Atenolol

Atenolol is a beta blocker medication primarily used to treat high blood pressure and heart-associated chest pain. Other uses include the prevention of migraines and treatment of certain irregular heart beats. It is taken by mouth or by injection into a vein. It can also be used with other blood pressure medications. Atenolol is a beta blocker medication primarily used to treat high blood pressure and heart-associated chest pain. Other uses include the prevention of migraines and treatment of certain irregular heart beats. It is taken by mouth or by injection into a vein. It can also be used with other blood pressure medications. Common side effects include feeling tired, heart failure, dizziness, depression, and shortness of breath. Other serious side effects include bronchospasm. Use is not recommended during pregnancy. Other medications are preferred when breastfeeding a young baby. It works by blocking β1-adrenergic receptors in the heart, thus decreasing the heart rate and workload. Atenolol was patented in 1969 and approved for medical use in 1975. It is available as a generic medication. In the United States, the wholesale cost per month is less than 15 USD as of 2018. In the United Kingdom, a month of treatment costs the NHS less than 5 pounds. In 2016, it was the 20th most prescribed medication in the United States, with more than 26 million prescriptions. Atenolol is used for a number of conditions including hypertension, angina, long QT syndrome, acute myocardial infarction, supraventricular tachycardia, ventricular tachycardia, and the symptoms of alcohol withdrawal. 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 general in hypertension was downgraded in June 2006 in the United Kingdom, and later in the United States, as they are less appropriate than calcium channel blockers, thiazide diuretics, angiotension converting enzyme (ACE) inhibitors, and angiotensin receptor blockers, particularly in the elderly. Off-label uses of atenolol, as with other cardioselective β-blockers, include symptomatic treatment of anxiety. β-blockers are effective for some of the physical effects of anxiety. In these instances, dosing is used as needed instead of regular daily dosing. Atenolol 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. 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. In addition, atenolol has been found to lack mortality benefits and even to increase mortality in older adults. Symptoms of overdose are due to excessive pharmacodynamic actions on β1 and also β2-receptors. These include bradycardia (slow heartbeat), severe hypotension with shock, acute heart failure, hypoglycemia and bronchospastic reactions. Treatment is largely symptomatic. Hospitalization and intensive monitoring is indicated. 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.