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atenolol

atenolol (Tenormin)

Introduction:

  • atenolol is a “cardioselective” beta adrenergic blocker with primarily beta 1 blockade but with some beta 2 blockade (hence use with care in asthmatics).
  • half life ~6h
  • duration of action ~24h

Clinical usages

angina without cardiac failure

  • beta blockers improve angina symptoms by reducing myocardial oxygen demand mainly via slowing sinus rate (ideally to around 50-60bpm).

antiarrhythmic

  • beta blockers have class II V-W actions and can be used to reduce risk of VT, as well as slowing the ventricular rate of AF, and potentially reverting SVT.

hypertension

  • beta blockers are one of the main Rx options in the Mx of hypertension

aortic dissection

  • beta blockers have an important role in reducing further dissection in acute aortic dissection

Contraindications

Dose

general points

  • dosing intervals for iv doses are 12hrly

iv slow bolus dose:

  • 2.5mg over 2.5min (1mg/min), repeat in 5 min if needed to max. 5mg total dose (higher in serious refractory cases)

iv infusion

  • 0.15mg/kg in either NSaline or 5% dextrose over 10min

oral

  • initial dose for adults is usually 50mg once daily (reduce in renal impairment or the elderly)
  • increase dose by 50mg/day each week as needed to max. 100mg/day for angina/arrhythmias, or to max. 200mg/d for hypertension
  • withdraw gradually over 8-14 days.
atenolol.txt · Last modified: 2009/02/24 21:06 (external edit)