Tenormin
Tenormin (Atenolol)Structure
Active substance-atenolol.
Pharmacological action
Hypotensive, antianginal, antiarrhytmic. The negative chronotropic effect is shown through 1 h, reaches a maximum later 2-4 h proceeds to 24 h. Reduces warm emission, a systolic BP, reduces an orthostatic tachycardia. Antihypertensive action proceeds 24 h. Reduces requirement of a myocardium for oxygen. Enlarges survival rate of the patients who have transferred a myocardial infarction (lowers frequency of ventricular arrhythmias and stenocardia attacks). Practically it is not metabolized in a liver, it is deduced by kidneys by a glomerular filtration.
Indications to application
Arterial hypertensia, stenocardia, acute myocardial infarction (at stable indicators of a hemodynamic), a tachycardia: atrial, ventricular, etc., a flutter and an atrial fibrillation, a hyperkinetic cardial syndrome, a neurocirculatory dystonia on hypertensive type; complex therapy of a hypertrophic cardiomyopathy, a pheochromocytoma, a thyrotoxicosis, an essential tremor; a migraine (preventive maintenance).
Contraindications
Hypersensitivity, sinus bradycardia (Frequency of warm reductions is less than 50 ud./mines), sinuatrial blockade, a syndrome of delicacy of sinus knot, AV blockade II-III of degree, an arterial hypotension (a systolic BP less than 90 mm hg), an acute or chronic heart failure in decompensation stages, a cardiogenic shock, disturbance of a peripheric circulation, feeding by a breast.
Side effect
From nervous system and sense organs: undue fatigability, delicacy, giddiness, a headache, drowsiness or a sleeplessness, night nightmares, depression, anxiety, confusion of consciousness or short-term loss of memory, hallucination, weakening of reactionary ability, paresthesia, cramps; sight disturbance, reduction of secretion of a saliva and a plaintive liquid, a conjunctivitis. From cardiovascular system and blood (a hemopoiesis, a hemostasis): a bradycardia, palpitation, disturbance of conductivity of a myocardium, AV blockade, arrhythmias, weakening of contractility of a myocardium, a heart failure, a hypotension, a syncope, a vasculitis, a stethalgia, a thrombocytopenia, an agranulocytosis. From organs GASTROINTESTINAL TRACT: dryness in an oral cavity, a nausea, vomiting, an abdominal pain, a diarrhoeia, a constipation, disturbances of function of a liver. From respiratory system: a dyspnea, laringo - and a bronchospasm. Allergic reactions: Itch, eruption, erythema, urticaria, psoriasiform and dystrophic changes of a skin. Other: a reversible alopecia, a hyperhidrosis, a cold snap of extremities, a myasthenia, an impotency, change of activity of enzymes, bilirubin level, a withdrawal, a hypothyroid condition, a hypoglycaemia.
Interaction
Antiarrhytmic and narcotic agents strengthen action (the risk of development of a bradycardia, an arrhythmia, a hypotension, a heart failure raises). Cimetidinum brakes a metabolism. MAO is incompatible with inhibitors.
Overdosage
Symptoms: a bradycardia, AV blockade II-III of degree, a heart failure, breath disturbance, a hypotension, a bronchospasm, a hypoglycaemia. Treatment: a gastric lavage and appointment of adsorbing agents; symptomatic therapy: atropine, warm glycosides or a glucagon, diuretics, angiotonic agents (Dopaminum, Dobutaminum or Norepinephrinum), selective beta-adrenomimetiki, a glucose solution (i.v.), the equipment of the artificial driver of a rhythm. Dialysis carrying out is possible.
Special indicatings
It is limited to application at: a diabetes, a hypoglycaemia, chronic obstructive diseases of lungs (an emphysema, a bronchial asthma), disturbances of function of a liver and-or kidneys, a myasthenia, depression, a psoriasis, a pheochromocytoma, metabolic an acidosis, pregnancy, children's (efficiency and safety are not defined) and advanced age. Application at pregnancy and feeding by a breast: Probably, if the expected effect of therapy exceeds potential risk for a foetus. For the period of treatment it is necessary to stop thoracal feeding. Treatment is spent at the regular medical control. Before the therapy beginning it is necessary to compensate a heart failure. During treatment monitoring of frequency of warm reductions, a BP, glucose level in blood (correction of a dose of antidiabetic preparations is possible) and the control over occurrence of symptoms of a heart failure is necessary. With care to apply in an operating time to drivers of vehicles and the people which trade is bound to the raised concentration of attention. For the period of therapy it is recommended to exclude alcohol reception. More detailed information see the instruction on application.
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