Atenolol

(ah-TEN-oh-lohl] Pregnancy Category: C

Apo-Atenol M, Gen-Atenolol M, Med-Atenolol M, Novo-Atenol M, Nu-Atenol M, Taro-Atenolol M, Tenolin M, Tenormin [Rx]

Classification: Beta-adrenergic blocking agent

See also Beta-Adrenergic Blocking Agents.

Action/Kinetics: Predominantly beta-1 blocking activity. Has no membrane stabilizing activity or intrinsic sympathomimetic activity. Low lipid solubility. Peak blood levels: 2-4 hr. tVi: 6-9 hr. 50% eliminated unchanged in the feces. Uses: Hypertension (either alone or with other antihypertensives such as thiazide diuretics). Angina pectoris due to hypertension, coronary atherosclerosis, and AMI. Non-FDA Approved Uses: Prophylaxis of migraine, alcohol withdrawal syndrome, situational anxiety, ventricular arrhythmias, prophylacti-cally to reduce incidence of supraven-tricular arrhythmias in coronary artery bypass surgery. Contraindications: Hypersensitiv-ity to atenolol, cardiogenic shock, 2nd or 3rd degree heart block, sinus bradycardia, congestive heart failure, cardiac failure. Special Concerns: Aortic or mitral valve disease, asthma, COPD, diabetes mellitus, major surgery, renal disease, thyroid disease, well-compensated heart failure. Side Effects: Oral: Dry mouth. CV: Bradycardia, CHF, cold extremities, postural hypotension, profound hypotension, 2nd or 3rd degree heart block. CNS: Catatonia, depression, dizzi-

ness, drowsiness, fatigue, hallucinations, insomnia, lethargy, mental changes, memory loss, strange dreams. GI: Diarrhea, ischemic colitis, nausea, mesenteric arterial thrombosis, vomiting. Hematologic: Agranulocytosis, thrombocytopenia. Allergic: Fever, sore throat, respiratory distress, rash, pharyngitis, laryngos-pasm, anaphylaxis. Skin: Pruritus, rash, increased skin pigmentation, sweating, dry skin, alopecia, skin irritation, psoriasis. Ophthalmic: Dry, burning eyes. GU: Dysuria, impotence, nocturia. Other: Hypoglycemia or hyperglycemia. Respiratory: Bronchospasm, dyspnea, wheezing. Drug Interactions: See also Drug Interactions for Beta-Adrenergic Blocking Agents and Antihypertensive Agents.

How Supplied: Injection: 0.5 mg/mL; Tablet: 25 mg, 50 mg, 100 mg

Dosage-

Hypertension. Initial: 50 mg/day, either alone or with diuretics; if response is inadequate, 100 mg/day. Doses higher than 100 mg/day will not produce further beneficial effects. Maximum effects usually seen within 1—2 weeks.

Angina.

Initial: 50 mg/day; if maximum response is not seen in 1 week, increase dose to 100 mg/day (some clients require 200 mg/day).

Alcohol withdrawal syndrome. 50-100 mg/day.

Prophylaxis of migraine. 50-100 mg/day.

Ventricular arrhythmias. 50-100 mg/day.

Prior to coronary artery bypass surgery.

50 mg/day started 72 hr prior to surgery.

Adjust dosage in cases of renal failure to 50 mg/day if creatinine clearance is 15-35 mL/min/1.73 m2 and to 50 mg every other day if crea-

tinine clearance is less than 15 mL/min/1.73 m2. • IV

Acute myocardial infarction. Initial: 5 mg over 5 min followed by a second 5-mg dose 10 min later. Begin treatment as soon as possible after client arrives at the hospital. In clients who tolerate the full 10-mg dose, give a 50-mg tablet 10 min after the last IV dose followed by another 50-mg dose 12 hr later. Then, 100 mg/day or 50 mg b.i.d. for 6-9 days (or until discharge from the hospital).

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