Uses of Tenomin

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Tenormin drug with active ingredient is Atenolol 50mg, a selective beta 1-adrenergic receptor blocker. The drug is indicated in cases of hypertension, angina pectoris, acute myocardial infarction, ventricular and supraventricular arrhythmias.

1. Uses of Tenomin

Tenormin is indicated for use in the following cases:
Hypertension; Stable angina ; Treatment of arrhythmias, ventricular and supraventricular tachycardia; Acute myocardial infarction ; Prevention of migraine; Concomitant use with benzodiazepines for the treatment of acute alcohol withdrawal syndrome. Contraindications to the use of Tenomin:
Bradycardia, atrioventricular block - second and third grade; Cardiogenic shock, decompensated heart failure; Untreated pheochromocytoma; Hypersensitivity or allergy to any of the ingredients in Tenomin; Hypotension, severe peripheral arterial circulation disorder, metabolic acidosis.

2. How to take Tenomin

Tenormin 50 mg is to be taken orally, during or away from a meal. Use Tenomin under the guidance of your doctor.
2.1. Dosage of the drug Tenomin Hypertension:
The starting dose of the drug is 50 mg / time x 1 time / day. If an optimal response has not been achieved within 1-2 weeks, the dose should be increased to 100 mg/day or in combination with a diuretic or peripheral vasodilator. Increasing the dose beyond 100 mg/day does not increase the effectiveness of the drug. Stable angina:
Initial dose is 50 mg/time/day. If an optimal therapeutic response has not been achieved within 1 week, the dose may be increased to 100 mg once daily or 50 mg twice daily. Dose increments are generally unlikely to further enhance efficacy, however, it may be possible for some patients to increase the dose up to 200 mg/day to achieve an optimal therapeutic response. Arrhythmias: Tenormin 50 mg orally is usually used for maintenance after patients have controlled their arrhythmias with intravenous atenolol. Tenomin 50mg dose used for maintenance is 50-100mg x 1 time / day. Myocardial infarction:
Early intervention after acute myocardial infarction: Tenormin 50 mg orally after intravenous administration of Atenolol 15 minutes, if the patient is well tolerated by the intravenous dose and there is no effect any accident occurred. Patients after intravenous injection can continue to receive a dose of 50mg and repeat after 12 hours. Oral maintenance dose for 6-9 days (or until contraindications appear such as bradycardia or hypotension) at 100 mg/day, administered once or in two divided doses. If bradycardia and/or hypotension or any other undesirable effect occurs, Tenormin should be discontinued. Late intervention after acute myocardial infarction (patients hospitalized several days after acute myocardial infarction) Oral tenormin should be indicated for long-term prevention of myocardial infarction: Dose: 100 mg/day, administered 1 or divided into 2 times. Elderly:
The dose may be reduced, especially in patients with impaired renal function; Migraine prevention:
Dosage is 50-100 mg/day; Patients with renal impairment:
Creatinine clearance 15 - 35 ml/min: Maximum dose 50 mg/day; Creatinine clearance < 15 ml/min: Maximum dose 25 mg/day, or 50 mg orally every other day; Hemodialysis patients: 25 - 50 mg orally after each dialysis session, closely monitored because hypotension may occur.

2.2. What to do in case of an overdose of Tenomin? Symptoms of Tenomin overdose may occur when acute doses of 5g or more are used.
Common symptoms of Tenomin overdose are: lethargy, sinus arrest, bradycardia, hypotension, bronchospasm, respiratory disorders, wheezing...
Treatment of overdose by induce vomiting, gastric lavage or oral activated charcoal or use laxatives within 1 hour of taking the drug, in order to reduce the absorption of the drug from the gastrointestinal tract.
Atenolol can be removed from the general circulation by hemodialysis. Other treatments should be at the discretion of the physician, including:
Bradycardia: Intravenous atropine in the presence of second- or third-degree atrioventricular block. If the patient does not respond, Isoproterenol can be used. In refractory cases, use a temporary intravenous pacemaker; Heart failure: Use Digitalis or diuretics. Intravenous Glucagon may be indicated; Hypotension: Use vasoconstrictors such as Dopamine, Dobutamine, Adrenalin or Noradrenalin and monitor blood pressure. If blood pressure remains low and unresponsive to vasopressors, intravenous infusion of Glucagon may be indicated; Bronchospasm: Using beta-agonists such as Isoproterenol, Terbutalin; Atropine; Intravenous Aminophyllin or Nebulized Ipratropium. Hypoglycemia: Intravenous glucose infusion. Depending on the severity of symptoms to decide to support intensive care and means of cardiac and respiratory support.

