Tenormin


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Related to Tenormin: atenolol

Tenormin

 [ten´or-min]
trademark for preparations of atenolol, a beta-adrenergic blocking agent used in treatment of hypertension, angina, and myocardial infarction.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

atenolol

Antipressan (UK), Atenix (UK), Novo-Atenol (CA), Tenormin

Pharmacologic class: Beta-adrenergic blocker (selective)

Therapeutic class: Antianginal, anti-hypertensive

Pregnancy risk category D

FDA Box Warning

• Caution patients with coronary artery disease (CAD) not to discontinue drug abruptly, because this may cause severe angina exacerbation, myocardial infarction, and ventricular arrhythmias. (The last two complications may occur with or without preceding angina exacerbation.) With planned drug discontinuation, observe patients carefully and advise them to minimize physical activity; if angina worsens or acute coronary insufficiency develops, drug should be reinstituted promptly, at least temporarily. Because CAD is common and may go unrecognized, abrupt withdrawal may pose a risk even in patients treated only for hypertension.

Action

Selectively blocks beta1-adrenergic (myocardial) receptors; decreases cardiac output, peripheral resistance, and myocardial oxygen consumption. Also depresses renin secretion without affecting beta2-adrenergic (pulmonary, vascular, uterine) receptors.

Availability

Tablets: 25 mg, 50 mg, 100 mg

Indications and dosages

Hypertension

Adults: Initially, 50 mg P.O. once daily, increased to 100 mg after 7 to 14 days if needed

Angina pectoris

Adults: Initially, 50 mg P.O. once daily, increased to 100 mg after 7 days if needed. Some patients may require up to 200 mg daily.

Acute myocardial infarction

Adults: 50 mg tablet P.O., then give 50 mg P.O. in 12 hours. Maintenance dosage is 100 mg P.O. daily or 50 mg b.i.d. for 6 to 9 days.

Dosage adjustment

• Renal impairment

• Elderly patients

Contraindications

• Cardiogenic shock

• Sinus bradycardia

• Greater than first-degree heart block

• Heart failure (unless secondary to tachyarrhythmia treatable with beta-adrenergic blockers)

Precautions

Use cautiously in:

• renal failure, hepatic impairment, pulmonary disease, diabetes mellitus, thyrotoxicosis

• pregnant or breastfeeding patients

• children.

Administration

Adjust initial and subsequent dosages downward depending on clinical observations, including pulse rate and blood pressure.

Don't discontinue drug suddenly. Instead, taper dosage over 2 weeks.

Adverse reactions

CNS: fatigue, lethargy, vertigo, drowsiness, dizziness, depression, disorientation, short-term memory loss

CV: hypertension, intermittent claudication, cold arms and legs, orthostatic hypotension, bradycardia, arrhythmias, heart failure, cardiogenic shock, myocardial reinfarction

EENT: blurred vision, dry eyes, eye irritation, conjunctivitis, stuffy nose, rhinitis, pharyngitis, laryngospasm

GI: nausea, vomiting, diarrhea, constipation, gastric pain, flatulence, anorexia, ischemic colitis, retroperitoneal fibrosis, acute pancreatitis, mesenteric arterial thrombosis

GU: impotence, decreased libido, dysuria, nocturia, Peyronie's disease, renal failure

Hematologic: agranulocytosis

Hepatic: hepatomegaly

Metabolic: hypoglycemia

Musculoskeletal: muscle cramps, back and joint pain

Respiratory: dyspnea, wheezing, respiratory distress, bronchospasm, bronchial obstruction, pulmonary emboli

Other: decreased exercise tolerance, allergic reaction, fever, development of antinuclear antibodies, hypersensitivity reaction

Interactions

Drug-drug. Amiodarone, cardiac glycosides, diltiazem, verapamil: increased myocardial depression, causing excessive bradycardia and heart block

Amphetamines, cocaine, ephedrine, norepinephrine, phenylephrine, pseudoephedrine: excessive hypertension, bradycardia

Ampicillin, calcium salts: decreased antihypertensive and antianginal effects

Aspirin, bismuth subsalicylate, magnesium salicylate, nonsteroidal anti-inflammatory drugs: decreased anti-hypertensive effect

Clonidine: life-threatening blood pressure increase after clonidine withdrawal or simultaneous withdrawal of both drugs

Dobutamine, dopamine: decrease in beneficial beta-cardiovascular effects

Lidocaine: increased lidocaine levels, greater risk of toxicity

MAO inhibitors: bradycardia Prazosin: increased risk of orthostatic hypotension

Reserpine: increased hypotension, marked bradycardia

Theophylline: decreased theophylline elimination

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, antinuclear antibody titer, blood urea nitrogen, creatinine, lactate dehydrogenase, platelets, potassium, uric acid: increased levels

Glucose: increased or decreased level

Insulin tolerance test: false result

Drug-behaviors. Alcohol use: increased hypotension

Patient monitoring

• Watch for signs and symptoms of hypersensitivity reaction.

