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atenolol
Anselol‡, Apo-Atenol†, Noten‡, Nu-Atenol†, Tenormin, Tensig‡

Pregnancy Risk Category D

How supplied
Tablets:
25 mg, 50 mg, 100 mg
Injection:
5 mg/10 ml

Action
A beta blocker that selectively blocks beta1-adrenergic receptors; decreases cardiac output, peripheral resistance, and cardiac oxygen consumption; and depresses renin secretion.

Indications & dosage
Hypertension
--
Adults:
initially, 50 mg P.O. daily as a single dose, increased to 100 mg once daily after 7 to 14 days. Dosages over 100 mg are unlikely to produce further benefit.
Angina pectoris
--
Adults:
50 mg P.O. once daily, increased, p.r.n., to 100 mg daily after 7 days for optimal effect. Maximum dose is 200 mg daily.
To reduce CV mortality and risk of reinfarction in patients with acute MI
--
Adults:
5 mg I.V. over 5 minutes; then another 5 mg after 10 minutes. After an additional 10 minutes, 50 mg P.O.; then 50 mg P.O. in 12 hours. Thereafter, 100 mg P.O. daily (as a single dose or 50 mg b.i.d.) for at least 7 days.
Adjust-a-dose:
For renally impaired patients with creatinine clearance of 15 to 35 ml/minute, maximum dose is 50 mg/day; if it is below 15 ml/minute, maximum dose is 25 mg/day.
  Hemodialysis patients need 25 to 50 mg after each dialysis session; monitor closely because of risk of hypotension.

Adverse reactions
CNS:
fatigue, lethargy, vertigo, drowsiness, dizziness.
CV:
bradycardia, hypotension, heart failure, intermittent claudication.
GI:
nausea, diarrhea.
GU:
elevated BUN and creatinine.
Hematologic:
elevated platelet count.
Hepatic:
elevated transaminase, alkaline phosphatase, LD levels.
Metabolic:
elevated serum levels of potassium, uric acid; increased or decreased serum glucose levels in diabetic patients.
Respiratory:
dyspnea, bronchospasm.
Skin:
rash.
Other:
fever, leg pain.

Interactions
Drug-drug.
Antihypertensives: enhanced hypotensive effect. Use together cautiously.
Cardiac glycosides, diltiazem, verapamil:
excessive bradycardia and increased depressant effect on myocardium. Use together cautiously.
Insulin, oral antidiabetics:
can alter dosage requirements in previously stabilized diabetic patient. Observe patient carefully.
Reserpine:
may cause hypotension. Use with caution.

Effects on diagnostic tests
Drug may cause changes in exercise tolerance and ECG.

Contraindications
Contraindicated in patients with sinus bradycardia, greater than first-degree heart block, overt cardiac failure, or cardiogenic shock.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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