Class: β-Adrenergic Blocker, Cardioselective
Dosage Forms. Tablet: 25 mg, 50 mg, 100 mg
Common FDA Label Indication, Dosing, and Titration.
1. Angina pectoris, chronic: 50 mg po daily; titrate to 100-200 mg po daily
2. Hypertension: Adults, 50 mg po daily, titrate to 100 mg po daily; Children, 0.5-1 mg/kg/d po in 1-2 divided doses, titrate to 2 mg/kg/d po in 1-2 divided doses (max 100 mg/d)
1. Cardiac dysrhythmia: Adults, 50-100 mg po daily; Children, 0.3-1.4 mg/kg po daily, titrate to 2 mg/kg po daily
2. Migraine prophylaxis: 50-100 mg po daily
MOA. Atenolol is a cardioselective beta-adrenergic that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmias.
Drug Characteristics: Atenolol
Medication Safety Issues: Atenolol
Drug Interactions: Atenolol
Adverse Reactions: Atenolol
Efficacy Monitoring Parameters. Decreased BP, reduction of chest pain, decreased number of weekly angina attacks, reduction in use of prophylactic nitroglycerin to relieve chest pain, improvement in signs/symptoms of heart failure.
Toxicity Monitoring Parameters. Signs/symptoms of heart failure, decreased heart rate. Monitor serum electrolytes, and renal function at baseline and periodically.
Key Patient Counseling Points. Take on an empty stomach and avoid alcohol. Avoid abrupt discontinuation; exacerbations of angina may occur. Report signs/symptoms of hypotension, CHF, or exacerbation of angina with initial dosing and dose changes. May cause dizziness. Diabetic patients to carefully follow blood sugar levels as beta-blockers may mask symptoms of hypoglycemia.
Clinical Pearls. Safety and efficacy not established in children.