Related Subjects:
|Hypertension
|Acute Heart Failure
|Chronic Heart Failure
Use IV must be with close cardiac and physiological monitoring
- Block Beta-adrenergic receptors in heart, peripheral vessels, lungs, pancreas and liver
- Atenolol is more lipid-soluble with potentially more CNS side effects
- Cardio selective
Indications for beta blockers
- Hypertension - reduced Cardiac output, block peripheral receptors, some reduce plasma renin activity. Full dose often not needed.
- Angina - reduces cardiac oxygen demand. Avoid verapamil as can precipitate heart failure
- Post-MI - STEMI and NSTEMI can reduce mortality
- Anti-arrhythmic - reduce automaticity and conduction. Can use with or instead of Digoxin to control AF rate.
- Thyrotoxicosis - useful to control sympathetic symptoms
- Heart failure - only Bisoprolol and Carvedilol reduce mortality. Nebivolol can be used in mild to moderate heart failure in the over 70s
Indications/Dose
- ACS/post MI/arrhythmias: Atenolol 2.5-5 mg slow IV over 5-10 min at a rate of 1 mg/minute. May be repeated after 15 min
- ACS/post MI : Atenolol 25-100 mg/day PO.
- Hypertension: Atenolol 25-50 mg od
- Angina: Atenolol 50-100 mg daily in 1-2 doses
- Arrhythmias: Atenolol 50-100 mg daily in 1-2 doses
Dose range:You must check with BNF or drug datasheet
Name | Dose | Frequency | Route |
Atenolol | 25-100 mg | OD | PO |
Atenolol | 2.5 mg | Every 5 minutes if required up to 10 mg | IV |
Contraindications
- Bradycardia <60bpm, systolic BP <100mmHg
- Asthma/Bronchospasm, 2nd or 3rd-degree heart block
- Avoid in Diabetes especially with thiazide
- Uncontrolled/Decompensated/Acute heart failure/severe heart failure
- Severe hypotension, Phaeochromocytoma except with an alpha-blocker
- Sick sinus syndrome, Significant peripheral vascular disease
- Concomitant use of verapamil
Side effects
- Fatigue, Cold peripheries, Bradycardia, Heart failure
- Hypotension, Conduction disturbances, Bronchospasm
- Impotence, Worsening diabetic control, Worsening psoriasis
References