OzEMedicine - Wiki for Australian Emergency Medicine Doctors

see also beta adrenergic blockers, hypertension, angina

• MIMS

• 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

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

• 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.

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

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

• see beta adrenergic blockers

• dosing intervals for iv doses are 12hrly

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

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

• 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.