Betanol

• Hypertension: Treatment of high blood pressure to reduce the risk of cardiovascular events.
• Angina Pectoris: Management of stable angina to decrease frequency and severity of attacks.
• Acute Myocardial Infarction (AMI): Prevention of mortality when started early after AMI.
• Arrhythmias: Treatment of certain supraventricular tachyarrhythmias and ventricular arrhythmias.
• Chronic Heart Failure: Adjunct therapy in stable patients to improve survival and reduce hospitalizations.
• Off-label uses: Prevention of migraine headaches, thyrotoxicosis symptoms control, and anxiety-related tachycardia.

• Adults:
• Hypertension: 50 mg orally once daily; may increase up to 100 mg daily based on response.
• Angina: 50–100 mg orally once daily.
• Post-myocardial infarction: Initial dose 25–50 mg orally twice daily, then 50–100 mg once daily.
• Arrhythmias: Typically 50–100 mg daily in divided doses.
• Heart failure: Start with low doses (e.g., 12.5–25 mg daily) and titrate slowly to target doses (up to 100 mg/day).
• Pediatrics:
• Limited data; use with caution and under specialist supervision.
• Elderly:
• Start at lower doses; monitor for bradycardia and hypotension.
• Renal Impairment:
• Dose adjustment may be necessary in severe renal impairment (creatinine clearance <35 mL/min).
• Hepatic Impairment:
• No specific dose adjustment required but monitor clinical response.
• Administration:
• Oral tablets, with or without food.
• Take at the same time each day for consistent blood levels.

Atenolol is a selective beta-1 adrenergic receptor antagonist (beta-blocker). It blocks beta-1 receptors predominantly in cardiac tissue, reducing heart rate, myocardial contractility, and cardiac output, thereby decreasing myocardial oxygen demand. Atenolol also reduces renin release from the kidneys, contributing to its antihypertensive effect. Its cardioselectivity reduces beta-2 receptor-related bronchoconstriction, making it relatively safer in patients with respiratory conditions compared to non-selective beta-blockers.

• Absorption: Rapid and complete absorption after oral administration; bioavailability approximately 50%.
• Distribution: Low lipid solubility; volume of distribution about 0.7 L/kg.
• Metabolism: Minimal hepatic metabolism; largely excreted unchanged.
• Half-life: Approximately 6–7 hours, allowing once or twice daily dosing.
• Excretion: Primarily excreted unchanged by the kidneys (40–50%).

• Pregnancy: Category D (FDA) due to risk of fetal harm including growth retardation and bradycardia; use only if benefits justify risks.
• Lactation: Excreted in breast milk in small amounts; caution advised. Monitor infant for bradycardia or hypoglycemia.

• Beta-1 selective adrenergic receptor blocker (Beta-blocker)
• Cardiovascular agent

• Known hypersensitivity to atenolol or beta-blockers.
• Severe bradycardia (<45 beats/min).
• Second- or third-degree atrioventricular (AV) block without pacemaker.
• Cardiogenic shock or decompensated heart failure.
• Sick sinus syndrome without pacemaker.
• Severe peripheral arterial disease.
• Untreated pheochromocytoma.

• Use cautiously in patients with diabetes as it may mask hypoglycemia symptoms.
• May worsen bronchospastic diseases; avoid in severe asthma or COPD unless necessary.
• Taper gradually when discontinuing to avoid rebound hypertension or angina exacerbation.
• Monitor heart rate and blood pressure regularly.
• Caution in patients with peripheral vascular disease and hepatic or renal impairment.

• Common:
• Fatigue, dizziness, cold extremities, bradycardia, hypotension.
• Cardiovascular:
• Bradycardia, heart block, worsening heart failure (rare).
• Central nervous system:
• Depression, insomnia, vivid dreams.
• Respiratory:
• Bronchospasm (rare, especially in sensitive patients).
• Gastrointestinal:
• Nausea, diarrhea.
• Rare/Serious:
• Severe bradyarrhythmias, heart failure exacerbation, allergic reactions.

• Additive bradycardia and hypotension with calcium channel blockers (verapamil, diltiazem), digoxin, and other antihypertensives.
• May potentiate hypoglycemic effects of insulin and oral antidiabetics; also may mask hypoglycemia symptoms.
• Avoid concurrent use with drugs that impair atrioventricular conduction.
• NSAIDs may reduce antihypertensive efficacy.
• Cimetidine may increase atenolol plasma concentration.

• Current hypertension guidelines recognize atenolol as effective but recommend beta-blockers as second-line therapy except in specific indications such as post-MI and heart failure.
• Emphasis on individualized treatment due to variable effects on cardiovascular outcomes compared to other antihypertensives.
• Monitoring for metabolic adverse effects (e.g., glucose intolerance) advised.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep tablets in original container tightly closed.
• Keep out of reach of children.