Atenolol is a Beta 1 selective blocking agent most commonly used for the treatment of cardiovascular problems. It is broadly classified in the group of drugs named as Beta blockers (β-blockers). Other drugs included in this group are Metorpolol, Betaxolol, Acebutolol, Celiprolol, Bisoprolol, Esmolol and Nebivolol. Atenolol is marketed all over with world with different brand or trade names like Tenormin, Inderal etc. Beta 1 receptors are predominantly located in the heart and eye. In heart Beta 1 receptors mediate the heart rate and contractility. Increased stimulation of these receptors lead to increase heart rate and increase contractility. So, Atenolol inhibits the Beta 1 receptors in the heart and decreases the heart rate as well as contractility of the heart.
What is Atenolol used for?
Although Atenolol is predominantly used for the management of cardiovascular problem, however, certain non cardiac indications of Atenolol do exist. Here are the common conditions in which Atenolol is used:
- Hypertension – Atenolol is advised for hypertension in addition to some other antihypertensives like Angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers
- Angina – Atenolol is effective in the management of stable angina. It decreases the heart rate and contractility and thus decreases the oxygen consumption of the heart
- Myocardial infarction – in acute inferior myocardial infarction there are greater chances of having ventricular arrhythmias that can be prevented my Atenolol
- Tachycardia – as it decreases the heart rate by blockade of Beta 1 receptors in the heart, it is used for the management of both ventricular and supraventricular tachycardias
- Alcohol withdrawal syndrome – Atenolol plays a vital role in the reducing the symptoms of alcohol withdrawal syndrome. Common symptoms of alcohol withdrawal syndrome are increased blood pressure, agitation, anxiety, palpitations and restlessness
- Thyrotoxicosis – Grave’s disease is the most common type of hyperthyroidism or thyrotoxicosis occurring mostly in women. Atenolol is used to lessen the symptoms of thyrotoxicosis mediated through Beta 1 receptors. It is usually given before the initiation of anti thyroid drugs
- Migraine – Although it has been used for the treatment and prevention of migraine in the past, however, it is not used these days. It is not a lipophilic drug and thus does not cross the blood brain barrier easily.
What are the common side effects of Atenolol?
Atenolol is a beta 1 selective antagonist and because of this it has limited side effects as compared to non selective beta blockers. Moreover, it is a hydrophilic drug and cannot cross blood brain barrier as compared to its counterparts like propanolol. So, it has mild to no central side effects.
Common side effects of Atenolol are:
- Type 2 Diabetes Mellitus – it is the most common and dangerous side effect because of which Atenolol use was discouraged and limited for the treatment of hypertension.
- Masking off symptoms of hypoglycemia – Atenolol use can attenuate the symptoms of decreased sugar levels in the blood (hypoglycemia) which can be life threatening. Common symptoms are increased heart rate, sweating and agitation
- Gastrointestinal disturbances – it may cause stomach pains, cramps, constipation or indigestion. If any of these symptoms are severe, the drug may be discontinued
- Giddiness and dizziness – episodes of dizziness may be present in the individuals using this drug which may lead to fainting occasionally
- Increased thirst – during the use of this drug, there is usually a feeling of dry mouth and thirst is increased in most of the individuals
- Cold peripheries- extremities or peripheries especially the hands and feet usually remain cold due to beta 2 blocking effect of the drug. Beta 2 receptor stimulation is responsible for vasodilation of blood vesses
- Impotency – almost all beta blocking agents are responsible for causing impotence and due to this grave side effect, drug compliance of the patient is affected. One needs to be counseled before the start of this drug
- Psychiatric disorders – beta blockers are notorious for causing depression in normal healthy individuals. Moreover, Atenolol may cause disturbed sleep pattern: decreased sleep, insomnia, early awakening, bad dreams, night mares etc. While using this drug patient remains in a confused state most of the times. Hallucinations also occur during the use of Atenolol.
- Weakness – individuals on Atenolol feel fatigued all the times. They lack energy to carry out day to day activities
- Drowsiness – after the use of this drug one feels drowsy. In order to prevent any accident driving and handling of machines must be prohibited for that specific time.
- Loss of hair (Alopecia) – it is another marked side effect of long term Atenolol use. It can affect both the men and women.
- Hearing loss may occur
What are the side effects of Atenolol on children?
As compared to other beta blocking agents, Atenolol is safer in children. However, following conditions must be ruled out before initiation of the treatment in children:
- Known allergy to any of the beta blocking agents
- Cardiac conditions characterized by decreased heart rate (bradycardia)
- Childhood asthma or other respiratory illnesses
What are the side effects of Atenolol on men?
The most common and bothering side effect of Atenolol in men is impotency. There is decreased libido and erectile dysfunction.
What are the side effects of Atenolol on women?
In women, sexual dysfunction is also common during the use of Atenolol. Moreover, loss of hair is another disfiguring effect of Atenolol in women.
What are the side effects of Atenolol on pregnant women?
Controlled trials have shown that use of Atenolol during pregnancy may cause following effects to the fetus:
- Low or decreased birth weight – underweight baby is born usually
- Decreased sugar level of blood (Hypoglycemia) in fetus
- Decreased heart rate ( Bradycardia)
What are the side effects of Atenolol on elderly?
All the side effects of Atenolol are exaggerated in the elderly. Neuropsychiatric side effects like depression, night mares, confusion and insomnia are most commonly seen in the elderly. Moreover, elderly patient usually does not respond to Atenolol as compared to the younger individuals.