Atenolol: Difference between revisions

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*caution if breastfeeding
*caution if breastfeeding
*caution if myasthenia gravis
*caution if myasthenia gravis
*caution if severe anaphylactic reaction hx
*caution if severe anaphylactic reaction history
*caution in elderly patients
*caution in elderly patients



Revision as of 07:52, 13 July 2016

General

  • Type: Beta blocker
  • Dosage Forms: PO
  • Common Trade Names: Tenormin

Adult Dosing

Hypertension

  • 50-100 mg PO qd, Start 50 mg PO qd
  • Max: 100 mg/day

Angina

  • 50-200 mg PO qd, Start 50 mg PO qd
  • Max: 200 mg/day

Cardiovascular event prevention, post-MI

  • 100 mg/day PO divided qd-bid

Pediatric Dosing

Hypertension

  • 1-2 mg/kg PO qd, Start 0.8-1 mg/kg PO qd
  • Max: 2 mg/kg/day

Supraventricular arrhythmias

  • 0.3-2 mg/kg PO qd
  • Max: 2 mg/kg/day

Special Populations

  • Pregnancy Rating: D
  • Lactation: Possibly unsafe
  • Renal Dosing
    • Adult: CrCl 10-50: decr. dose 50%, give q48h, max 50 mg/day; CrCl<10: decr. dose 50-70%, give q96h, max 25 mg/day; HD: give dose after dialysis, no supplement; PD: no supplement
    • Pediatric: CrCl 30-50: max 1 mg/kg up to 50 mg q24h; CrCl<30: max 1 mg/kg up to 25 mg q24h or up to 50 mg q48h; HD: give dose after dialysis, no supplement; PD: no supplement
  • Hepatic Dosing
    • Adult: not defined
    • Pediatric: not defined

Contraindications

  • Allergy to class/drug
  • sinus bradycardia
  • 2nd or 3rd degree AV block
  • heart failure, uncompensated
  • cardiogenic shock
  • sick sinus syndrome with out pacemaker
  • pheochromocytoma, untreated
  • avoid abrupt withdrawal
  • caution if peripheral vascular disease
  • caution if bronchospastic disease
  • caution if major surgery
  • caution if diabetes mellitus
  • caution if thyroid disorder
  • caution if WPW syndrome
  • caution if renal impairment
  • caution if pregnancy
  • caution if breastfeeding
  • caution if myasthenia gravis
  • caution if severe anaphylactic reaction history
  • caution in elderly patients

Adverse Reactions

Serious

  • CHF
  • bradycardia, severe
  • heart block
  • angina exacerbation if abrupt D/C
  • MI if abrupt D/C
  • ventricular arrhythmia during tx and if abrupt D/C
  • Raynaud phenomenon
  • bronchospasm
  • hypersensitivity reaction
  • lupus erythematosus

Common

  • bradycardia
  • hypotension
  • fatigue
  • dizziness
  • cold extremities
  • depression
  • dyspnea
  • hypotension, orthostatic
  • leg pain
  • bronchospasm
  • lightheadedness
  • lethargy
  • diarrhea
  • nausea
  • vertigo
  • drowsiness

Pharmacology

  • Half-life: 6-7h
  • Metabolism: CYP450
  • Excretion: urine 40-50%, feces 50%
  • Mechanism of Action: selectively antagonizes beta-1 adrenergic receptors

See Also

References