ATENOLOL (a-ten'oh-lole) Apo-Atenolol , Tenormin Classifications: autonomic nervous system agent; beta-adrenergic antagonist (sympatholytic, blocking agent); antihypertensive agent Prototype: Propranolol Pregnancy Category: D |
25 mg, 50 mg, 100 mg tablets; 5 mg/10 mL vial
In therapeutic doses, atenolol selectively blocks beta1-adrenergic receptors located chiefly in cardiac muscle. With large doses, preferential effect is lost and inhibition of beta2-adrenergic receptors may lead to increased airway resistance, especially in patients with asthma or COPD. Mechanisms for antihypertensive action include central effect leading to decreased sympathetic outflow to periphery, reduction in renin activity with consequent suppression of the renin-angiotensin-aldosterone system, and competitive inhibition of catecholamine binding at beta-adrenergic receptor sites.
Reduces rate and force of cardiac contractions (negative inotropic action); cardiac output is reduced, as well as systolic and diastolic BP. Atenolol decreases peripheral vascular resistance both at rest and with exercise.
Management of hypertension as a single agent or concomitantly with other antihypertensive agents, especially a diuretic, and in treatment of stable angina pectoris, MI.
Antiarrhythmic, mitral valve prolapse, adjunct in treatment of pheochromocytoma and of thyrotoxicosis; and for vascular headache prophylaxis.
Sinus bradycardia, greater than first-degree AV heart block, uncompensated heart failure, cardiogenic shock, peripheral vascular disease, Raynaud's disease, hypotension; abrupt discontinuation, pulmonary edema. Safety during pregnancy (category D), or lactation is not established.
Hypertensive patients with CHF controlled by digitalis and diuretics, vasospastic angina (Prinzmetal's angina); asthma, bronchitis, emphysema, and COPD; major depression; diabetes mellitus; impaired renal function, dialysis; myasthenia gravis; pheochromocytoma, hyperthyroidism, thyrotoxicosis; older adults.
Hypertension, Angina Adult: PO 2550 mg/d, may increase to 100 mg/d Child: PO 0.81.5 mg/kg/d (max: 2 mg/kg/d) MI Adult: PO 10 min after second IV dose, start 50 mg/d IV 5 mg q5min times 2 doses, then switch to PO |
Intravenous PREPARE: Direct: Use undiluted or diluted in 1050 mL of NS, D5W, D5/NS, D5/0.45NS, or 0.45NS. ADMINISTER: Direct: Give over 5 min. |
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