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Atenolol ๐
Related Subjects: |Hypertension |Acute Heart Failure |Chronic Heart Failure
โ ๏ธ IV use must only be undertaken with close cardiac and physiological monitoring.
๐ About
Always check the BNF link here for up-to-date dosing.
- Beta-blockers block beta-adrenergic receptors in the heart, vessels, lungs, pancreas, and liver.
- Atenolol is more lipid-soluble, with potentially more CNS side effects.
- It is relatively cardio-selective (greater effect on ฮฒ1 than ฮฒ2 receptors).
๐ฏ Indications
- Hypertension โ lowers cardiac output, blocks peripheral receptors, reduces plasma renin activity (often effective at low dose).
- Angina โ reduces cardiac oxygen demand. โ ๏ธ Avoid verapamil co-prescription (risk of heart failure).
- Post-MI (STEMI/NSTEMI) โ reduces mortality.
- Arrhythmias โ decreases automaticity and AV conduction. May be used with or instead of digoxin for AF rate control.
- Thyrotoxicosis โ controls adrenergic symptoms (tachycardia, tremor).
- Heart failure โ only bisoprolol, carvedilol, and nebivolol (in โฅ70 years, mild/moderate HF) reduce mortality.
๐ Indications & Dosing Atenolol
- ACS/Post-MI/Arrhythmias (IV): 2.5โ5 mg slow IV over 5โ10 min (1 mg/min rate), may repeat after 15 min up to 10 mg.
- ACS/Post-MI (PO): 25โ100 mg daily.
- Hypertension: 25โ50 mg once daily.
- Angina: 50โ100 mg daily (single or divided doses).
- Arrhythmias (PO): 50โ100 mg daily (single or divided doses).
โ ๏ธ Dose range: Always confirm with the BNF or drug datasheet.
โ Contraindications
- Bradycardia (<60 bpm) or systolic BP <100 mmHg.
- Asthma/bronchospasm.
- Second- or third-degree heart block.
- Uncontrolled, decompensated, or acute severe heart failure.
- Severe hypotension.
- Phaeochromocytoma (unless combined with an ฮฑ-blocker).
- Sick sinus syndrome.
- Significant peripheral vascular disease.
- Diabetes mellitus (especially if also on thiazide diuretics โ masks hypoglycaemia).
- โ ๏ธ Concomitant use with verapamil (risk of complete heart block).
โ ๏ธ Side Effects
- Fatigue, lethargy.
- Cold peripheries, bradycardia, hypotension.
- Heart failure, conduction abnormalities.
- Bronchospasm.
- Impotence, reduced exercise tolerance.
- Worsening diabetic control (masks hypoglycaemia symptoms).
- Worsening of psoriasis in susceptible patients.
๐ References
- Atenolol in BNF
- Oxford Handbook of Clinical Medicine.
- ESC Guidelines on Hypertension & ACS.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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