Amlodipine + Atenolol Pharmacology

Amlodipine + Atenolol

About Amlodipine + Atenolol
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Mechanism of Action of Amlodipine + Atenolol
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Pharmacokinets of Amlodipine + Atenolol
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Onset of Action for Amlodipine + Atenolol
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Duration of Action for Amlodipine + Atenolol
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Half Life of Amlodipine + Atenolol
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Side Effects of Amlodipine + Atenolol
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Contra-indications of Amlodipine + Atenolol
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Special Precautions while taking Amlodipine + Atenolol
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Pregnancy Related Information
Contraindicated since Amlodipine and Atenolol are contraindicated in pregnancy.
Old Age Related Information
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Breast Feeding Related Information
Contraindicated since Atenolol is contraindicated in lactation
Children Related Information
N/A
Indications for Amlodipine + Atenolol
1.Hypertension
2.Angina
Interactions for Amlodipine + Atenolol
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Typical Dosage for Amlodipine + Atenolol
Adult: one tablet once daily
Amlodipine: 5mg + Atenolol: 25mg or
Amlodipine: 5mg + Atenolol: 50mg
Schedule of Amlodipine + Atenolol
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Storage Requirements for Amlodipine + Atenolol
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Effects of Missed Dosage of Amlodipine + Atenolol
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Effects of Overdose of Amlodipine + Atenolol
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Amlodipine

About Amlodipine
Calcium Channel Blocker, Anti hypertensive,anti angina.
Mechanism of Action of Amlodipine
Amlodipine is a second generation dihydropyridine Ca channel blocker. It exerts it`s antihypertensive, antianginal actions through blocking the influx of Ca 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 markedly relax arterioles and milder effects on veins. They do not compromise haemodynamics and cerebral and renal perfusion.
Pharmacokinets of Amlodipine
Absorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized in liver, but there is no active metabolite.
Onset of Action for Amlodipine
Slow
Duration of Action for Amlodipine
24 hours
Half Life of Amlodipine
N/A
Side Effects of Amlodipine
1.Palpitation
2.Flushing
3.Nausea
4.Vomiting
5.Abdominal pain
6.Edema
7.Headache
8.Dizziness
9.Paresthesia
10.Light headedness
11.Fatigue
12.Aggravates myocardial ischaemia
13.Rashes
Contra-indications of Amlodipine
1.Heart failure
2.Aortic stenosis
3.Hypersensitivity to the drug
4.Unstable angina
5.Hepatic impairment
6.Along with other anti hypertensive drugs.
Special Precautions while taking Amlodipine
1.Cardiovascular disorders: Use cautiously in cardiovascular disorders because it aggravates myocardial ischaemia.
2.Sick sinus syndrome
3.Renal impairment
4.Use cautiously along with other antihypertensive drugs,
Pregnancy Related Information
Contraindicated.
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution.
Children Related Information
Contraindicated
Indications for Amlodipine
1.Hypertension
2.Prinzmetal`s angina
3.Stable angina
Interactions for Amlodipine
ACE inhibitors, Thiazide diuretics: Potentiates effect of these drugs.
Beta Blockers: Best avoided, especially by those with impaired LV function due to depressant effect on myocardial contractibility or AV conduction.
Fentanyl: Severe hypotension or increased fluid volume requirements.
Typical Dosage for Amlodipine
5 mg once daily.
Maximum dose: 10mg/day
Prinzmetal`s angina and Stable angina:
5 to 10mg once daily.
Hypertension: 2.5 to 5mg once daily. Dose may increase up to 10mg once daily as required by the individual needs.
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Schedule of Amlodipine
H
Storage Requirements for Amlodipine
Store at room temperature below 30 degree C. Protect from moisture and light.

Effects of Missed Dosage of Amlodipine
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 Amlodipine
Monitor &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.

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

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