Cardiogenic shock, heart block greater than first degree, hypersensitivity to beta blockers, overt heart failure, sinus bradycardia
Interactions
amiodarone: Additive atenolol effects calcium channel blockers, such as verapamil and diltiazem: Possibly symptomatic bradycardia and conduction abnormalities catecholamine-depleting , such as reserpine: Additive antihypertensive effect
clonidine: Rebound hypertension disopyramide: Increased risk of severe bradycardia, asystole, and heart failure
Side Efect
CNS: Depression, disorientation, dizziness, drowsiness, emotional lability, fatigue, fever, lethargy, light-headedness, short-term memory loss, vertigo
CV: Arrhythmias, including bradycardia and heart block; cardiogenic shock; cold arms and legs; heart failure; mesenteric artery thrombosis; mitral insufficiency; myocardial reinfarction; orthostatic hypotension; Raynaud’s phenomenon
EENT: Dry eyes, laryngospasm, pharyngitis
GI: Diarrhea, ischemic colitis, nausea
GU: Renal failure
HEME: Agranulocytosis
MS: Leg pain
RESP: Bronchospasm, dyspnea, pulmonary emboli, respiratory distress, wheezing
SKIN: Erythematous rash
Other: Allergic reaction
Cautions
Use atenolol cautiously in patients with heart failure controlled by digitalis glycosides or diuretics, patients with conduction abnormalities or left ventricular dysfunction who take verapamil or diltiazem, patients with arterial circulatory disorders, and patients with impaired renal function. Use atenolol cautiously in diabetic patients because it may mask tachycardia caused by hypoglycemia. Unlike other beta-adrenergic blockers, it doesn’t mask other signs of hypoglycemia, cause hypoglycemia, or delay the return of blood glucose to a normal level. At first sign of heart failure, expect patient to receive a digitalis glycoside, a diuretic, or both and to be monitored closely. If failure continues, expect to stop atenolol. Closely monitor patient with hyperthyroidism because atenolol may mask some signs of thyrotoxicosis. Abrupt withdrawal of atenolol may precipitate thyrotoxicosis. If patient also receives clonidine, expect to stop atenolol several days before gradually withdrawing clonidine. Then expect to restart atenolol therapy several days after clonidine has been discontinued. During I.V. atenolol therapy, monitor vital signs and cardiac rhythm closely. Discard parenteral mixture with atenolol if it isn’t used within 48 hours. Stop atenolol and notify prescriber if patient develops bradycardia, hypotension, or other serious adverse reaction. PATIENT SAFTY
Instruct patient not to stop taking atenolol abruptly. Otherwise, angina may worsen, and an MI or arrhythmia may occur. While patient is being weaned from atenolol, tell him to perform minimal physical activity to prevent chest pain. Instruct patient to take a missed dose as soon as possible. However, if it’s within 8 hours of the next scheduled dose, tell him to skip the missed dose and return to his regular schedule. Explain that atenolol may alter serum glucose level and mask hypoglycemia. Inform the patient that he may experience fatigue and reduced tolerance to exercise and that he should notify his prescriber if this interferes with his normal lifestyle.
Trade Name & Company Name
effect of Atenolol in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. Hypertension complicates 5-10% of pregnancies and is a leading cause of maternal and perinatal death and morbidity. Severe hypertension (systolic BP = 170mmHg and/or diastolic BP = 110mmHg) should be treated immediately. Mild, chronic hypertension is associated with increased maternal and fetal risks, but there is no consensus as to whether mild to moderate hypertension should be treated during pregnancy. The incidence of transient severe hypertension, antenatal hospitalization, proteinuria, and neonatal RDS may be decreased by therapy, but fetal growth may be impaired. In one small trial, atenolol reduced the incidence of preeclampsia in women selected for increased cardiac output. Of all b-blockers, the evidence that atenolol is associated with IUGR is the strongest, but appears to reflects excess maternal b-blockade, causing a decrease in cardiac output. Atenolol has also been used to treat congenital long QT syndrome during pregnancy. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Atenolol crosses the placenta. There is no substantive evidence of teratogenicity. As a group, b-blockers are associated with IUGR, though controversy continues as to whether this is drug or disease related. Atenolol reduces cardiac output, and failure to reduce the dose to prevent an excessive decline in output is associated with IUGR. Some rodent studies reveal a dose-dependent increase in embryo/fetal resorption. Breastfeeding
Atenolol is concentrated in breast milk, and significant bradycardia may occur in newborns nursed by women on atenolol. It should probably be avoided.
the follwing drugs will increse Atenolol by inhepiting cyp450
the follwing drugs will decrease Atenolol by inhancing cyp450
trad drugs based on Atenolol
| Gen name | Trade name | Catagory name |
| atenolol | Tenormin | Cardioselective beta blockers |
| atenolol / chlorthalidone | Tenoretic | Beta blockers with thiazides |
| atenolol / chlorthalidone | Tenoretic 100 | Beta blockers with thiazides |
| atenolol / chlorthalidone | Tenoretic 50 | Beta blockers with thiazides |
| Atenolol | BETATEN 100MG FC TABS | |
| Atenolol | BETATEN 25MG FC TABLETS | |
| Atenolol | BETATEN 50MG FCTABLET | |
| Atenolol | CANAR 100 MG TABLET | |
| Atenolol | CANAR 50 MG TABLET | |
| Atenolol | CARDOL 100MG TAB | |
| Atenolol | NORMOTEN 100 MG FC TAB | |
| Atenolol | NORMOTEN 50 MG FC TAB | |
| Atenolol | NOVO-ATENOL 100MG TAB | |
| Atenolol | NOVO-ATENOL 50MG TAB | |
| Atenolol | PRESLO 100MG FC TABLETS | |
| Atenolol | PRESLO 50MG FC TABLETS | |
| Atenolol | TENOL 100 MG FILM COATED TABLETS | |
| Atenolol | TENOL 50 MG FILM COATED TABLETS | |
other drugs from same cataogory