Atenolol

Atenolol Brand Names- First-Atenolol | Tenormin

What is Atenolol

Atenolol is a competitive, beta-1-selective adrenergic antagonist, similar to metoprolol.

Atenolol has a longer plasma half-life than does metoprolol, which allows for once-daily dosing.

Due to its low-lipid solubility, atenolol is renally eliminated, minimally metabolized, and has a lower potential for inducing CNS side effects compared to lipid-soluble beta-blockers (e.g., propranolol).

As with other ‘cardioselective’ beta-blockers, high doses result in attenuated or lost selectivity for the beta-1-receptor.

Unlike pindolol, atenolol does not have intrinsic sympathomimetic properties.

Atenolol also does not possess membrane-stabilizing activity as pindolol and propranolol do.

The 2007 AHA guidelines for the management of hypertension state beta-blockers should not be used as first-line therapy for the treatment of hypertension, as several comparative clinical trials have shown beta blockers to be inferior to ACE inhibitors, angiotensin-receptor blockers, or calcium channel blockers for preventing both stroke and coronary artery disease complications.

These guidelines do, however, recommend the use of beta-blockers for the treatment of hypertension in patients with angina, prior myocardial infarction, or heart failure.

Atenolol was approved by the FDA in 1981.

Indications

  1. acute myocardial infarction, STEMI
  2. alcohol withdrawal
  3. angina
  4. atrial fibrillation
  5. atrial flutter
  6. hypertension
  7. migraine prophylaxis
  8. myocardial infarction prophylaxis
  9. paroxysmal supraventricular tachycardia (PSVT) prophylaxis
  10. reduction of cardiovascular mortality
  11. tremor
  12. unstable angina

Side Effects

  1. alopecia
  2. angina
  3. atrial fibrillation
  4. atrial flutter
  5. AV block
  6. bradycardia
  7. bronchospasm
  8. cardiac arrest
  9. depression
  10. diabetes mellitus
  11. diaphoresis
  12. diarrhea
  13. dizziness
  14. drowsiness
  15. dyspnea
  16. elevated hepatic enzymes
  17. erythema
  18. fatigue
  19. hallucinations
  20. headache
  21. heart failure
  22. hyperbilirubinemia
  23. hyperglycemia
  24. hypertension
  25. hypertriglyceridemia
  26. hypoglycemia
  27. hypotension
  28. impotence (erectile dysfunction)
  29. lethargy
  30. lupus-like symptoms
  31. myocardial infarction
  32. nausea
  33. nightmares
  34. orthostatic hypotension
  35. palpitations
  36. penile fibrosis
  37. peripheral vasoconstriction
  38. psoriaform rash
  39. psoriasis
  40. psychosis
  41. pulmonary embolism
  42. purpura
  43. rash
  44. renal failure (unspecified)
  45. serum sickness
  46. sinus tachycardia
  47. supraventricular tachycardia (SVT)
  48. syncope
  49. teratogenesis
  50. thrombocytopenia
  51. tremor
  52. ventricular tachycardia
  53. vertigo
  54. visual impairment
  55. wheezing
  56. withdrawal
  57. xerophthalmia
  58. xerostomia

Monitoring Parameters

  • blood pressure
  • heart rate
  • serum creatinine/BUN

Contraindications

  • abrupt discontinuation
  • acute bronchospasm
  • asthma
  • AV block
  • beta-blocker hypersensitivity
  • bradycardia
  • breast-feeding
  • bronchitis
  • cardiogenic shock
  • cerebrovascular disease
  • chronic obstructive pulmonary disease (COPD)
  • depression
  • diabetes mellitus
  • dialysis
  • driving or operating machinery
  • emphysema
  • geriatric
  • heart failure
  • hyperthyroidism
  • hypotension
  • labor
  • myasthenia gravis
  • obstetric delivery
  • peripheral vascular disease
  • pheochromocytoma
  • pregnancy
  • psoriasis
  • pulmonary disease
  • pulmonary edema
  • Raynaud’s phenomenon
  • renal disease
  • renal failure
  • renal impairment
  • sick sinus syndrome
  • surgery
  • thyroid disease
  • thyrotoxicosis
  • vasospastic angina
  • ventricular dysfunction

