This road I am embarking on is going to be hard. These first 5 days of my liquid diet have been testament to that fact. I finally lost it in my office at work yesterday. I was trying to complete some tasks to get out for the day. The phone kept ringing, my phone kept ringing, people kept coming in and asking question (which is normal for any day). I finally shouted for everything to "Leave me the fuck alone!". Not knowing anyone was around me, a peer poked her head in and asked if I was OK. I felt instant embarrassment because at work, I am complete composure. Sure I may looked stressed at times when we are really busy and I may be short with people at other times when we are REALLY busy; but, normally I hopefully bring an air of calm to an otherwise chaotic existence sometimes.
I find my self tired most of the time since this past Saturday, when I started my liquid diet. I also started taking a full pill of the Atenolol on Saturday. This is the description of what Atenolol is:
Atenolol (Tenormin) is a selective β1 receptor antagonist, a drug belonging to the group of beta blockers (sometimes written β-blockers), a class of drugs used primarily in cardiovascular diseases. Introduced in 1976, atenolol was developed as a replacement for propranolol in the treatment of hypertension. The chemical works by slowing down the heart and reducing its workload. Unlike propranolol, atenolol does not pass through the blood-brain barrier thus avoiding various central nervous system side effects.[1]
Atenolol is one of the most widely used β-blockers in the United Kingdom and was once the first-line treatment for hypertension. The role for β-blockers in hypertension was downgraded in June 2006 in the United Kingdom to fourth-line, as they perform less well than newer drugs, particularly in the elderly. Some evidence suggests that even in normal doses the most frequently used β-blockers carry an unacceptable risk of provoking type 2 diabetes.[2]
Indications
Atenolol can be used to treat cardiovascular diseases and conditions such as hypertension, coronary heart disease, arrhythmias, angina (chest pain) and to treat and reduce the risk of heart complications following myocardial infarction (heart attack). It is also used to treat the symptoms of Graves Disease, until antithyroid medication can take effect.
Due to its hydrophilic properties, the drug is less suitable in migraine prophylaxis compared to propranolol, because, for this indication, atenolol would have to reach the brain in high concentrations, which is not the case (see below).
Cardioselectivity and asthma
Atenolol is classified as a β1-selective (or 'cardioselective') drug, one that exerts greater blocking activity on myocardial β1-receptors than on β2 receptors in the lung. The β2 receptors are responsible for keeping the bronchial system open. If these receptors are blocked, bronchospasm with serious lack of oxygen in the body can result. However, due to its cardioselective properties, the risk of bronchospastic reactions if using atenolol is reduced compared to nonselective drugs as propranolol. Nonetheless, this reaction may also be encountered with atenolol at high doses. Although traditionally B-blockers have been contraindicated when a person carries a diagnosis of asthma, recent studies have revealed that at moderate doses selective B blockers such as Atenolol are well tolerated.
Provisional data suggests that antihypertensive therapy with atenolol provides weaker protective action against cardiovascular complications (e.g. myocardial infarction and stroke) compared to other antihypertensive drugs. In some cases, diuretics are superior. However, controlled studies are lacking.[3]
Unlike most other commonly-used β-blockers, atenolol is excreted almost exclusively by the kidneys. This makes it attractive for use in individuals with end-stage liver disease.
Contraindications- bradycardia (pulse less than 50 bpm)
- cardiogenic shock
- asthma (may cause broncho-constriction), although unlikely as atenolol is cardioselective
- symptomatic hypotension (blood pressure of less than 100/60 mm Hg with dizziness, vertigo etc.)
- angina of the Prinzmetal type (vasospastic angina)
- metabolic acidosis (a severe condition with a more acid blood than normal)
- severe disorders in peripheral arterial circulation
- AV-Blockage of second and third degree (a particular form of arrhythmia)
- acutely decompensated congestive heart failure (symptoms may be fluid retention with peripheral edema and/or abdominal fluid retention (ascites), and/or lung edema)
- sick sinus syndrome (a particular form of arrhythmia)
- hypersensitivity and/or allergy to atenolol
- phaeochromocytoma (a rare type of tumor of the adrenal glands)
Caution: patients with preexisting bronchial asthma
Caution: only if clearly needed during pregnancy, as atenolol may retard fetal growth and possibly cause other abnormalities.
Side effects
Atenolol causes significantly fewer central nervous system side effects (depressions, nightmares) and fewer bronchospastic reactions, both due to its particular pharmacologic profile.
It was the main β-blocker identified as carrying a higher risk of provoking type 2 diabetes, leading to its downgrading in the United Kingdom in June 2006 to fourth-line agent in the management of hypertension.[2]
In addition, β-blockers blunt the usual sympathetic nervous system response to hypoglycemia (i.e. sweating, agitation, tachycardia). These drugs therefore have an ability to mask a dangerously low blood sugar, which further decreases their safety and utility in diabetic patients.
Side effects include:
- indigestion, constipation
- dry mouth
- dizziness or faintness (especially cases of orthostatic hypotension)
- cold extremities
- hair loss
- problems with sexual function
- runny/blocked nose
- depression
- confusion
- difficulty sleeping, nightmares
- fatigue, weakness or lack of energy
Hang in there!! There is a light at the end of this tunnel and a huge success story with it!! Always remember, God give us what we can handle and we are in the palm of his hands!! Be strong!!!
ReplyDeleteKathy