Home Drug Guide Atenolol

Drug Guide

Generic Name

Atenolol

Brand Names Tenormin

Classification

Therapeutic: Cardiovascular agent, Beta-blocker

Pharmacological: Selective beta-1 adrenergic antagonist

FDA Approved Indications

  • Angina pectoris
  • Hypertension
  • Prevention of myocardial infarction

Mechanism of Action

Atenolol selectively blocks beta-1 adrenergic receptors in the heart, leading to decreased heart rate, myocardial contractility, and cardiac output, ultimately reducing blood pressure and oxygen demand.

Dosage and Administration

Adult: Initially 50 mg once daily; may be increased to 100 mg once daily based on response.

Pediatric: Not typically used in children; consult specific pediatric dosing guidelines.

Geriatric: Start at lower doses due to increased sensitivity; monitor as elderly may have decreased clearance.

Renal Impairment: Adjust dose; initial dose 25-50 mg once daily, titrate as needed.

Hepatic Impairment: Use with caution; no specific adjustments specified but monitor closely.

Pharmacokinetics

Absorption: Well absorbed orally, bioavailability approximately 50-70%.

Distribution: Widely distributed; crosses the placenta, tissues, and to some extent the brain.

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged by the kidneys.

Excretion: Renal excretion of unchanged drug.

Half Life: Approximately 6-7 hours.

Contraindications

  • Second or third-degree heart block
  • Severe bradycardia
  • Sick sinus syndrome
  • Uncompensated heart failure

Precautions

  • Use with caution in patients with asthma, COPD, diabetes (may mask hypoglycemia symptoms), peripheral vascular disease, or depression.

Adverse Reactions - Common

  • Fatigue (Common)
  • Dizziness (Common)
  • Bradycardia (Uncommon)

Adverse Reactions - Serious

  • Heart failure worsening (Uncommon)
  • Bronchospasm in susceptible patients (Rare)
  • Severe hypotension (Rare)

Drug-Drug Interactions

  • Verapamil, diltiazem (may increase risk of bradycardia or heart block)
  • Other antihypertensives (additive effect)
  • Insulin and hypoglycemics (may mask hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, respiratory status, and signs of heart failure.

Diagnoses:

  • Risk for decreased cardiac output
  • Impaired gas exchange
  • Risk for falls

Implementation: Administer with food to reduce gastrointestinal upset; monitor vital signs regularly.

Evaluation: Assess for therapeutic effectiveness (blood pressure, anginal episodes) and adverse effects.

Patient/Family Teaching

  • Do not discontinue abruptly—may cause tachycardia, hypertension, or ischemia.
  • Report signs of bradycardia, dizziness, fatigue, or worsening heart failure.
  • Use daily as prescribed; avoid sudden stopping.
  • Caution about driving or operating machinery until effects are known.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: No well-established genetic factors influencing atenolol response.

Lab Test Interference: May interfere with glucose monitoring in diabetics; beta-blockers can mask hypoglycemia symptoms.

Overdose Management

Signs/Symptoms: Severe hypotension, bradycardia, heart block, bronchospasm, hypoglycemia.

Treatment: Supportive care, intravenous atropine for bradycardia, vasopressors for hypotension, airway support, and possibly dialysis in severe cases.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under proper storage conditions for the duration of shelf life.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.