BETABLOK

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    Komposisi:

    Atenolol 50 dan 100 mg

    Bentuk sediaan:

    Tablet

    Farmakologi:

    Merupakan penghambat reseptor ß-1 adrenergik utama (bersifat kardioselektif) tanpa aktivitas stimulasi reseptor ß-2 (yang ada di pernapasan) sehingga mencegah adrenalin menempel pada reseptornya di jantung sehingga kerja jantung lebih ringan dan berakibat turunnya tekanan darah

    Indikasi:

    Hipertensi, angina pektoris stabil kronik

    Kontraindikasi:

    Sinus bradikardi, blok jantung derajat 2 dan , syok kardiogenik karena gagal jantung

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    Dosis:

    Hipertensi: dosis awal 50 mg, selanjutnya dapat ditingkatkan hingga 100 mg/hari. Angina pektoris: 50 hingga 100 mg perhari

    Peringatan dan Perhatian:

    Penyakit bronkospastik: gunakan hanya pada pasien yang tidak merespons atau tidak mentolerir pengobatan antihipertensi lain. Gunakan dosis serendah mungkin dan agonist beta 2–stimulating agent (bronkodilator) harus tersedia. Gagal jantung: gunakan hanya pada CHF yang dikendalikan oleh digitalis dan diuretik. Gangguan fungsi ginjal: menggunakan dosis yang lebih rendah. Kehamilan: gunakan hanya jika manfaat melebihi potensi risiko terhadap janin. Ibu menyusui: hentikan menyusui saat meminum obat. Anak-anak: keamanan dan efektivitas belum ditetapkan

    Efek Samping:

    Bradikardi, pusing, lemas, letargi, vertigo, sakit kepala ringan, depresi, nausea, diare, kemerahan kulit dan atau mata kering

     

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    BETABLOK

     

    Composition:

    Each tablet contains: Atenolol 50 mg or 100 mg

    Presentation:

    Box of 3 strips x 10 tablets

    Pharmacology:

    Atenolol is a beta-blocker which is beta1-selective (kardioselektif). Selectivity decreases with increasing dose. Atenolol is without intrinsic sympathomimetic and membrane stabilising activities and as with other beta-blockers, has negative inotropic effects (and is therefore contraindicated in uncontrolled heart failure). Absorption of atenolol following oral dosing is consistent but incomplete (approximately 40-50%) with peak plasma concentrations occurring 2-4 hours after dosing.

    Indications:

    - Hypertension - Angina pectoris - Myocardial infarction, late intervention

    Contraindications:

    Should not be used in patients with any of the following: known hypersensitivity to the active substance, or to any of the excipients; bradycardia (< 45 bpm); cardiogenic shock; hypotension; metabolic acidosis; severe peripheral arterial circulatory disturbances; second-or third-degree heart block; sick sinus syndrome; untreated phaeochromocytoma; uncontrolled heart failure.

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    Dosage:

    The dose must always be adjusted to individual requirements of the patients, with the lowest possible starting dosage. The following are guidelines: Adults: - Hypertension: Most patients respond to 50-100 mg daily given orally as a single daily dose. The effect will be fully established after one to two weeks. A further reduction in blood pressure may be achieved by combining atenolol with other antihypertensive agents. - Angina pectoris: Most patients with angina pectoris will respond to 100 mg given orally once daily or 50 mg given twice daily. It is unlikely that additional benefit will be gained by increasing the dose. - Late intervention after acute myocardial infarction: For patients who present some days after suffering an acute myocardial infarction, an oral dose of atenolol 100 mg daily is recommended for long-term prophylaxis of myocardial infarction. Elderly: Dosage requirements may be reduced, especially in patients with impaired renal function. Children: It is not recommended for use in children. Renal Failure Since atenolol is excreted via the kidneys the dosage should be adjusted in cases of severe impairment of renal function. No significant accumulation of atenolol occurs in patients who have a creatinine clearance greater than 35 ml/min/1.73 m2 (normal range is 100-150 mL/min/1.73m2). For patients with a creatinine clearance of 15-35 mL/min/1.73m2 (equivalent to serum creatinine of 300-600 micromol/litre) the oral dose of atenolol should be 50 mg daily. For patients with a creatinine clearance of less than 15 mL/min/1.73m2 (equivalent to serum creatinine of > 600 micromol/litre) the oral dose of atenolol should be reduced to 50 mg on alternate days. Patients on haemodialysis should be given 50 mg atenolol orally after each dialysis; this should be done under hospital supervision as marked falls in blood pressure can occur.

    Warning and Precautions:

    - Should not be withdrawn abruptly. The dosage should be withdrawn gradually over a period of 7-14 days. - When a patient is scheduled for surgery, and a decision is made to discontinue beta¬blocker therapy, this should be done at least 24 hours prior to the procedure. If treatment is continued, an anaesthetic with little negative inotropic activity should be selected to minimise the risk of myocardial depression. The patient may be protected against vagal reactions by intravenous administration of atropine. - Caution must be exercised in patients whose cardiac reserve is poor. - May increase the number and duration of angina attacks in patients with Prinzmetal’s angina. - Although contraindicated in severe peripheral arterial circulatory disturbances, may also aggravate less severe peripheral arterial circulatory disturbances. - Caution must be exercised if it is given to patients with first degree heart block. - May mask the symptoms of hypoglycaemia, in particular, tachycardia. - May mask the signs of thyrotoxicosis. - May reduce heart rate. - Should be used with caution in the elderly, starting with a lesser dose. - Caution should be exercised when atenolol is administered during pregnancy or to a woman who is breast-feeding.

    Adverse events:

    Bradicardia, cold extremitas, dizziness, gastrointestinal disturbance, fatigue, skin rash, dry eyes.

    Drugs Interaction:

    Calcium channel blockers with negative inotropic activity e.g. verapamil and diltiazem, dihydropyridine, e.g. nifedipine, digitalis glycoside, class I anti-arrhythmic drugs (e.g. disopyramide) and amiodarone, sympathomimetic agents, e.g. adrenaline, insulin and oral antidiabetic drugs, prostaglandin synthetase inhibiting drugs (e.g. ibuprofen and indomethacin), anaesthetic drugs with negative inotropic activity.

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