Atenolol is used to treat hypertension and angina and in stable heart attack patients to prevent death.
Atenolol blocks beta-1 receptors, which are present on the heart. This prevents the action of nerve chemicals adrenaline and noradrenaline on the heart. As a result, heart beats at a slower rate and with lesser force, and thus pumps out lesser blood into blood vessels. This action of atenolol reduces blood pressure in the hypertensive patients. Since the heart treated with atenolol beat slowly and with less force, it uses lesser energy thus relieving pain in angina and also reduces the risk of heart attack.
Atenolol is absolutely contraindicated in the patients with the following conditions:
• Clinical depression
• Known allergy to the drug
• Second or third degree heart block
• Persistent low heart rate (bradycardia)
• Poor blood circulation due to heart failure
• Tumour of adrenal gland called pheochromocytoma
• Breast feeding mother
The dosage of the drug varies as per the medical condition.
• In acute heart attack patient: Oral therapy with atenolol must be started once the patient is in a stable condition following the intravenous atenolol for acute heart attack. First oral dose (50 mg) must be given after 10 minutes of the last intravenous dose. Another 50 mg dose should be given after 12 hours. Then a 100 mg must be given once a day or 50 mg twice a day for 6 to 9 days or until discharge from the hospital.
• For hypertension or angina: 50 mg once daily. Dose may be increased to 100 mg once daily after one-two weeks.
• Take the drug as soon as you remember.
• Never take two doses together.
• If it is less than 8 hours until the next dose, skip the missed dose.
• Take the tablet with water.
• Taking the drug after meal is advisable to reduce chances of stomach upset. However, the drug can be taken empty stomach.
• Never stop taking the drug without consulting your prescribing doctor. Abrupt cessation may cause severe health problems.
• Consult your doctor before any surgery or dental procedure. Atenolol may be required to be stopped before any such treatment.
• The drug may block the symptoms of low blood glucose levels. Diabetic patients must take extra care while using this drug.
• Atenolol interacts with many drugs. Make sure your doctor knows all the drugs you are taking before starting the treatment with atenolol.
• Patient may develop an allergic reaction.
• Heart- Slow heart rate, heart failure, low blood pressure.
• Central Nervous System- Headache, fatigue, dizziness, hallucinations, confusion and sleep disturbances.
• Gastrointestinal - Diarrhea and nausea.
• Respiratory - Wheezing and shortness of breath.
• Others: Lack of sexual drive, impotence, and erectile dysfunction.
The drug should be used with extreme precaution if the patient is having any of these conditions:
• Occasional numbness and tingling in the fingers.
• Chronic obstructive pulmonary disease (COPD).
• Diabetes, since it may mask the effects of low blood sugar levels.
• Hyperthyroidism, or high thyroid hormone levels.
• Kidney function problems, since the drug is eliminated from the body in the urine
• Liver function problems.
• Skin condition called psoriasis.
• Muscle weakness known as myasthenia gravis.
Regular blood pressure and blood sugar monitoring are recommended in the patient taking atenolol and also having any of the above conditions.
Atenolol should be avoided with:
• Other beta blockers due to additive effects.
• Other drugs that can slow down the heart like verapamil, digitalis, amiodarone and diltiazem.
• Drugs used in the treatment of asthma due to opposite effects on the bronchi.
• Antidiabetes medications since atenolol can block the signs of hypoglycemia.
• Drugs that act on alpha receptors. Along with alpha agonists like ephedrine, it can produce excessive rise in blood pressure, while with alpha blockers like prazosin, it can result in excess fall in blood pressure.
• NSAIDs like ibuprofen and naproxen, which may block the effect of atenolol on blood pressure.
• Anticholinesterase drugs used in Alzheimer's disease like rivastigmine due to additive effect on the heart and blood pressure.
• Drugs that lower blood pressure and increase potassium levels like chlorthiazide.
• Other drugs that may lower blood pressure like antihypertensive medications, aldesleukin, and barbiturates.
Store the drug in a cool, dry place away from direct sunlight. Keep out of the reach of children.
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