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Adenosine
  • Albiglutide
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alfentanil
  • Alfuzosin
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Alogliptin; Metformin
  • Alpha-blockers
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amifostine
  • Amiodarone
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Ampicillin
  • Ampicillin; Sulbactam
  • Amyl Nitrite
  • Antithyroid agents
  • Apomorphine
  • Apraclonidine
  • Aripiprazole
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Baclofen
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Beta-agonists
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bosentan
  • Bretylium
  • Brexpiprazole
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Cabergoline
  • Caffeine; Ergotamine
  • Calcium
  • Calcium Acetate
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Calcium Chloride
  • Calcium Gluconate
  • Calcium; Vitamin D
  • Canagliflozin; Metformin
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Cariprazine
  • Ceritinib
  • Cevimeline
  • Charcoal
  • Chloroprocaine
  • Chlorthalidone; Clonidine
  • Choline Salicylate; Magnesium Salicylate
  • Chromium
  • Clevidipine
  • Clonidine
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Conivaptan
  • Crizotinib
  • Dapagliflozin; Metformin
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Desflurane
  • Dexmedetomidine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Digoxin
  • Dihydroergotamine
  • Diltiazem
  • Dipeptidyl Peptidase-4 Inhibitors
  • Dipyridamole
  • Disopyramide
  • Dolasetron
  • Donepezil
  • Donepezil; Memantine
  • Doxazosin
  • Dronedarone
  • Dulaglutide
  • Duloxetine
  • Dutasteride; Tamsulosin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril; Felodipine
  • Encainide
  • Enflurane
  • Epoprostenol
  • Ergonovine
  • Ergotamine
  • Ertugliflozin; Metformin
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Etomidate
  • Exenatide
  • Felodipine
  • Fingolimod
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flecainide
  • Fluorescein
  • Fluoxetine; Olanzapine
  • food
  • Fospropofol
  • Galantamine
  • General anesthetics
  • Ginger, Zingiber officinale
  • Glipizide; Metformin
  • Glucagon
  • Glyburide; Metformin
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Guanabenz
  • Guanfacine
  • Haloperidol
  • Halothane
  • Hetastarch; Dextrose; Electrolytes
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Icosapent ethyl
  • Iloperidone
  • Iloprost
  • Incretin Mimetics
  • Indacaterol; Glycopyrrolate
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Intravenous Lipid Emulsions
  • Isocarboxazid
  • Isoflurane
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Isradipine
  • Ivabradine
  • Ketamine
  • Lacosamide
  • Lanreotide
  • Lasmiditan
  • Levobupivacaine
  • Levodopa
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Lidocaine
  • Linagliptin; Metformin
  • Linezolid
  • Liothyronine
  • Liraglutide
  • Lithium
  • Lixisenatide
  • Lofexidine
  • Lopinavir; Ritonavir
  • Lovastatin; Niacin
  • Lurasidone
  • Magnesium Salicylate
  • Mefloquine
  • Meglitinides
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methacholine
  • Methohexital
  • Methylergonovine
  • Methysergide
  • Milrinone
  • Moxifloxacin
  • Nefazodone
  • Nesiritide, BNP
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Non-Ionic Contrast Media
  • Nonsteroidal antiinflammatory drugs
  • Octreotide
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Oxymetazoline
  • Paliperidone
  • Pasireotide
  • Pentoxifylline
  • Perindopril; Amlodipine
  • Phenelzine
  • Phenoxybenzamine
  • Phentolamine
  • Pilocarpine
  • Pramlintide
  • Prazosin
  • Prilocaine
  • Prilocaine; Epinephrine
  • Procainamide
  • Procaine
  • Propafenone
  • Propantheline
  • Propofol
  • Quinidine
  • Rasagiline
  • Remifentanil
  • Reserpine
  • Risperidone
  • Ritonavir
  • Rivastigmine
  • Ropivacaine
  • Salsalate
  • Selegiline
  • Semaglutide
  • Sevoflurane
  • SGLT2 Inhibitors
  • Silodosin
  • Siponimod
  • Succinylcholine
  • Sufentanil
  • Sulfonylureas
  • Sympathomimetics
  • Tacrine
  • Tamsulosin
  • Tasimelteon
  • Terazosin
  • Tetrabenazine
  • Tetracaine
  • Thalidomide
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Thyroid hormones
  • Tizanidine
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Verapamil
  • Warfarin
  • Yohimbine
  • Ziprasidone
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