• Monitor vital signs (especially blood pressure), ECG, and exercise tolerance.

• Check closely for hypotension in hemodialysis patients.

• Monitor blood glucose level regularly if patient is diabetic; drug may mask signs and symptoms of hypoglycemia.

Patient teaching

Instruct patient to immediately report signs and symptoms of allergic response, breathing problems, and chest pain.

• Advise patient to take drug at same time every day.

Inform patient that he may experience serious reactions if he stops taking drug suddenly. Advise him to consult prescriber before discontinuing.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Tell patient that drug may cause a temporary blood pressure decrease if he stands or sits up suddenly. Instruct him to rise slowly and carefully.

• Inform women that drug shouldn't be taken during pregnancy. Urge them to report planned or suspected pregnancy.

• Tell men that drug may cause erectile dysfunction. Advise them to discuss this issue with prescriber.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

Tenormin

(tə-nôr′mĭn)
A trademark for preparations of the drug atenolol.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

Tenormin®

Atenolol, see there.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

Tenormin

A brand name for ATENOLOL.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
One or 2 years ago bouts of tachycardia became more frequent and atenolol (Tenormin) was added to her drug regimen.
These agents include atenolol (Tenormin) and metoprolol (Lopressor).
Tenormin (atenolol) dosing is 1-1.2 mg/kg/dose PO daily for children and 25-100 mg/dose PO daily for adults (Barone, 1996, p.
In order to help iron out concerns that the Commission's competition authorities originally had about this mega-merger, Astra and Zeneca agreed to divest their exclusive distribution rights for Tenormin (a plain betablocker made by Zeneca) in Sweden and Norway.
QI AM 65 and have high blood pressure, for which I take Adalat and Tenormin. Since the menopause, I have been greatly bothered by excess sweating.
Among them: Norpramin; Norpramin with Inderal (to lower high blood pressure caused by the Norpramin); Prozac (at first to counteract the Inderal, which made me depressed); Prozac and Norpramin; Prozac, Norpramin, and Yocon (to alleviate sexual dysfunction caused by the Prozac); Wellbutrin (warning: .01 percent chance of a seizure); Tenormin; Zoloft; Zoloft with Norpramin and Tenormin; Zoloft with Desyrel (warning: possibility of priapism); Desyrel alone; Buspar; Buspar with Desyrel; Buspar with lithium; Paxil with lithium; Paxil, lithium, and acidophilus (for stomachache side effects); Paxil with Pondimin (because Paxil made me eat like a pig); Paxil alone; Paxil with Synthroid (to raise thyroid levels); Serzone; Luvox; Prozac with Synthroid.
Antihypertensives (with central nervous system effects) -- Aldomet, Wytensin, Tenex, Catapres, Ismelin, Hylorel, reserpine, Inderal, Corgard, Tenormin, Blocadren, Lopressor, Visken, Normodyne/Trandate, Sectral, Levatol, Cartol, Isoptin/Calan/Verelan, Kerlone
Nerve Blockers Generic Name Trade Name rauwolfia derivatives Reserpine guanethidine Ismelin guanadrel Hylorel alpha methyldopa Aldomlet clonidine Catapres guanabenz Wytensin prazosin Minipress terazosin Hytrin Beta Blockers propranolol Inderal metoprolol Lopressor nadolol Corgard atenolol Tenormin timolol Blocadren pindolol Visken acebutolol Sectral labetolol Normodyne or Trandate Blood Vessel Dilators hydralazine, Apresoline minoxidil Loniten(**) Hormone inhibitors captopril Capoten enalapril Vasotec lisinopril Prinivel or Zestril Calcium Channel Blockers nifedipine Procardia verapamil Isoptin or Calan diltiazem Cardizem nicardipine Cardene (*) Many combinations of these drugs are available--usually with a diuretic.
Some commonly prescribed drugs in this class include atenolol (Tenormin), betaxolol (Kerlone), bisoprolol (Zebeta), carteolol (Cartrol), acebutolol (Sectral), metoprolol (Lopressor, Toprol-XL), nadolol (Corgard), propranolol (Inderal), sotolol (Betapace) and timolol (Blocadren).
Beta blockers such as atenolol (Tenormin) and metoprolol (Lopressor) are used to treat high blood pressure, heart failure, heart arrhythmias, and angina (chest pain).
ACE inhibitors (such as Capoten, Vasotec, Prinivil, Zestril, Monopril, Altace, Accupril, Aceon, Mavic and Univasc) are less effective when combined with yohimbine, as are beta-blockers (such as Tenormin, Kerlone, Corego, Trandate, Lopressor, Toprol XL, Corgard, Levatol and Inderal).
* antihypertensive meds (beta blockers, adrenergics, and calcium channel blockers) including Inderal, Toprol, Tenormin, and Lorpressor