3. Tenormin side effects

Common undesirable effects:
Whole body: Fatigue, muscle weakness, cold extremities; Cardiovascular: Bradycardia, second and third degree atrioventricular block, hypotension; Gastrointestinal disorders: Diarrhea, nausea. Uncommon side effects:
Sleep disturbance, decreased sex drive; Increased liver enzymes (AST and ALT) Rare adverse effects:
Systemic: Headache, dizziness, paresthesias; Cardiovascular: Exacerbation of heart failure, onset of atrioventricular block, orthostatic hypotension, claudication, Raynaud's syndrome in susceptible patients; Blood: Thrombocytopenia; Psychiatric: Hallucinations, nightmares, depression, mood swings, psychosis; Gastrointestinal: dry mouth, liver toxicity; Skin: Alopecia, skin rash, purpura, psoriasis-like skin reactions, exacerbation of psoriasis; Eyes: Visual disturbances, dry eyes; Reduced sexual desire, impotence.

4. Notes when using Tenormin

Here are some notes when using Tenormin:
Tenormin should not be stopped suddenly because it can aggravate angina symptoms, promote myocardial infarction and ventricular arrhythmias in patients with vascular disease. rim. Tenomin should be reduced in dose for 7-14 days and closely monitored, especially in high-risk patients; Caution should be exercised in patients with thyrotoxic syndrome because tachycardia due to hyperthyroidism may mask symptoms; Caution should be exercised when atenolol is used concurrently with anesthetics because it can cause a sharp, prolonged drop in blood pressure and difficulty maintaining heart rate during surgery. This effect is reversible with Dobutamine or Isoproterenol; Tenomin should be discontinued at least 24 hours prior to surgery. If the decision is made to remain on medication, close monitoring for signs of heart failure is necessary. During surgery, if symptoms of parasympathetic hyperparathyroidism appear, use Atropin immediately; Tenomin is contraindicated in patients with decompensated heart failure, but it can still be used with caution in patients with compensated heart failure; Non-selective beta-blockers may inhibit tracheal smooth muscle relaxation, and therefore should not be used in COPD or bronchial asthma. However, Tenomin is a selective beta-1 receptor blocker, so it can be used with caution in patients with bronchospasm who are intolerant to other antihypertensive agents; Patients with a history of allergies may be at increased risk of allergic reactions and severe reactions while taking beta-blockers. In addition, the drug increases the frequency and severity of anaphylaxis, which is often unresponsive to adrenaline. In that case, Glucagon or Ipratropium should be used instead; Patients with Prinzmetal's Angina: Use of Tenomin may increase the frequency and duration of chest pain. Therefore, the drug should be used with caution in these patients; Use caution in patients with first-degree atrioventricular block because the drug has an inhibitory effect on myocardial conduction time; The dose of Tenomin should be reduced when the patient has bradycardia <50 beats/min; Pheochromocytoma: Using the drug should use alpha blocker concomitantly; Diabetes: The drug may mask the signs of tachycardia due to hypoglycemia; Pregnancy: Tenomin can cross the placenta. Taking the drug in women who are about to give birth can cause bradycardia, decreased blood glucose and blood pressure in the baby. In addition, drug use is associated with fetal growth retardation. Weigh the benefits and harms before taking the drug; Lactation: The drug is excreted into breast milk at a rate of about 1.5-6.8 times the maternal plasma concentration. Bradycardia and hypoglycaemia may occur while taking the drug.

5. Drug interactions

Some drugs may interact with Tenormin such as:
Atenolol, the main active ingredient in Tenomin, has a synergistic effect, increasing the antihypertensive effect of other antihypertensive drugs such as calcium channel blockers (Verapamil, Diltiazem). , Nifedipine , Amlodipine...); Hydralazine. This synergistic effect is often therapeutically beneficial but requires tight dose control. Digitalis glycosides when combined with beta-blockers may increase atrioventricular conduction time. Concomitant administration of Reserpine may potentiate the hypotensive and bradycardia effects of Atenolol due to the catecholamine-destroying effect of Reserpine. Atenolol may exacerbate hypertension due to the rebound effect that occurs with abrupt discontinuation of Clonidine. Patients taking two drugs atenolol and Clonidine concurrently, should take atenolol a few days before stopping Clonidine. The combination of Amiodarone with Atenolol has a synergistic effect on pacing, aggravating bradycardia, cardiac arrest. Concomitant use with sympathomimetic agents, eg adrenaline, may reverse the effect of beta-blockers. Insulin and oral antidiabetic drugs: Atenolol may mask tachycardia and hypoglycemia. Cyclooxygenase inhibitors (such as Indomethacin) may reduce the antihypertensive effect of beta-blockers. In summary, the use of Tenomin is to treat hypertension, angina pectoris, arrhythmia and myocardial infarction. All information above is for reference only. The use of the drug must be under the guidance of a specialist.

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