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Athenol oral
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Athenol oral Overview

Atenolol is a selective β1 receptor antagonist, a drug belonging to the group of beta blockers (sometimes written β-blockers), a class of drugs used primarily in cardiovascular diseases. Introduced in 1976, atenolol was developed as a replacement for propranolol in the treatment of hypertension. It works by slowing down the heart and reducing its workload. Unlike propranolol, atenolol does not pass through the blood–brain barrier thus avoiding various central nervous system side effects.

Atenolol is one of the most widely used β-blockers in the United Kingdom and was once the first-line treatment for hypertension. The role for β-blockers in hypertension was downgraded in June 2006 in the United Kingdom to fourth-line, as they perform less appropriately or effectively than newer drugs, particularly in the elderly.

Contraindications

bradycardia (pulse less than 60 bpm)
cardiogenic shock
asthma (may cause broncho-constriction).
symptomatic hypotension (blood pressure of less than 90/60 mm Hg with dizziness, vertigo etc.)
angina of the Prinzmetal type (vasospastic angina)
metabolic acidosis (a severe condition with a more acidic blood than normal)
severe disorders in peripheral arterial circulation
Atrioventricular blockage of second and third degree (a particular form of arrhythmia)
acutely decompensated congestive heart failure (symptoms may be fluid retention with peripheral edema and/or abdominal fluid retention (ascites), and/or lung edema)
sick sinus syndrome (a particular form of arrhythmia)
hypersensitivity and/or allergy to atenolol

Pharmacokinetic data

tcmax = 2 to 4 hours after oral dosing (time elapsed before maximal concentration in the blood plasma is reached)
The mean elimination halflife is 6 hours. However, the action of the usual oral dose of 25 to 100 mg lasts over a period of 24 hours.
Atenolol is a hydrophilic drug. The concentration found in brain tissue is approximately 15% of the plasma concentration only. The drug crosses the placenta barrier freely. In the milk of breastfeeding mothers, approximately 3 times the plasma concentrations are measured.
Atenolol is almost exclusively eliminated renally and is well removable by dialysis. A compromised liver function does not lead to higher peak-activity and/or a longer halflife with possible accumulation.

ATHENOL ORAL WARNING

If you are allergic to tartrazine, talk with healthcare provider. Some products contain tartrazine.

If you have an allergy to any type of nuts or seeds, talk with healthcare provider. Some products contain nuts.

Check medicines with healthcare provider. This medicine may not mix well with other medicines.

Tell healthcare provider if you are pregnant or plan on getting pregnant.

Tell healthcare provider if you are breast-feeding.
What are some possible side effects of this medicine?

Skin irritation.

Reasons to call healthcare provider immediately

If you suspect an overdose, call your local poison control center or emergency department immediately.

Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.

Severe skin irritation.

Any rash.

No improvement in condition or feeling worse.

ATHENOL ORAL USES

Medical uses

Atenolol is used for a number of conditions including: hypertension, angina, Long cough, acute myocardial infarction, supraventricular tachycardia, ventricular tachycardia, and the symptoms of alcohol withdrawal.

It is also used to treat the symptoms of Graves' disease until antithyroid medication can take effect.

Due to its hydrophilic properties, the drug is less suitable in migraine prophylaxis compared to propranolol, because, for this indication, atenolol would have to reach the brain in high concentrations, which is not the case, because, as mentioned, atenolol does not pass through the blood–brain barrier.

ATHENOL ORAL SIDE EFFECTS

Side effects

Atenolol causes significantly fewer central nervous system side effects (depression, nightmares).

It was the main β-blocker identified as carrying a higher risk of provoking type 2 diabetes, leading to its downgrading in the United Kingdom in June 2006 to fourth-line agent in the management of hypertension.

In addition, β-blockers blunt the usual sympathetic nervous system response to hypoglycemia (i.e. sweating, agitation, tachycardia). These drugs therefore have an ability to mask a dangerously low blood sugar, which further decreases their safety and utility in diabetic patients.

Side effects have been known to include the following

indigestion, constipation
dry mouth
dizziness or faintness (especially cases of orthostatic hypotension)
cold extremities
impotence
rhinitis
depression
confusion
insomnia, nightmares
fatigue, weakness or lack of energy
edema

The following more-serious side effects have also been observed and/or reported:

hallucinations
low blood pressure (hypotension)
skin reactions, e.g. rash, hives, flaking of skin, worsening of psoriasis
sensation of 'pins and needles' hands or feet
irritated eyes, visual disturbances
difficulty hearing
difficulty speaking
unsteadiness when walking

Atenolol is classified as a β1-selective (or 'cardioselective') drug, one that exerts greater blocking activity on myocardial β1-receptors than on β2 receptors in the lung. The β2 receptors are responsible for keeping the bronchial system open. If these receptors are blocked, bronchospasm with serious lack of oxygen in the body can result. However, due to its cardioselective properties, the risk of bronchospastic reactions if using atenolol is reduced compared to nonselective drugs as propranolol. Nonetheless, this reaction may also be encountered with atenolol at high doses. Although traditionally β-blockers have been contraindicated when a person carries a diagnosis of asthma, recent studies have revealed that at moderate doses selective β-blockers such as Atenolol are well tolerated.

Provisional data suggests that antihypertensive therapy with atenolol provides weaker protective action against cardiovascular complications (e.g. myocardial infarction and stroke) compared to other antihypertensive drugs. In some cases, diuretics are superior. However, controlled studies are lacking.

Unlike most other commonly used β-blockers, atenolol is excreted almost exclusively by the kidneys. This makes it attractive for use in individuals with end-stage liver diseases.

ATHENOL ORAL PRECAUTIONS

Before using trolamine salicylate, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other salicylates (such as salsalate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, growths in the nose (nasal polyps).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This drug is similar to aspirin. Children and teenagers should not use this drug if they have chickenpox, flu, or any undiagnosed illness or if they have recently received a vaccine. In these cases, this drug may increase the risk of Reye's syndrome, a rare but serious illness.

During the first 6 months of pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the last 3 months of pregnancy due to possible harm to the unborn baby and problems with normal labor/delivery. Discuss the risks and benefits with your doctor.

It is unknown if this product passes into breast milk. Consult your doctor before breast-feeding.

ATHENOL ORAL INTERACTIONS

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

ATHENOL ORAL OVERDOSE

Overdose

Symptoms of overdose are due to excessive pharmacodynamic actions on β1 and also β2-receptors. These include bradycardia, severe hypotension with shock, acute heart failure, hypoglycemia and bronchospastic reactions. Treatment is largely symptomatic. Hospitalization and intensive monitoring is indicated. In early cases emesis can be induced. Activated charcoal is useful to absorb the drug. Atropine will counteract bradycardia, glucagon helps with hypoglycemia, dobutamine can be given against hypotension and the inhalation of a β2-mimetic as hexoprenalin or salbutamol will terminate bronchospasms. Blood or plasma atenolol concentrations may be measured to confirm a diagnosis of poisoning in hospitalized patients or to assist in a medicolegal death investigation. Plasma levels are usually less than 3 mg/L during therapeutic administration, but can range from 3–30 mg/L in overdose victims.

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