Adbeta is a cardioselective beta1-blocker without intrinsic sympathomimetic activity. This medication has antihypertensive, antianginal and antiarrhythmic action. Atenolol reduces the stimulatory effect on the heart sympathetic innervation and circulating catecholamines.
The hypotensive effect of this drug is associated with a decrease in minute volume of blood, decreased activity of the renin-angiotensin system (has a greater significance for patients with initial hypersecretion of renin), sensitivity of baroreceptors of the aortic arch (not going to enhance their activity in response to decreased blood pressure) and the effect on the CNS; manifested lower both systolic and diastolic blood pressure, decreasing stroke volume and cardiac output. In the medium therapeutic doses it has no effect on the tone of peripheral arteries.
The antianginal effect of Adbeta is associated with decreased myocardial oxygen demand by decreasing heart rate (lengthening of diastole and improved myocardial perfusion) and contractility, as well as reduced sensitivity to the effects of myocardial sympathetic innervation. Decrease in heart rate occurs at rest and during exercise.
The antiarrhythmic effect of this medicine is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increase of cAMP, hypertension), decrease in the rate of spontaneous excitation of the sinus and ectopic pacemakers and slowing of AV conduction.
The hypotensive effect lasts 24 hours, with regular admission is stabilized by the end of 2 weeks of treatment. The negative chronotropic effect is manifested by 1 h after administration, reaches a maximum after in 2-4 hours and lasts up to 24 hours.
After oral administration the absorption of Adbeta from the gastrointestinal tract is 50-60%, its bioavailability is 40-50%. This drug is practically not metabolized in the body; poorly penetrates the BBB. The plasma protein binding is 6-16%. T1/2 is 6-9 h. Atenolol is primarily excreted by the kidneys in unchanged form. Renal dysfunction accompanied mainly to the increase of T1/2 and cumulation. This medication is excreted during hemodialysis. For elderly patients T1/2 of atenolol is increased.
Why is Adbeta prescribed?
Hypertension, hypertensive crisis, mitral valve prolapse, cardiac hyperkinetic syndrome of functional origin, neurocirculatory dystonia of hypertensive type.
Treatment: coronary artery disease, angina pectoris (stress, rest and unstable).
Treatment and prevention of: myocardial infarction (acute phase in stable hemodynamic parameters, secondary prevention).
Arrhythmias (including at the general anesthesia, congenital syndrome prolongation QT, myocardial infarction without signs of congestive heart failure, thyrotoxicosis), sinus tachycardia, paroxysmal atrial tachycardia, supraventricular and ventricular premature beats, supraventricular and ventricular tachycardia, atrial tachyarrhythmia, atrial flutter.
Essential and senile tremor, agitation and tremors withdrawal syndrome.
In the combined therapy: hypertrophic obstructive cardiomyopathy, pheochromocytoma (only in combination with alpha-blockers), hyperthyroidism; migraine (prophylaxis).
Dosage and administration
The dosing regimen of Adbeta is set individually. The usual dose for adults for oral administration at the beginning of treatment is 25-50 mg 1 time / day. If necessary the dose is increased gradually. If impaired renal function in patients with CC 15-35 ml / min - 50 mg / day; with CC less than 15 ml / min - 50 mg every other day.
The maximum dose for adults for oral administration is 200 mg / day in 1 or 2 doses.
Adbeta side effects, adverse reactions
Cardiovascular system: in some cases - bradycardia, hypotension, AV-conduction disturbances, symptoms of heart failure.
Digestive system: at the beginning of therapy it is possible nausea, constipation, diarrhea, dry mouth.
CNS and peripheral nervous system: at the beginning of therapy may be fatigue, dizziness, depression, mild headache, sleep disturbances, coldness and paresthesia in extremities, reduced reactivity of the patient, reducing the secretion of tear fluid, conjunctivitis.
Endocrine system: reduced potency, hypoglycemic state in patients with diabetes.
Respiratory system: in predisposed patients - symptoms of bronchial obstruction.
Allergic reactions: itching.
Other: increased sweating, redness of the skin.
AV-block II and III degree, sinoatrial block, SSS, bradycardia (HR < 40 bpm), hypotension (in case of myocardial infarction, systolic blood pressure less than 100 mm Hg), cardiogenic shock, congestive heart failure IIB-III stages, acute heart failure, Prinzmetal's angina, lactation, concomitant use of MAO inhibitors, hypersensitivity to atenolol.
Using during pregnancy and breastfeeding
Atenolol crosses the placental barrier, so use during pregnancy is only possible if the intended benefits to the mother justifies potential risk to the fetus.
Adbeta is excreted in breast milk, so if you need to use during lactation is recommended to stop breastfeeding.
Category effects on the fetus by FDA - D.
With caution use this medication in hepatic failure.
Adbeta should be used with caution in diabetes, COPD (including asthma, emphysema), metabolic acidosis, hypoglycemia, allergic reactions, a history of chronic heart failure (compensated), obliterating peripheral arterial disease (intermittent claudication, Raynaud's syndrome), pheochromocytoma, liver failure, chronic renal insufficiency, myasthenia gravis, hyperthyroidism, depression (including in history), psoriasis, pregnancy, elderly patients, in pediatrics (the efficacy and safety are not defined).
While taking atenolol it can decrease tear fluid production, which is important for patients who use contact lenses.
Cancellation of this drug after prolonged treatment should be carried out gradually under medical supervision.
Upon the termination of the combined use of atenolol and clonidine, clonidine treatment continued for several days after discontinuation of atenolol, otherwise you may experience severe arterial hypertension.
When the need for inhaled anesthesia in patients receiving Adbeta, a few days before anesthesia to stop taking atenolol or find a medication for anesthesia with minimal negative inotropic effects.
Patients whose work requires high concentration, the question of outpatient use of atenolol should be addressed only after an assessment of individual response.
Adbeta drug interactions
Antiarrhythmic and anesthetic facilities increase cardiodepressive action of this drug (increased risk of developing bradycardia, arrhythmia, hypotension, heart failure).
Reserpine, methyldopa, clonidine, guanfacine, cardiac glycosides potentiate the negative chrono-, drome- and bathmotropic effect, insulin and other antidiabetic funds - hypoglycemia.
NSAIDs, estrogens, sympathomimetics, xanthines weaken the anti-hypertensive effect, absorption; sympatholytic, nitroglycerin, hydralazine, and other antihypertensive drugs increase it; antacids slow down this medication absorption.
Cimetidine inhibits the metabolism of Adbeta.
This medication prolongs the action of anti-depolarizing muscle relaxant, anticoagulant effect of coumarins.
Three / tetracyclic antidepressants, antipsychotics, sedatives, hypnotics and alcohol potentiate CNS depression.
Adbeta is incompatible with MAO inhibitors.
Adbeta in case of emergency / overdose
Symptoms: bradycardia, AV block II-III degree, heart failure, respiratory failure, hypotension, bronchospasm, hypoglycemia.
Treatment: gastric lavage and the appointment of adsorbing medications; Symptomatic treatment: atropine, isoprenaline, orciprenaline, cardiac glycosides or glucagon, diuretics, pressor agents (dopamine, dobutamine or norepinephrine), selective beta-adrenoceptor agonists, IV glucose solution, installation of an artificial pacemaker. Perhaps dialysis.