Atenolol
A cardioselective, water-soluble beta blocker used for high blood pressure, angina and early after a heart attack.
Drug card
- Class
- Beta blocker
- How it works
- Blocking beta receptors, so the heart beats slower and less forcefully
- Used for
- High blood pressure
- Angina
- Early after a heart attack, to cut deaths
- Known for
- Slow heart rate (bradycardia)
- Cold hands and feet
- Its name
- -olol means a beta blocker
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does atenolol work?
Atenolol blocks mainly β1 receptors and has no intrinsic sympathomimetic activity. It is hydrophilic and barely touched by the liver: about half of a dose is absorbed, and the kidneys clear it unchanged, so it accumulates when kidney function falls. Its half-life is 6 to 7 hours.
Like other beta blockers: They block β-adrenergic receptors, so epinephrine and norepinephrine act less: in the heart (β1) rate and force of contraction fall and AV conduction slows, and the kidneys release less renin. Cardioselective ones (atenolol, bisoprolol, metoprolol) act mainly on β1; non-selective ones also block β2 in airways and vessels; carvedilol and labetalol block α1 as well.
Uses
What is atenolol used for?
- High blood pressure
- Angina
- Early after a heart attack, to cut deaths
Side effects
Side effects of atenolol
- Slow heart rate (bradycardia)Known for
- Cold hands and feetKnown for
- Tiredness
- Dizziness
- Depression
- Nausea
- Diarrhea
- Worsening heart failureSerious
- Wheezing in asthma, less than with non-selective onesSerious
- Hidden warning signs of low blood sugarSerious
- Angina or a heart attack if stopped suddenlySerious
- Liver problems, including jaundice (rare)Serious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Kidney impairment: it builds up once creatinine clearance drops under 35 mL/min, so doses are cut.
- Pregnancy: use from the second trimester has been linked to babies small for gestational age.
- Do not stop suddenly in coronary disease: severe angina, heart attacks and ventricular arrhythmias have followed.
Good to know: Water-soluble and cleared by the kidneys, unlike propranolol and metoprolol, which the liver metabolizes.
Remember it
A way to remember it
One heart, two lungs: β1 for the heart, β2 for the lungs.
β1 receptors dominate in the heart and β2 receptors in the airways. Cardioselective beta blockers act mainly on β1, so they narrow the airways less than non-selective ones such as propranolol, though all need care in asthma.
A mnemonic widely used in teaching
Its name
-olol means beta blocker
Labetalol (-alol) and carvedilol (-dilol) are beta blockers that also block alpha-1 receptors. Stanozolol, an anabolic steroid, ends in -olol by chance.
- Every drug name stem
Its class
Beta blockers
Other beta blockers with a card:
Easily mixed up with alpha-1 blockers and non-dihydropyridine calcium channel blockers.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Blood pressure
Atenolol is one of 27 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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