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[[Image:Atenolol-structure.png|250px|right|Structure of Atenolol]]
== Pharmacology and Indications ==
'''Atenolol''' is a drug belonging to the group of [[beta blocker]]s, a class of drugs used primarily in cardiovascular diseases ([[hypertension]], [[coronary heart disease]], [[arrhythmia]]s), and treatment of [[myocardial infarction]] after the acute
Atenolol is a so called beta1-selective (or 'cardioselective') drug. That means that it exerts greater blocking activity on myocardial beta1-receptors than on pulmonal beta2 ones. Therefore the risk of bronchospastic reactions is reduced compared to nonselective drugs. Atenolol can with extreme caution be given to asthmatic patients. The dose should be as low as possible, because in higher doses Atenolol may loose its cardioselectivity. If an asthma attack occurs the inhalation of an beta2-mimetic antiasthmatic will usually suppress the symptoms.
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== Dosage ==
In patients with normal renal function, the daily dose is 25 to 100mg (in one dose or in two divided doses) depending on the indication. In most patients, the physician will start with a low initial dose and make increments in weekly intervalls as tolerated.
In patients with chronic heart failure the initial dose should be particular low and increments should be made slowly.
In patients with a creatinin-clearance less than 35 ml/Min./1,73 m² the daily dose should be reduced to 25 to 50mg daily according to the clinical response of the individual patient. If a patient with end-stage renal failure is scheduled on regular dialysis, usually 50mg are given after each dialysis procedure. In these patients a severe hypotension may occur afterwards.
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