ATENOLOL and PROPRANOLOL

Atenolol

Mechanism of Action:

• By inhibiting beta receptors in the heart, it lowers blood pressure largely by reducing cardiac output.
• Additionally, atenolol lowers sympathetic outflow from the CNS and inhibits renin release from the kidney, which reduces the production of angiotensin-II and aldosterone.

Indication

• Treatment of hypertension.
• Management of angina pectoris.

Dose

• Adult:
  • Hypertension: 50mg od, may increase to 100mg / d * ay
  • Angina Pectoris: 50mg od, may increases to 100mg / d * ay

Contraindication

Pulmonary oedema, Cardiogenic shock, bradycardia, heart block without a pacemaker ,uncompensated congestive heart failure, sinus node dysfunction, A-V conduction abnormalities, diabetes mellitus.

Side Efect

• Bradycardia, hypotension, headache, dizziness, depression, paraesthesia, fatigue, nightmares, impotence, names, vomiting heart failure, 2 and 3 degree AV block,

Nursing Consideration

• Throughout the course of therapy, check your blood pressure, ECG, and pulse often during the dose adjustment phase.
• Keep an eye on daily weights and the ratios of input to output. Regularly check for heart failure. Notify the doctor right once if dyspnea, weight gain, peripheral oedema, etc. are evident.
• Notify the doctor if you experience breathing difficulties, a nighttime cough, oedema, bradycardia, disorientation, or depression.
• Use with caution in individuals who are at risk for heart failure, have diabetes, hyperthyroidism, brochospastic illness, or impaired renal or hepatic function.
• Avoid stopping a medicine abruptly after receiving long-term therapy. To prevent severe adverse effects, such as severe angina exacerbations, medication withdrawal should be done gradually. ventricular arrhythmias and myocardial infarction.
• Notify the doctor if you experience breathing problems, a nighttime cough, oedema, bradycardia, confusion, or depression, or if you develop a rash, fever, or a sore throat.
• Instruct patient to change position slowly if orthostatic hypotension occurs.

Propanolol

Mechanism of Action

• It is a nonselective beta blocker that lowers cardiac output and heart rate. also reduces peripheral resistance with continued usage. Reduced blood pressure.
• Also decreased is the myocardial work burden.
• In the plasma, propanolol lowers renin activity.
• It helps with arrhythmias and stabilizes the membrane.

Indication:

• Treatment of Ventricular tachycardia, prevention of myocardial infarction.
• Management of hypertension, angina pectoris, pheochromocytoma, supraventricular arrhythmias
• Migraine headache prophylaxis.

Dose:

• Adult:
  • Hypertension: 40mg bd or 60-80mg od or bd (po).
  • Arrhythmias: 10-40mg tid or qid (po).
  • Migraine headache prophylaxis: initial 80mg / d * ay in 3 or 4 divided dose, increase by 20-40mg tid or qid X po.

Contraindication

Cardiogenic shock, sinus bradycardia, 2 ^ (nd) * k 3rd degree heart block, pulmonary oedema, bronchial asthma, CCF, heart failure, severe hypoglycemia, 2nd & 3rd trimesters pregnancy.

Side Effect

Fatigue, depression, sexual disorder, hypoglycaemia, bradycardia, cold extremities, insomnia, Raynaud's syndrome, syncope, cognitive dysfunction, bronchospasm, pulmonary oedema, hyperlipidaemia

Nursing Consideration

• Give oral medication along with food.
• Regularly check your blood pressure and pulse. When helping the patient get out of a supine posture, check for orthostatic hypotension.
• If your pulse is fewer than 50 beats per minute, hold the dosage and call your doctor right away.
• Avoid stopping the medicine suddenly; instead, ease the dosage gradually over the course of two weeks to avoid potentially fatal arrhythmias, hypertension, or myocardial ischemia.
• If a patient has diabetes mellitus, this medication may prevent the typical symptoms of hypoglycemia; check blood or urine glucose levels closely.
• To prevent feeling queasy, drowsy, lightheaded, or having blurred vision, avoid operating machinery or engaging in other risky activities.
• Report any breathing difficulties, night coughs, swelling of the extremities, slow heartbeat, confusion, or depressive symptoms to your doctor.