Atenolol
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Trade Name
Tenormin (primary brand name); generic atenolol
Classification
Beta-adrenergic blocker; selective β1-blocker; antihypertensive, antianginal
Dosage/Route
- * Dosage: Tablets: 25 mg, 50 mg, 100 mg
- * Route: Oral (PO); IV available but less common in outpatient settings
Usual Dosage
- * Hypertension: 25-50 mg PO once daily; max 100 mg/day
- * Angina: 50 mg PO once daily; may increase to 100 mg/day; max 200 mg/day
- * Post-MI: 50-100 mg PO daily (start IV in acute setting, transition to PO)
- * Elderly/Renal Impairment: Start 25 mg/day; adjust if CrCl <35 mL/min
Mechanism of Action
Selectively blocks β1-adrenergic receptors in the heart, reducing heart rate, myocardial contractility, and cardiac output. Lowers blood pressure and oxygen demand; slows AV conduction, aiding arrhythmia control
Side Effects & Adverse Effects
- * Side Effects: Fatigue, dizziness, bradycardia, cold hands/feet
- * Adverse Effects:
- – Severe bradycardia or heart block (esp. with overdose)
- – Hypotension (orthostatic)
- – Bronchospasm (less likely, but caution in asthma/COPD)
- – Masking hypoglycemia signs (diabetics); rebound HTN if stopped abruptly
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor HR, BP before each dose (hold if HR <50-60 bpm or SBP <90 mmHg, per protocol)
- – Assess for heart failure signs (dyspnea, edema) or respiratory issues
- – Check pulse in extremities (peripheral effects)
- – Avoid in uncompensated HF or severe bradycardia
- * Teachings:
- – Take same time daily, with/without food
- – Rise slowly to avoid dizziness
- – Report slow pulse, shortness of breath, or fainting
- – Don’t stop suddenly—taper over 1-2 weeks
Indication for This Patient
- * Hypertension (chronic management)
- * Angina pectoris (reduces chest pain frequency)
- * Post-myocardial infarction (improves survival, started IV then PO)
Time
- * Timing: Once daily (morning or evening, consistent)
- * Onset: 1-2 hours
- * Peak: 2-4 hours
- * Duration: 24 hours
