Atenolol

From WikEM
Jump to: navigation, search

General

  • Type: Beta blocker
  • Dosage Forms: tablet
  • Dosage Strengths: 25, 50, 100mg
  • Routes of Administration: PO
  • Common Trade Names: Tenormin

Adult Dosing

Hypertension

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

Stable angina

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

Cardiovascular event prevention, post-MI

  • 100mg/day PO divided QD-bid

Pediatric Dosing

Hypertension

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

Supraventricular arrhythmias

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

Special Populations

  • Pregnancy Rating: D
  • Lactation: Possibly unsafe
  • Renal Dosing
    • Adult: CrCl 10-50: decrease dose 50%, give q48h, max 50mg/day; CrCl<10: decrease dose 50-70%, give q96h, max 25mg/day; HD: give dose after dialysis, no supplement; PD: no supplement
    • Pediatric: CrCl 30-50: max 1mg/kg up to 50mg q24h; CrCl<30: max 1mg/kg up to 25mg q24h or up to 50mg 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 discontinuation
  • Myocardial infarction if abrupt discontinuation
  • ventricular arrhythmia during treatment and if abruptly discontinue
  • 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