[tablets 1 cent each]
- PO, NG
- acute myocardial infarction
- secondary prevention in patients with coronary artery disease
- rate control
PRESENTATION AND ADMINISTRATION:
- PO/ NG:
Pacific atenolol: orange 50mg and 100mg tablets.
Tablets may be crushed and administered via nasogastric tube.
Commence at 50mg daily; increase to 100mg daily as tolerated.
Note: generally metoprolol is used as the 1st line beta blocker rather than atenolol in our ICU
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
- Dose in renal impairment [GFR (ml/min)]
<10: 50mg once daily
10-20: dose as in normal renal function
>20-50: dose as in normal renal function
- Dose in renal replacement therapy
CAPD: 50mg once daily
HD: 50mg once daily
CVVHDF: dose as in normal renal function
DOSAGE IN PAEDIATRICS:
- Safety and effectiveness in paediatric patients have not been established 1-2mg/kg PO 12-24hrly.
- Atenolol is a beta1-selective (cardioselective) beta-adrenergic receptor blocking agent without membrane stabilizing or intrinsic sympathomimetic (partial agonist) activities. This preferential effect is not absolute, however, and at higher doses, atenolol inhibits beta2-adrenoreceptors, chiefly located in the bronchial and vascular musculature. Absorption of an oral dose of atenolol is rapid and consistent but incomplete. Approximately 50% of an oral dose is absorbed from the gastrointestinal tract, the remainder being excreted unchanged in the faeces. Peak blood levels are reached between 2 and 4 hours after ingestion.
- sinus bradycardia
- heart block greater than first degree
- cardiogenic shock
- overt cardiac failure
- Cardiac Failure:
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure.
- Discontinuation of therapy:
Discontinuation of therapy in a patient with coronary artery disease may lead to rebound angina, arrhythmia or myocardial infarction.
- Diabetes and Hypoglycemia:
Beta blockers may mask tachycardia occurring with hypoglycaemia.
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm.
Atenolol may aggravate peripheral arterial circulatory disorders.
- Laboratory Tests:
No tests in addition to routine ICU tests are required
- Drug/Laboratory Test Interactions :
IMPORTANT DRUG INTERACTIONS FOR THE ICU
- Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine
- Body as a Whole:
- Cardiovascular System:
Bradycardia , Cold extremities, Hypotension, Leg pain
- Respiratory System:
- Digestive System:
- Nervous System:
Dizziness, Vertigo, Light-headedness