Atenolol

General

• Type: Beta blocker
• Dosage Forms: PO
• Common Trade Names: Tenormin

Adult Dosing

Hypertension

• 50-100mg PO qd, Start 50mg PO qd
• Max: 100mg/day

Stable angina

• 50-200mg PO qd, Start 50mg PO qd
• Max: 200mg/day

Cardiovascular event prevention, post-MI

• 100mg/day PO divided qd-bid

Pediatric Dosing

Hypertension

• 1-2mg/kg PO qd, Start 0.8-1mg/kg PO qd
• Max: 2mg/kg/day

Supraventricular arrhythmias

• 0.3-2mg/kg PO qd
• Max: 2mg/kg/day

Special Populations

• Pregnancy Rating: D
• Lactation: Possibly unsafe
• Renal Dosing
  • Adult: CrCl 10-50: decrease dose 50%, give q48h, max 50mg/day; CrCl<10: decrease dose 50-70%, give q96h, max 25mg/day; HD: give dose after dialysis, no supplement; PD: no supplement
  • Pediatric: CrCl 30-50: max 1mg/kg up to 50mg q24h; CrCl<30: max 1mg/kg up to 25mg q24h or up to 50mg q48h; HD: give dose after dialysis, no supplement; PD: no supplement
• Hepatic Dosing
  • Adult: not defined
  • Pediatric: not defined

Contraindications

• Allergy to class/drug
• sinus bradycardia
• 2nd or 3rd degree AV block
• heart failure, uncompensated
• cardiogenic shock
• sick sinus syndrome with out pacemaker
• pheochromocytoma, untreated
• avoid abrupt withdrawal
• caution if peripheral vascular disease
• caution if bronchospastic disease
• caution if major surgery
• caution if diabetes mellitus
• caution if thyroid disorder
• caution if WPW syndrome
• caution if renal impairment
• caution if pregnancy
• caution if breastfeeding
• caution if myasthenia gravis
• caution if severe anaphylactic reaction history
• caution in elderly patients

Adverse Reactions

Serious

• CHF
• bradycardia, severe
• heart block
• angina exacerbation if abrupt discontinuation
• Myocardial infarction if abrupt discontinuation
• ventricular arrhythmia during treatment and if abruptly discontinue
• Raynaud phenomenon
• bronchospasm
• hypersensitivity reaction
• lupus erythematosus

Common

• bradycardia
• hypotension
• fatigue
• dizziness
• cold extremities
• depression
• dyspnea
• hypotension, orthostatic
• leg pain
• bronchospasm
• lightheadedness
• lethargy
• diarrhea
• nausea
• vertigo
• drowsiness

Pharmacology

• Half-life: 6-7h
• Metabolism: CYP450
• Excretion: urine 40-50%, feces 50%
• Mechanism of Action: selectively antagonizes beta-1 adrenergic receptors

References

Authors

Tasha Fernando, Ross Donaldson, Claire, Neil Young, Daniel Ostermayer