Atenolol is a beta blocker used to treat hypertension, myocardial infarction, and heart failure by reducing heart rate and contractility, by decreasing cardiac output and oxygen consumption, and by suppressing the RAAS system. Inhibition of beta-1 signaling at the AV node can lead to heart block and cardiac arrest. 

Key Points

  • Atenolol [a TEN oh lole] (Tenormin)
    • Mechanism of Action
      • Beta-1 receptor blocker (Beta blocker)
        • Reduces blood pressure, heart rate, and contractility
        • Decreases cardiac output and cardiac oxygen consumption
        • Suppresses renin-angiotensin-aldosterone system (RAAS)
    • Clinical Use 
      • Hypertension
        • Hold before induction of dialysis to prevent hypotension
        • Monitor vital signs for hypotension and bradycardia
      • Myocardial Infarction
        • May also be used to treat angina
      • Heart failure
        • Reduces mortality in patients with chronic heart failure
    • Side Effects and Adverse Reactions
      • Heart block (AV block)
        • Inhibition of beta-1 signalling at AV node can lead to heart block and cardiac arrest
      • Masking of hypoglycemia
        • monitor blood glucose closely
      • May exacerbate pulmonary edema or uncompensated cardiac failure
        • Since reduction of cardiac output may increase congestion
      • SGA Birth, contraindicated in pregnancy