Atenolol Flashcards
Alternate Names
Propranolol, Inderal, Inderal LA, metoprolol, Toprol XL many others: COst 4-52$, up to 108$ for Inderal LA
Drug Class
Pharm: Beta adrenoceptor blocker (beta 1 specificity)
Therapeutic: antihypertensive, antiarrhthmic, primary and secondary prevention of MI, anti-anginal
Pharmacodynamics
Binds directly to beta-receptors, with a preference for Beta1 over beta2 receptors, leading to lower BP via several potential mechanisms (less CO, less RAAS); recent evidence suggests less effective in preventing strokes than other drugs, hence no longer used as initial monotherapy in most patients
Pharmacokinetics
Available po or IV, variable oral F; onset 1-2 hours h, duration 12-24 hours, can be given once per day; renally excreted (longer half life)
Toxicity
Excessive hypotension; bradycardia; heart block can worsen severe CHF (but indicated for mild to moderate CHF) worsen bronchospasm in severe asthmatics
Interactions
Additive effects with most other antihypertensives, additive AV block with CEBs
Special Considerations
May be especially useful in HTN patients with exertional angina, MI, atrial fibrillation, watch out for abrupt withdrawal; may no longer be first line drug unless other indications exist
Indications and Dose / Route
For treatment of hypertension, 25-100 mg per day, in one or two doses
Monitoring
BP, HR, exercise tolerance