RiteMED Atenolol

HTN as alone or in combination w/ other antihypertensive drugs particularly thiazide diuretic. Angina pectoris. Cardiac arrhythmias. MI (early intervention in acute phase & long-term prophylaxis after recovery).

Individualized dose. HTN Initially 50 mg once daily either alone or added to diuretic therapy, may be increased to 100 mg once daily. Angina pectoris Initially 50 mg once daily, may be increased to 100 mg once daily or 50 mg bid if optimal response is not achieved w/in 1 wk. Cardiac arrhythmia Maintenance dose having controlled the cardiac arrhythmias w/ IV atenolol: 50-100 mg once daily. MI 5 mg by slow IV inj (1 mg/min) w/in 12 hr of the onset of chest pain followed by another 5 mg IV after 10 min. If patient tolerates the 10 mg IV dose, initiate 50 mg oral dose 10 min after the last IV dose followed by another 50 mg oral dose after 12 hr. Thereafter, either 100 mg once daily or 50 mg bid oral dose for 6-9 days or until discharge from hospital. 100 mg daily oral dose is recommended for long-term prophylaxis. Elderly & renal impairment CrCl 15-35 mL/min/1.73 m² Max oral dose: 50 mg daily, <15 mL/min/1.73 m² Max oral dose: 25 mg daily or 50 mg on alternate days, hemodialysis Max oral dose: 25 or 50 mg after each dialysis.

May be taken with or without food.

Hypersensitivity. Severe peripheral arterial circulatory disturbances; shock including cardiogenic & hypovolemic shock; CHF; hypotension; 2nd- or 3rd-degree heart block; sick sinus syndrome; sinus bradycardia (<45-50 beats/min); significant right ventricular hypertrophy; right ventricular failure secondary to pulmonary HTN; bronchospasm; allergic disorders including allergic rhinitis; untreated pheochromocytoma; metabolic acidosis. Anesth w/ agents that produce myocardial depression eg, ether, chloroform, cyclopropane.

History of anaphylactic reaction. Discontinue use if cardiac failure continues despite adequate treatment. Avoid abrupt discontinuation of therapy in patients w/ CAD. Avoid use if there is risk of bronchospasm. Contraindicated in cardiac failure not promptly & effectively controlled by IV furosemide 80 mg or equivalent therapy in patients w/ acute MI. Not suitable for use in MI in patients w/ systolic BP <120 mmHg & 1st-degree AV block. May mask some important premonitory signs of acute hypoglycemia ie, tachycardia. May result in loss of diabetic control & delayed recovery from hypoglycemia in patients w/ insulin or non-insulin dependent diabetes particularly labile diabetes or w/ history of spontaneous hypoglycemia. May impair peripheral circulation & exacerbate symptoms of peripheral vascular disease. Various skin rashes & conjunctival xerosis. Patients w/ CHF controlled by digitalis &/or diuretics; bronchospastic disease who do not respond to or cannot tolerate other antihypertensive treatment; pheochromocytoma; Prinzmetal or variant angina; 1st-degree heart block. Continue maintenance of beta-blockade peri-operatively. Closely monitor patients suspected of developing thyrotoxicosis from whom atenolol is to be w/drawn. Reduce dose if patients develop symptoms which may be attributable to slow heart rate. Concomitant use of Ca channel blockers. Severe renal impairment. Pregnancy & lactation. Childn. Elderly.

Fatigue, malaise, lupus syndrome, sclerosing serositis; bradycardia, postural hypotension (which may be associated w/ syncope), hypotension, HF, heart block, supraventricular & ventricular tachycardia, atrial fibrillation & flutter, cardiac reinfarction & failure, total & nonfatal cardiac arrest, cardiogenic shock, development of ventricular septal defect & mitral regurgitation, arrhythmias, sick sinus syndrome, left ventricular insufficiency, intermittent claudication, Raynaud's phenomenon, cold extremities, deterioration in heart failure, increase in early death secondary to bradycardia & shock; diarrhea, nausea, dry mouth, mesenteric arterial thrombosis, ischemic colitis, GI disturbance including indigestion, constipation, hepatic toxicity including intrahepatic cholestasis; nonthrombocytopenic or thrombocytopenic purpura, thrombocytopenia, agranulocytosis, increased ANA; angioedema, urticaria, fever combined w/ aching & sore throat, laryngospasm, & resp distress; elevated liver enzymes, AST, BUN, serum creatinine, bilirubin, hypoglycemia; ataxia, leg pain; dizziness, vertigo, light-headedness, tiredness, fatigue, lethargy, drowsiness, depression, vivid dreams, hallucination, headache, psychoses, reversible mental depression progressing to catatonia (acute reversible syndrome), short-term memory loss, emotional lability w/ slightly clouded sensorium, decreased performance on neuropsychometrics, confusion, mood changes, nightmares, paresthesia, vertigo, insomnia, sleep disturbance; impotence, Peyronie's disease; wheezing, dyspnea, bronchospasm, pulmonary emboli, asthma, nasal congestion; psoriasiform skin reactions, psoriasis exacerbation, reversible alopecia, skin & erythematous rash; visual disturbance, dry eyes, conjunctivitis, tinnitus, otitis; renal failure.

Concomitant use w/ anesth (eg, methoxyflurane) is contraindicated. May potentiate atrial conduction time & induce -ve inotropic effect w/ class I (eg, disopyramide) & class III (eg, amiodarone) anti-arrhythmic agents. Hypotension, bradycardia & asystole may occur w/ verapamil & diltiazem. Excessive hypotension w/ dihydropyridine Ca antagonists eg, nifedipine. Hypotension &/or marked bradycardia w/ catecholamine-depleting agents eg, reserpine. May exacerbate rebound HTN that may follow after clonidine w/drawal. Excessive bradycardia w/ digitalis/digitalis glycosides. Concomitant use w/ insulin & oral hypoglycemics. Hypotensive effects may be decreased w/ prostaglandin synthetase inhibitors eg, ibuprofen, indomethacin. Effect may be counteracted w/ sympathomimetic drugs eg, epinephrine.

Beta-Blockers

C07AB03 - atenolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.

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