atenolol
Apo-Atenol (CAN), Novo-Atenol (CAN),
Tenormin
Nursing Considerations
• Use atenolol cautiously in patients with
heart failure controlled by digitalis glycosides
or diuretics, patients with conduction
abnormalities or left ventricular dysfunction
who take verapamil or diltiazem,
patients with arterial circulatory disorders,
and patients with impaired renal function.
• Use atenolol cautiously in diabetic patients
because it may mask tachycardia caused by
hypoglycemia. Unlike other beta-adrenergic
blockers, it doesn’t mask other signs of
hypoglycemia, cause hypoglycemia, or
delay the return of blood glucose to a normal
level.
• At first sign of heart failure, expect patient
to receive a digitalis glycoside, a diuretic,
or both and to be monitored closely. If
failure continues, expect to stop atenolol.
• Closely monitor patient with hyperthyroidism
because atenolol may mask some
signs of thyrotoxicosis. Abrupt withdrawal
of atenolol may precipitate thyrotoxicosis.
• If patient also receives clonidine, expect to
stop atenolol several days before gradually
withdrawing clonidine. Then expect to
restart atenolol therapy several days after
clonidine has been discontinued.
• During I.V. atenolol therapy, monitor vital
signs and cardiac rhythm closely.
• Discard parenteral mixture with atenolol if
it isn’t used within 48 hours.
• Stop atenolol and notify prescriber if
patient develops bradycardia, hypotension,
or other serious adverse reaction.
PATIENT TEACHING
• Instruct patient not to stop taking atenolol
abruptly. Otherwise, angina may worsen,
and an MI or arrhythmia may occur.
•While patient is being weaned from atenolol,
tell him to perform minimal physical
activity to prevent chest pain.
• Instruct patient to take a missed dose as
soon as possible. However, if it’s within
8 hours of the next scheduled dose, tell
him to skip the missed dose and return to
his regular schedule.
• Explain that atenolol may alter serum glucose
level and mask hypoglycemia.
• Inform the patient that he may experience
fatigue and reduced tolerance to exercise
and that he should notify his prescriber if
this interferes with his normal lifestyle.
