Atenolol - instructions for use, dose, side effects, contraindications

Selective beta₁-blocker, which does not have internal sympathomimetic activity. Has antihypertensive, antiarrhythmic, antianginal action. In therapeutic doses does not affect the tone of peripheral arteries.

Reduces the effect of catecholamines on the heart muscle, thereby reducing the heart rate, minute and shock volumes of blood within 24 hours.

Eliminates the effects of arrhythmogenic factors: tachycardia, hypertension, elevated levels cyclic adenosine monophosphate.

Antianginal action is due to a decrease in myocardial oxygen demand with prolonged diastole and improved perfusion of the heart muscle.

Pharmacokinetics:

After oral intake absorbed in the gastrointestinal tract in 50%.

The half-life of atenolol is 6-9 hours. The maximum concentration is achieved in 2-4 hours. Atenolol binds to plasma proteins up to 16%. Poorly penetrates the blood-brain barrier, penetrates the placenta. Partially metabolized in the liver, eliminated by the kidneys. When hemodialysis is removed from the blood plasma.

Indications:

It is used for relief of hypertensive crises, neurocirculatory dystonia according to the hypertonic type, for the treatment of coronary heart disease, with any form of angina. Used for arrhythmias: from single extrasystoles to atrial flutter.

In complex therapy is prescribed with pheochromocytoma in combination with alpha-adrenoblockers, as well as for the prevention of migraine.

ICD-10

IV.E00-E07.E05 Thyrotoxicosis [hyperthyroidism]

IX.I20-I25.I20 Angina pectoris [angina pectoris]

IX.I20-I25.I21.4 Acute subendocardial myocardial infarction

IX.I30-I52.I42 Cardiomyopathy

IX.I10-I15.I10 Essential [primary] hypertension

IX.I20-I25.I21 Acute myocardial infarction

IX.I30-I52.I47.1 Nadzheludochkovaya tachycardia

IX.I30-I52.I47.2 Ventricular tachycardia

IX.I30-I52.I48 Atrial fibrillation and flutter

Contraindications:

Cardiogenic shock, atrioventricular block II-III degree, bradycardia, chronic heart failure - resistant to the action of cardiac glycosides, bronchial asthma, renal and hepatic insufficiency.

Individual intolerance.

Carefully:

Chronic bronchitis with asthmatic component, obliterating arterial diseases, atrioventricular block I degree, disturbance of water-electrolyte balance.

Pregnancy and lactation:

Recommendations for FDA - category D without teratogenicity. Not applicable in pregnancy and lactation.

Dosing and Administration:

Inside once a day for 30-40 minutes before meals for 25-50 mg, if necessary, the dose increases.

The highest daily dose: 200 mg in one or two doses.

The highest single dose: 200 mg.

Side effects:

Central nervous system: dizziness, insomnia, asthenia.

Respiratory system: dyspnea, rarely - bronchospasm.

Cardiovascular system: bradycardia, atrioventricular block, cold extremities.

System of blood: neutropenia, thrombocytopenia.

Sense organs: "dry eye syndrome", transient visual impairment.

Gastrointestinal tract: indigestion, diarrhea or constipation.

Reproductive system: decreased potency.

Skin: Hyperhidrosis.

Allergic reactions.

Overdose:

Pronounced bradycardia, arterial hypotension.

Treatment. Intravenous 1-2 mg atropine, 2.5 mcg / kg dobutamine, intravenously bolus 10 mg glucagon, intravenously drip 10-20 mcg isoprenaline at a rate of not more than 5 mcg per minute.

Interaction:

Strengthens the effect of lidocaine in systemic application.

Negative dromo-, foreign, chromotropic influences are intensified with simultaneous admission with amiodarone, anesthetics, antiarrhythmics, digoxin, diltiazem, verapamil.

Increases the bioavailability of atenolol together with cimetidine.

Special instructions:

With chronic renal failure, the dose is corrected: creatinine clearance of 15-35 ml per minute - 50 mg per day; when creatinine clearance is less than 15 ml per minute - 50 mg every other day.

When giving general anesthesia to patients receiving atenolol, means with minimal inotropic action are used. Before surgery, it is recommended to stop taking the medication 48 hours before the operation.

Instructions

Atenolol (Atenololum)