Antianginal Agent; Antihypertensive; Beta-Blocker, Beta-1 Selective

CCP: Angina

CCP: Hypertension

CCP: NSTEMI/STEMI

• Hypersensitivity
• Bradycardia
• Heart block greater than first-degree (except in patients with a functioning artificial pacemaker); cardiogenic shock
• Uncompensated cardiac failure
• Documentation of allergenic cross-reactivity for beta-blockers
• Cor pulmonale
• Hypotension
• Severe peripheral arterial disorders
• Anesthesia with agents that produce myocardial depression
• Pheochromocytoma (in the absence of alpha-blockade)
• Metabolic acidosis

Cautions

• Use with caution in patients with renal impairment; dosage adjustment required.
• Bradycardia may be observed more frequently in elderly patients (>65 years of age); dosage reductions may be necessary.

Onset: ≤ 1 hour

Peak effect: 2-4 hours

Duration: 12-24 hours

Half-life: 6-7 hours

Cardiovascular

• Hypotension, cardiac failure, bradycardia, ventricular tachycardia, cold extremities, supraventricular tachycardia
• Bundle branch block, atrial fibrillation, heart block, atrial flutter, orthostatic hypotension, pulmonary embolism

Central nervous system:

• Fatigue, dizziness, depression
• Abnormal dreams, lethargy, vertigo, drowsiness

Gastrointestinal

• Nausea, diarrhea

Neuromuscular & skeletal

• Limb pain

Respiratory

• Bronchospasm

• Atenolol crosses the placenta and is found in cord blood. Maternal use of atenolol may cause harm to the fetus.
• Beta blockers are not recommended as first-line agents for hypertension.
• Patients with bronchospastic disease should not receive beta-blockers.
• Consider pre-existing conditions such as sick sinus syndrome before initiating.
• Use with caution in patients with diabetes mellitus; may potentiate hypoglycemia and/or mask signs and symptoms.
• Use with caution in patients with myasthenia gravis.
• May precipitate or aggravate symptoms of arterial insufficiency in patients with PVD and Raynaud disease.
• Adequate alpha-blockade is required prior to use of any beta-blocker in patients with an untreated pheochromocytoma.
• May mask signs of hyperthyroidism (eg, tachycardia).
• Beta-blockers without alpha1-adrenergic receptor blocking activity should be avoided in patients with Prinzmetal variant angina since unopposed alpha1-adrenergic receptors mediate coronary vasoconstriction and can worsen anginal symptoms.

• Acetylcholinesterase Inhibitors
• Alfuzosin
• Alpha1-Blockers
• Alpha2-Agonists
• Amifostine
• Amiodarone
• Amphetamines
• Ampicillin
• Antipsychotic Agents (Second Generation [Atypical])
• Bacampicillin
• Barbiturates
• Benperidol
• Beta2-Agonists
• Bradycardia-Causing Agents
• Brigatinib
• Brimonidine (Topical)
• Bromperidol
• Bupivacaine
• Ceritinib
• Cholinergic Agonists
• Dexmethylphenidate
• Diazoxide
• Dipyridamole
• Disopyramide
• DOBUTamine
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• EPHEDrine (Systemic)
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• Epinephrine (Racemic)
• EPINEPHrine (Systemic)
• Ergot Derivatives
• Etofylline
• Fexinidazole
• Fingolimod
• Glycopyrrolate (Systemic)
• Grass Pollen Allergen Extract (5 Grass Extract)
• Herbal Products with Blood Pressure Lowering Effects
• Hypotension-Associated Agents
• Insulins
• Ivabradine
• Lacosamide
• Levodopa-Containing Products
• Lidocaine (Systemic)
• Lormetazepam
• Mepivacaine
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• Tasimelteon
• Terlipressin
• Theophylline Derivatives
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• White Birch Allergen Extract