Atenolol (Tenormin)


  • Nervous system


  • Antihypertensive, antianginal, class II antidysrhythmic: (beta blocker)


  • Angina pectoris due to coronary atherosclerosis,

  • Hypertension, acute MI

  • Several non-FDA approved uses


  • Cardiogenic shock, 2nd or 3rd degree heart block, sinus bradycardia

  • CHF unless secondary to a tachyarrhythmia treatable with beta-blockers, overt cardiac failure


  • Pregnancy category C

  • Major surgery, diabetes mellitus, renal disease, thyroid disease, COPD, asthma

  • Well compensated heart failure, abrupt withdrawal, peripheral vascular disease

  • Do not discontinue drug abruptly, may precipitate angina

Adverse Reactions (Side Effects):

  • CNS: depression, dizziness, drowsiness, fatigue, hallucinations, insomnia, lethargy, memory loss, mental changes, strange dreams

  • CV: bradycardia, CHF, cold extremities, postural hypotension, profound hypotension, 2nd and 3rd degree heart block

  • EENT: dry burning eyes, sore throat visual disturbances

  • GI: diarrhea, dry mouth, ischemic colitis, mesenteric arterial thrombosis, nausea, vomiting

  • GU: impotence, sexual dysfunction

  • HEME: agranulocytosis, thrombocytopenia

  • METAB: hyperglycemia, hyperlipidemia, masked hypoglycemic response

  • RESP: bronchospasm, dyspnea, wheezing

  • SKIN: alopecia, pruritis, rash  


Administered orally and intravenously

  • Adult: 

    • IV 

      • 5mg over 5 min

      • repeat in 10 minutes if initial dose is well tolerated

      • then start PO dose 10 minutes after last IV dose

    • PO 

      • 50mg daily

      • increase every 1-2 weeks to 100mg daily

      • may increase to 200mg daily for angina

  • Child: 

    • PO 

      • initial 1-1.2 mg/kg/dose given daily

      • maximum 2 mg/kg/day

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