Pregnancy Category C
Drug classes of Atenolol
Beta-adrenergic blocking agent (? selective)
Mechanism of action of Atenolol
Competitively blocks beta-adrenergic receptors in the heart and juxtoglomerular apparatus. They lead to decreased heart rate decreasing the work load by the heart. They do not produce coronary vasodilatation but lead to a shift and redistribution of coronary circulation to the ischemic areas. It decreases the release of renin from the kidney, thus lowering blood pressure.
Indications of Atenolol
Treatment of angina pectoris due to coronary atherosclerosis
Hypertension, as a step 1 agent, alone or with other drugs, especially
Treatment of myocardial infarction
Unlabeled uses: prevention of migraine headaches; alcohol withdrawal
syndrome, treatment of ventricular arrhythmias
Contraindications of Atenolol
Contraindicated in the presence of sinus bradycardia, second- or third-degree heart block, cardiogenic shock, CHF.
Use caution in the presence of renal failure, diabetes or thyrotoxicosis (atenolol can mask the usual cardiac signs of hypoglycemia and thyrotoxicosis), lactation.
Adverse effects of Atenolol
CNS: Dizziness, vertigo, tinnitus, fatigue, emotional depression, paresthesias, sleep disturbances, hallucinations, disorientation, memory loss, slurred speech
GI: Gastric pain, flatulence, constipation, diarrhea, nausea, vomiting, anorexia, ischemic colitis, renal and mesenteric arterial thrombosis, retroperitoneal fibrosis, hepatomegaly, acute pancreatitis
CV: Bradycardia, CHF, cardiac arrhythmias, sinoartial or AV nodal block, tachycardia, peripheral vascular insufficiency, claudication, CVA, pulmonary edema, hypotension
Respiratory: Bronchospasm, dyspnea, cough, bronchial obstruction, nasal stuffiness, rhinitis, pharyngitis (less likely than with propranolol)
GU: Impotence, decreased libido, Peyronie's disease, dysuria, nocturia, frequent urination
MS: Joint pain, arthralgia, muscle cramp
EENT: Eye irritation, dry eyes, conjunctivitis, blurred vision
Dermatologic: Rash, pruritus, sweating, dry skin
Allergic reactions: Pharyngitis, erythematous rash, fever, laryngospasm, respiratory distress
Other: Decreased exercise tolerance, development of antinuclear antibodies, hyperglycemia or hypoglycemia, elevated serum transaminase, alkaline phosphatase, and LDH
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