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- Pharmacology For Atenolol + Nitrendipine
Atenolol + Nitrendipine Pharmacology
Atenolol + Nitrendipine
About Atenolol + NitrendipineN/AMechanism of Action of Atenolol + NitrendipineN/APharmacokinets of Atenolol + NitrendipineN/AOnset of Action for Atenolol + NitrendipineN/ADuration of Action for Atenolol + NitrendipineN/AHalf Life of Atenolol + NitrendipineN/ASide Effects of Atenolol + NitrendipineN/AContra-indications of Atenolol + NitrendipineN/ASpecial Precautions while taking Atenolol + NitrendipineN/APregnancy Related InformationContraindicated; since Atenolol is contraindicated in pregnancyOld Age Related InformationN/ABreast Feeding Related InformationContraindicated; since Atenolol and Nitrendipine are contraindicated in lactationChildren Related InformationN/AIndications for Atenolol + Nitrendipine1. Mild to moderate hypertension not manageable with individual drugs.Interactions for Atenolol + NitrendipineN/ATypical Dosage for Atenolol + NitrendipineAdult: 1tablet / day
Atenolol 50mg + Nitrendipine 10mg or
Atenolol 50mg + Nitrendipine 20mg
Schedule of Atenolol + NitrendipineN/AStorage Requirements for Atenolol + NitrendipineN/AEffects of Missed Dosage of Atenolol + NitrendipineN/AEffects of Overdose of Atenolol + NitrendipineN/AAtenolol
About AtenololCardioselective Beta(Beta1 )-adrenergic blocking agent, Antihypertensive,anti anginal.Mechanism of Action of AtenololAtenolol is a cardio selective beta-1 adrenergic antagonist. It has negative chronotropic and negative inotropic effects on heart. It decreases oxygen consumption; cardiac work and aortic pressure. It decreases nor adrenaline and renin releases. It decreases central sympathetic out flow In sympathetic over activity, it prolongs systole by retarding conduction. It increases oxygen supply and exercise tolerance in angina patients. The drug decreases BP in hypertensive individuals; both systolic and diastolic BP is reduced.
Antimigraine action: Atenolol is useful in migraine due to its beta blockade action. Through beta blockade action it inhibits vasodilation and relieves migraine.
Pharmacokinets of AtenololAbsorption: Absorbed orally up to 60%, Distribution: Widely distributed but no CSF penetration Metabolism: A small portion is metabolized in liver. Excretion: Excreted mainly through urine. Remaining portion is excreted through faeces.Onset of Action for Atenolol1hourDuration of Action for AtenololBelow 1dayHalf Life of Atenolol6 - 7 hoursSide Effects of Atenolol1.Heart failure
2.Gastrointestinal problems
3.Nausea
4.Tiredness
5.Sinus bradycardia
6.Depression
7.Rash
8.Dizziess
9.Fatigue
10.Vomiting
11.Diarrhoea
12.Bronchospasm
13.Fever
14.Leg pain
15.Changes in kidney function tests
16.Changes in liver function tests.
Contra-indications of Atenolol1.Hypersensitivity to the drug
2.Second or third degree heart block
3.Heart failure
4.Cardiogenic shock
5.Sinus bradycardia
Special Precautions while taking Atenolol1.Congestive heart failure
2.Hepatic impairment
3.Renal impairment
4.The drug should be gradually withdraw with caution
5.Bronchospastic disorders
6.Diabetes mellitus
7.Hyper thyroidism
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Atenolol1.Hypertension
2. Angina
3.Myocardial infarction
4.Migraine prophylaxisInteractions for AtenololAlcohol, Anaesthetics, Antidepressants, Anxiolytics, Hypnotics, Cimetidine, Diuretics: Enhanced hypotensive effect.
Analgesics: NSAIDs antagonise hypotensive effect.
Antibacterials (Rifampicin): Reduce plasma concentration of atenolol.
Antidiabetics: Enhanced hypoglycemic effect.
Antihypertensives: Enhanced hypotensive effect, with clonidine there is increased severity of rebound hypertension.
Calcium channel Blockers: increased risk of bradycardia and AV block with diltiazem, severe hypotension and heart failure with verapamil, nifedipine
Cardiac glycosides: Increased AV block and bradycardia.
