Generic Name

Atenolol

Precaution

Compensated heart failure. Variant angina, acute MI, DM; peripheral vascular disorders; hepatic and renal dysfunction; elderly patients, children. Lactation. If atenolol and clonidine are co-admin, then gradual withdrawal of clonidine should take place a few days after withdrawal of atenolol. Lactation: Drug enters breast milk; neonates born to mothers who are receiving atenolol at parturition or breastfeeding may be at risk for hypoglycemia and bradycardia; use with caution

Indication

Hypertension, Migraine, Arrhythmias, MI, Angina pectoris

Contra Indication

Hypersensitivity. Sinus bradycardia, sinus node dysfunction, heart block >1st degree, compensated cardiac failure, cardiogenic shock, bronchospastic diseases, peripheral vascular diseases. Pregnancy.

Dose

N/A

Side Effect

>10% Tiredness (13%) 1-10% Hypotension (10%),Bradycardia (8%),Cold extremities (0.5- 7%),Postural hypotension (2-4%),Depression (3%),Nausea (2-3%),Dreaming (2%),Drowsiness (2%),Diarrhea (1-2%),Fatigue (1-2%),Leg pain (1-2%),Lethargy (1-2%),Lightheadedness (1-2%),Vertigo (1-2%),Dyspnea (0.4-2%),2°/3° atrioventricular (AV) block (1%) Frequency Not Defined Hypotension, severe congestive heart failure (CHF), sick sinus syndrome, Catatonia, disorientation, emotional lability, hallucinations, headache, impaired performance on neuropsychometric tests, psychoses, short-term memory impairment, Purpura, rashes,Nausea, Thrombocytopenia, Elevated serum hepatic enzymes and bilirubin, Impotence, Peyronie disease, Antinuclear antibodies (ANA), lupus syndrome, Visual disturbances, xerophthalmia, Raynaud phenomenon Potentially Fatal: Heart failure, 2nd or 3rd degree AV block.

Pregnancy Category

Mode of Action

Atenolol is a competitive cardioselective beta1-blocker and does not have effect on ?beta2-receptors except in high doses. It reduces resting and exercise-induced heart rate as well as myocardial contractility.

Interaction

Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive w/ Ca channel blockers, hydralazine, methyldopa. Increased risk of bradycardia and heart block w/ verapamil and diltiazem. May decrease hypotensive effects w/ NSAIDs (e.g. indometacin). Enhanced bradycardic effect w/ disopyramide, amiodarone or digitalis glycosides. May exacerbate rebound HTN upon discontinuance of clonidine treatment.

Pregnancy Category Note

Pregnancy category: D Lactation: Drug enters breast milk; neonates born to mothers who are receiving atenolol at parturition or breastfeeding may be at risk for hypoglycemia and bradycardia; use with caution

Adult Dose

Adult Hypertension 25-50 mg/day PO initially; may be increased to 100 mg/day PO Angina Pectoris 50 mg/day PO; after 1 week, may be increased to 100 mg/day PO; some patients may require 200 mg/day Post Myocardial Infarction Secondary prevention 100 mg PO once daily or divided q12hr for 6-9 days after myocardial infarction (MI) Elderly May be necessary to initiate dosing at 25 mg/day PO Hypertension 25 mg/day PO initially; may be increased to 100 mg/day PO Angina Pectoris 25 mg/day PO; after 1 week, may be increased to 100 mg/day; some patients may require 200 mg/day Post Myocardial Infarction Secondary prevention 100 mg PO once daily or divided q12hr for 6-9 days after MI

Child Dose

N/A

Renal Dose

Renal impairment: CrCl (ml/min) <15 25 mg or 50 mg on alternate days. 15-35 50 mg/day. Dialysis patients 25-50 mg after each dialysis.

Administration

May be taken with or without food.