Tenormin (Atenolol Tablets) Drug Information: Overdosage and Contraindications

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May 25, 2012

Atenolol

Atrial Fibrillation »

What is atrial fibrillation?

Atrial fibrillation (AF) is the most common, abnormal rhythm of the heart.

The heart contracts (beats) and pumps blood with a regular rhythm, for example, at a rate of 60 beats per minute there is a beat every second. The heart may beat faster or slower with a shorter or longer interval between beats, but at any one rate the interval between beats is constant. This regular rhythm occurs as a result of regular electrical discharges (currents) that travel through the heart and cause the muscle of the heart to contract. In atrial fibrillation, the electrical discharges are irregular and rapid and, as a result, the heart beats irregularly and, usually, rapidly.

Atrial fibrillation is common; half a million new cases are diagnosed yearly in the U.S., and billions of dollars are spent annually on its diagnosis and treatment.

What causes atrial fibrillation?

Normal function of the he...

Read the Atrial Fibrillation article »

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OVERDOSE

Overdosage with TENORMIN (atenolol tablets) has been reported with patients surviving acute doses as high as 5 g. One death was reported in a man who may have taken as much as 10 g acutely.

The predominant symptoms reported following TENORMIN (atenolol tablets) overdose are lethargy, disorder of respiratory drive, wheezing, sinus pause and bradycardia. Additionally, common effects associated with overdosage of any beta-adrenergic blocking agent and which might also be expected in TENORMIN (atenolol tablets) overdose are congestive heart failure, hypotension, bronchospasm and/or hypoglycemia.

Treatment of overdose should be directed to the removal of any unabsorbed drug by induced emesis, gastric lavage, or administration of activated charcoal. TENORMIN (atenolol tablets) can be removed from the general circulation by hemodialysis. Other treatment modalities should be employed at the physician's discretion and may include:

BRADYCARDIA: Atropine intravenously. If there is no response to vagal blockade, give isoproterenol cautiously. In refractory cases, a transvenous cardiac pacemaker may be indicated.

HEART BLOCK (SECOND OR THIRD DEGREE): Isoproterenol or transvenous cardiac pacemaker.

CARDIAC FAILURE: Digitalize the patient and administer a diuretic. Glucagon has been reported to be useful.

HYPOTENSION: Vasopressors such as dopamine or norepinephrine (levarterenol). Monitor blood pressure continuously.

BRONCHOSPASM: A beta2 stimulant such as isoproterenol or terbutaline and/or aminophylline.

HYPOGLYCEMIA: Intravenous glucose.

Based on the severity of symptoms, management may require intensive support care and facilities for applying cardiac and respiratory support.

CONTRAINDICATIONS

TENORMIN (atenolol tablets) is contraindicated in sinus bradycardia, heart block greater than first degree, cardiogenic shock, and overt cardiac failure. (See WARNINGS.)

TENORMIN (atenolol tablets) is contraindicated in those patients with a history of hypersensitivity to the atenolol or any of the drug product's components.

Last reviewed on RxList: 11/1/2010
This monograph has been modified to include the generic and brand name in many instances.