Typical clinico-pharmacological article
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Combined antihypertensive drug long-acting. Contains active substances, mutually complementary actions of each other.
Atenolol is a selective beta 1 adrenoceptor with no intrinsic sympathomimetic activity. It reduces the heart rate, reduces the IR and the IOC (within 24 hours); reduces the elevated blood pressure both in the patient's position "standing" and in the "lying" position.
Chlortalidone is a diuretic medium-strength agent, promotes elimination of Na + , Cl-, K + , Mg 2+ and water, delays Ca 2+ ; reducing the content of Na + in the vascular wall, reduces its sensitivity to vasoconstrictor effects. The duration of his diuretic action is 24-48 hours.
PHARMACOKINETICS
Suction
After ingestion, the absorption of atenolol from the digestive tract is 50%. TC max atenolol and chlorthalidone - 2-4 h.
Distribution
The connection with plasma proteins in atenolol is 6-16%, in chlorthalidone - 90% (including with erythrocytes).
Metabolism
Atenolol is slightly metabolized in the liver.
Excretion
Atenolol is excreted by the kidneys, chlorthalidone - by the kidneys and through the intestine. T 1/2 atenolol - 6-9 hours (with a single and with prolonged use).
INDICATIONS
- arterial hypertension.
DOSING MODE
Inside, 1 tab. per day (in the morning).
SIDE EFFECT
Bradycardia, AV blockade, development or aggravation of heart failure, cold extremities, asthenia, nausea, constipation or diarrhea, dizziness, sleep disturbances, hypokalemia, hypercalcemia, hyponatremia, hyperuricemia; skin itching, skin hyperemia, dyspnea, bronchospasm, thrombocytopenia, neutropenia, impaired vision, changes in glucose tolerance, decreased potency, impaired sweating, decreased secretion of tear fluid.
CONTRAINDICATIONS
hypersensitivity;
- AV-blockade of II-III st .;
- CHF (resistant to treatment with cardiac glycosides);
bradycardia;
- cardiogenic shock;
- Hepatic and / or renal insufficiency;
- bronchial asthma;
- Pregnancy;
- lactation period;
- childhood.
With caution: AV-blockade I st., Chronic bronchitis, emphysema, gout, obliterating arterial diseases, violations of water-electrolyte balance.
PREGNANCY AND LACTATION
Contraindicated in pregnancy, during lactation.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in renal failure. In patients with a decreased excretory function of the kidneys, QC control is necessary.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in liver failure.
APPLICATION FOR CHILDREN
Contraindicated in childhood.
SPECIAL INSTRUCTIONS
A systematic control of the electrolyte balance is required; in patients with a decreased excretory function of the kidneys - control of QC.
With prolonged treatment, it is necessary to prescribe potassium preparations.
Cancellation is carried out gradually, reducing the dose within 7-10 days.
Before surgery with general anesthesia, the abolition must be completed at least 48 hours before the surgery.
If the patient took the drug before the operation, he should choose a means for general anesthesia with a minimum negative inotropic effect.
With bronchoobstructive syndrome, it is possible to prescribe beta 2 -adrenostimulants.
OVERDOSE
Symptoms: severe bradycardia, arterial hypotension.
Treatment: with bradycardia - in / in 1-2 mg of atropine; 10 mg glucagon IV bolus. Dobutamine 2.5 Ојg / min / kg iv, 10-25 Ојg isoprenaline iv in the drip at a rate of 5 Ојg / min.
DRUG INTERACTION
Increases the concentration of lidocaine in the plasma.
Cimetidine increases the bioavailability of atenolol.
The hypotensive effect weakens NSAIDs (Na + delay and Pg synthesis blockade) and estrogens (Na + delay).
With simultaneous reception with verapamil, diltiazem, digoxin, amiodarone, antiarrhythmics, anesthetics - increased severity of negative chrono-, ino- and dromotropic influences.
