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