Cholinergics: Effects antagonised by atenolol.
Corticosteroids: Antagonism of hypotensive effect.
Ergotamine: Increased peripheral vasoconstriction
Sympathomimetics: Severe hypertension with adrenaline and noradrenaline.
Lab. Tests: Interferes with Glucose or insulin tolerence tests.Typical Dosage for AtenololHypertension: Starts with 50mg single dose then gradually increases at weekly intervals to 100mg/day once daily based on patient`s response.
Children: 1 to 1.3 mg/kg/day once daily or as two divided doses
Angina: Starts with 50mg single dose orally, and then gradually increases to 100mg/day based on patient`s response at one week intervals
Maximum dose: 200mg/day
Myocardial infarction: 5mg I.V. over 5minuts twice daily at 10minuts intervals. Then after 10minuts starts oral therapy with 50mg dose. Then 50mg at 12th hour. And increases to 100mg/day once daily or in two divided doses up to 9days
Migraine prophylaxis: 50 - 150mg / day in divided doses
Schedule of AtenololHStorage Requirements for AtenololStore at room temperature and protect from heat, moisture, and direct sunlightEffects of Missed Dosage of AtenololTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of AtenololTreatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis or gastric lavage. Administer activated charcoal to reduce absorptionNitrendipine
About NitrendipineA Dihydropyridine calcium channel blocker, Antihypertensive,antiangina.Mechanism of Action of NitrendipineNitrendipine is a vasoselective long acting dihydropyridine Ca channel blocker. It exerts antihypertensive, antianginal actions through blocking the influx of Ca2+ ions through voltage gated L-type Ca channels to the peripheral vascular smooth muscle cells, Coronary smooth muscle cells and to the myocardial cells. Thus causes dilatation of vascular endothelium, decrease peripheral resistance, & reduce myocardial oxygen demand .It produces smooth muscle relaxant action by the release of nitric oxide from endothelium and thus inhibits cyclic AMP-phosphodiesterase enzyme and resulting in raised cyclic AMP in smooth muscle. Nitric oxide exerts anti atherosclerotic action.Pharmacokinets of NitrendipineAbsorption: Well absorbed orally, bioavailability is reduced due to first pass metabolism. Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized in liver. Excretion: Excreted mainly through urine and small amount is excreted through faecesOnset of Action for NitrendipineHalf to one hourDuration of Action for Nitrendipine4 to 48hoursHalf Life of NitrendipineN/ASide Effects of Nitrendipine1.Flushing
2.Palpitation
3.Hypotension
4.Nausea
5.Edema
6.Headache
7.Dizziness
8.Fatigue
9.Paraesthesia
10.Gastrointestinal disturbances
Contra-indications of Nitrendipine1.Acute myocardial infarction
2.Heart failure
3.Aortic stenosis
4.Hypotension
5.Cardiogenic shock
6.Hypersensitivity to the drug
7.Unstable angina
Special Precautions while taking Nitrendipine1.Congestive heart failure
2.Cardiovascular insufficiency
3.Hypotension
4.Left ventricular outflow obstruction
5.Hepatic impairment
6.Slowly withdraw the drug with caution
7.Use cautiously along with other antihypertensive drugs
8.Diabetes mellitus
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationContraindicated.Children Related InformationContraindicatedIndications for Nitrendipine1.Hypertension
2.Angina pectoris
Interactions for NitrendipineBeta-blockers: Synergistic action, reverses depression of cardiac function.
Quinidine: Plasma levels of quinidine reduced.
Theophylline, phenytoin: Increases plasma levels of nitrendipine.Typical Dosage for NitrendipineStarts with 5 to 20mg once daily. Increased to 20mg twice daily if required.Schedule of NitrendipineHStorage Requirements for NitrendipineStore at room temperature below 30 degree C. Protect from moisture and avoid freezing.Effects of Missed Dosage of NitrendipineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of NitrendipineMonitor & support cardiac and respiratory functions. Measure the BP. Give cardiovascular support by elevating the limbs and maintaining fluid balance. Administer vasopressers like nor epinephrine and Calcium gluconate if required.
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