Atenolol + Indapamide Pharmacology

Atenolol + Indapamide

About Atenolol + Indapamide
N/A
Mechanism of Action of Atenolol + Indapamide
N/A
Pharmacokinets of Atenolol + Indapamide
N/A
Onset of Action for Atenolol + Indapamide
N/A
Duration of Action for Atenolol + Indapamide
N/A
Half Life of Atenolol + Indapamide
N/A
Side Effects of Atenolol + Indapamide
N/A
Contra-indications of Atenolol + Indapamide
N/A
Special Precautions while taking Atenolol + Indapamide
N/A
Pregnancy Related Information
Contraindicated; Atenolol and Indapamide are contraindicated in pregnancy. So the combination generic is contraindicated in pregnancy.
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated; since Atenolol and Indapamide are contraindicated in lactation. So the combination generic is contraindicated in breast feeding.
Children Related Information
N/A
Indications for Atenolol + Indapamide
Beta blocker and thiazide diuretics are given in combination to treat hypertension.
Atenolol reduces the work load on the heart and Indapamide reduce the hypertension by increasing the flow of urine.
1. Hypertension
Interactions for Atenolol + Indapamide
N/A
Typical Dosage for Atenolol + Indapamide
1 tablet to be taken daily
Schedule of Atenolol + Indapamide
N/A
Storage Requirements for Atenolol + Indapamide
N/A
Effects of Missed Dosage of Atenolol + Indapamide
N/A
Effects of Overdose of Atenolol + Indapamide
N/A

Atenolol

About Atenolol
Cardioselective Beta(Beta1 )-adrenergic blocking agent, Antihypertensive,anti anginal.
Mechanism of Action of Atenolol
Atenolol 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 Atenolol
Absorption: 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 Atenolol
1hour
Duration of Action for Atenolol
Below 1day
Half Life of Atenolol
6 - 7 hours
Side Effects of Atenolol
1.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 Atenolol
1.Hypersensitivity to the drug
2.Second or third degree heart block
3.Heart failure
4.Cardiogenic shock
5.Sinus bradycardia
Special Precautions while taking Atenolol
1.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 Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Atenolol
1.Hypertension
2. Angina
3.Myocardial infarction
4.Migraine prophylaxis
Interactions for Atenolol
Alcohol, 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 Atenolol
Hypertension: 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 Atenolol
H
Storage Requirements for Atenolol
Store at room temperature and protect from heat, moisture, and direct sunlight
Effects of Missed Dosage of Atenolol
Take 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 Atenolol
Treatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis or gastric lavage. Administer activated charcoal to reduce absorption

Indapamide

About Indapamide
Thiazide-related(a non-thiazide sulphonamide) drug, Diuretic, Antihypertensive.
Mechanism of Action of Indapamide
It exerts thiazides like diuretic action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion.
It causes vasodilatation by Ca channel blockade. It decreases total peripheral resistance and exerts anti hypertensive action. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.


Pharmacokinets of Indapamide
Absorption: It is compleately absorbed orally.
Distribution: Widely distributed
Metabolism: Extensively metabolized inside the body, and a small portion reaches tubular fluid.
Excretion: Excreted mainly through urine and rest is excreted through faeces.
Onset of Action for Indapamide
1 to 2 hours
Duration of Action for Indapamide
24 to 36 hours
Half Life of Indapamide
N/A
Side Effects of Indapamide
1. Dizziness
2 Headache
3. Orthostatic hypotension
4. Back pain
5. Infection
6. Rhinitis
7. Pharyngitis
8. Sinusitis
9. Vertigo
10 Nausea
11. Diarrhoea
12. Vomiting
13. Constipation
14. Muscle cramps
15. Peripheral edema
16. Polyuria
17. Weakness
18. Hypochloremia
19. Hypokalaemia
20. Hyponatraemia
21. Hyper urecaemia
22. Elevated levels of glucose calcium and lipids
23. Gastro intestinal disturbances
24. Impotence
25. Visual impairment
26. Electrolyte imbalance
27.Ototoxicity
Contra-indications of Indapamide
1. Hepatic impairment.
2. Hypersensitivity to the drug
3. Hypersensitivity to Sulfonamides
4. Anuric renal failure
5. Cerebro vascular accidents

Special Precautions while taking Indapamide
1. Renal impairment
2. Progressive Liver diseases
3. Hyper urecaemia and Gout
4. Diabetes mellitus
5. Fluid and electrolyte imbalance
6. Cirrhosis
7. Hyper calcaemia
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Indapamide
1. Hypertension
2. Oedema
Interactions for Indapamide
Diazoxide: Synergistic action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretic induced hypokalaemia may precipitate digitalis toxicity.
Frusemide: Synergy leading to profound diuresis and greater than predicted electroyte loss.
Sulfonylureas: Hypoglycaemic effects enhanced.
Chlorpropamide: Hypokalaemia.
Propantheline: Bioavailability of indapamide increased.
Metoclopramide: Bioavailability of indapamide decreased.
NSAID`s: Natriuretic effect of indapamide decreased.
Typical Dosage for Indapamide
Hyper tension: 1.25mg single daily dose. Increased to 2.5mg if required after 4 weeks.
Maximum dose: 5mg/day
Edema: 2.5mg single daily dose. Increased to 5mg if required after 1 week.

Schedule of Indapamide
G
Storage Requirements for Indapamide
Store at a cool dry place; and at a temperature below 30 degree C. in a well closed container. Keep out of reach of children.
Effects of Missed Dosage of Indapamide
Take 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 Indapamide
Treatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.

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