ATENOLOL

Question 1

Drug class

Answer 1

beta blocker

Question 2

Where are beta-1 receptors located?

Answer 2

heart

Question 3

Where are beta 2 adrenoreceptors located?

Answer 3

smooth muscle of blood vessels and airways

Question 4

How do beta blockers work on beta-1 receptors? (4)

Answer 4

1. reduce the force of contraction
2. reduce speed of conduction of the heart
3. this relieves myocardial ischaemia by reducing cardiac work and oxygen demand
4. this increases myocardial perfusion

Question 5

Why do beta blockers protect the heart in heart failure?

Answer 5

• as it protects the heart from the effects of chronic sympathetic stimulation

Question 6

How do beta blockers work in AF?

Answer 6

• by prolonging the refractory period of the AV node

- hence slowing the ventricular rate

Question 7

How do beta blockers work in SVT?

Answer 7

• they break the self-perpetuating circuit that takes in the AV node

Question 8

How do beta blockers work in hypertension?

Answer 8

• variety of means

- reduce renin secretion from the kidney - this is mediated by beta 1 receptors

Question 9

Indications (5)

Answer 9

1. ischaemic heart disease
2. chronic heart failure
3. atrial fibrilation
4. supraventricular tachycardia (SVT)
5. hypertension

Question 10

Contra-indications (5)

Answer 10

1. asthma
   - life threatening bronchospasm
2. heart failure
   - start at low dose then increase
   - may initially cause impaired cardiac function
3. haemodynamic instability
4. heart block
5. hepatic failure

Question 11

Side effects (6)

Answer 11

1. fatigue
2. cold extremities
3. headache
4. GI disturbance
   - nausea
5. sleep disturbance and nightmares
6. impotence - MEN

Question 12

Interactions

Answer 12

1. non-dihydropyridine calcium channel blockers
   e. g. verapamil, diltiazem

• heart failure
• bradycardia
• even asystole

Question 13

elimination

Answer 13

kidneys