Atenolol

CLINICAL USE

  • Beta-adrenoceptor blocker:Hypertension, angina, arrhythmias

    DOSE IN NORMAL RENAL FUNCTION

  • Oral: Hypertension: 25–50 mg daily Angina: 100 mg daily in 1 or 2 divided doses
  • Arrhythmias: 50–100 mg daily
  • IV:Arrhythmias: 2.5 mg at a rate of 1 mg/ min repeated at 5 minute intervals to a maximum of 10 mg
  • Infusion:150 mcg/kg, repeated every 12 hours if required

    PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :266.3
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :3
  • %Excreted unchanged in urine &nbsp &nbsp : >90
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :1.1
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :6–7/15–35

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Dialysed. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Anaesthetics: enhanced hypotensive effect Analgesics: NSAIDs antagonise hypotensive effect
  • Anti-arrhythmics: increased risk of myocardial depression and bradycardia; increased risk of bradycardia, myocardial depression and AV block with amiodarone
  • Antidepressants: enhanced hypotensive effect with MAOIs
  • Antihypertensives: enhanced hypotensive effect; increased risk of withdrawal hypertension with clonidine; increased risk of first dose hypotensive effect with post-synaptic alpha-blockers such as prazosin
  • Antimalarials: increased risk of bradycardia with mefloquine
  • Antipsychotics enhanced hypotensive effect with phenothiazines
  • Calcium-channel blockers: increased risk of bradycardia and AV block with diltiazem; hypotension and heart failure possible with nifedipine and nisoldipine; asystole, severe hypotension and heart failure with verapamil
  • Diuretics: enhanced hypotensive effect Moxisylyte: possible severe postural hypotension
  • Sympathomimetics: severe hypertension with adrenaline and noradrenaline and possibly with dobutamine
  • Tropisetron: increased risk of ventricular arrhythmias – use with caution

    ADMINISTRATION

    Reconstition

    Route

    Oral, IV

    Rate of Administration

    Infusion: 20 minutes IV injection: 1 mg/minute

    Comments

    Dilute with glucose 5% or sodium chloride 0.9%

    OTHER INFORMATION

    C
  • SM advise that beta-blockers are contraindicated in patients with asthma or history of obstructive airway disease