زائر
aten
(a ten' e)
Ap-Aten (AN), Gen-Aten (AN), Nv-Aten (AN), Tenin (AN), Tenmin
Pegnany ategy D
Dg asses
Beta1-seetive adenegi bking agent
Antiangina dg
Antihypetensive dg
Theapeti atins
Bks beta-adenegi eepts f the sympatheti nevs system in the heat and jxtagmea appaats (kidney), ths deeasing the exitabiity f the heat, deeasing adia tpt and xygen nsmptin, deeasing the eease f enin fm the kidney, and weing bd pesse.
Indiatins
· Teatment f angina petis de t nay athesesis
· Hypetensin, as a step 1 agent, ane with the dgs, espeiay dietis
· Teatment f myadia infatin
· nabeed ses: peventin f migaine headahes; ah withdawa syndme, teatment f ventia and spaventia ahythmias
ntaindiatins and atins
· ntaindiated with sins badyadia, send- thid-degee heat bk, adigeni shk, HF.
· se atisy with ena faie, diabetes thytxisis (aten an mask the sa adia signs f hypgyemia and thytxisis), atatin.
Avaiabe fms
Tabets--25, 50, 100 mg; injetin--5 mg10 m
Dsages
ADTS
· Hypetensin: Initiay 50 mg P ne a day; afte 1–2 wk, dse may be ineased t 100 mgday
· Angina petis: Initiay 50 mg P daiy. If ptima espnse is nt ahieved in 1 wk, inease t 100 mg daiy; p t 200 mgday may be needed.
· Ate MI: Initiay 5 mg IV given ve 5 min as sn as pssibe afte diagnsis; fw with IV injetin f 5 mg 10 min ate. Swith t 50 mg P 10 min afte the ast IV dse; fw with 50 mg P 12 h ate. Theeafte, administe 100 mg P daiy 50 mg P bid f 6–9 days nti dishage fm the hspita.
GEIATI PATIENTS PATIENTS WITH ENA IMPAIMENT
Dsage edtin is eqied bease aten is exeted thgh the kidneys. The fwing dsage is sggested:
eatinine eaane
mmin
Haf-ife (h)
Maximm Dsage
15–35
16–27
50 mgday
< 15
> 27
25 mgday
Patients n hemdiaysis: 50 mg afte eah diaysis; give ny in hspita setting; sevee hyptensin an .
Pediati patients: Safety and effiay nt estabished.
Phamakinetis
te
nset
Peak
Datin
a
Vaies
2–4 h
24 h
IV
Immediate
5 min
24 h
Metabism: T12: 6–7 h
Distibtin: sses paenta; passes int beast mik
Exetin: ine (40%–50%) and biefees (50%–60%)
IV fats
Pepaatin: May be dited in dextse injetin, sdim hide injetin, sdim hide and dextse injetin. Stabe f 48 h afte mixing.
Infsin: Initiate teatment as sn as pssibe afte admissin t the hspita; injet 5 mg ve 5 min; fw with anthe 5-mg IV injetin 10 min ate.
Advese effets
· Aegi eatins: Phayngitis, eythemats ash, feve, se that, ayngspasm, espiaty distess
· NS: Dizziness, vetig, tinnits, fatige, emtina depessin, paesthesias, seep distbanes, hainatins, disientatin, memy ss, sed speeh
· V: Badyadia, HF, adia ahythmias, sinatia AV nda bk, tahyadia, peiphea vasa insffiieny, adiatin, VA, pmnay edema, hyptensin
· Dematgi: ash, pits, sweating, dy skin
· EENT: Eye iitatin, dy eyes, njntivitis, bed visin
· GI: Gasti pain, fatene, nstipatin, diahea, nasea, vmiting, anexia, ishemi itis, ena and mesentei ateia thmbsis, etpeitnea fibsis, hepatmegay, ate paneatitis
· G: Imptene, deeased ibid, Peynie's disease, dysia, ntia, feqent inatin
· Msskeeta: Jint pain, athagia, mse amp
· espiaty: Bnhspasm, dyspnea, gh, bnhia bsttin, nasa stffiness, hinitis, phayngitis (ess ikey than with ppan)
· the: Deeased exeise teane, devepment f antinea antibdies, hypegyemia hypgyemia, eevated sem tansaminase, akaine phsphatase, and DH
Inteatins
Dg-dg
· Ineased effets with veapami, antihinegis, qinidine
· Ineased isk f thstati hyptensin with pazsin
· Ineased isk f idaine txiity with aten
· Pssibe ineased bd pesse-weing effets with aspiin, bismth sbsaiyate, magnesim saiyate, sfinpyazne, a ntaeptives
· Deeased antihypetensive effets with NSAIDs, nidine
· Deeased antihypetensive and antiangina effets f aten with ampiiin, aim sats
· Pssibe ineased hypgyemi effet f insin
Dg-ab test
· Pssibe fase ests with gse insin teane tests
Nsing nsideatins
Assessment
· Histy: Sins badyadia, send- thid-degee heat bk, adigeni shk, HF, ena faie, diabetes thytxisis, atatin
· Physia: Baseine weight, skin nditin, negi stats, P, BP, EG, espiaty stats, kidney and thyid fntin, bd and ine gse
Inteventins
· D nt disntine dg abpty afte ng-tem theapy (hypesensitivity t atehamines may have deveped, asing exaebatin f angina, MI, and ventia ahythmias). Tape dg gaday ve 2 wk with mniting.
· nst physiian abt withdawing dg if patient is t ndeg sgey (withdawa is ntvesia).
Teahing pints
· Take dg with meas if GI pset s.
· D nt stp taking this dg ness td t by a heath ae pvide.
· Avid diving danges ativities if dizziness, weakness .
· These side effets may : dizziness, ight-headedness, ss f appetite, nightmaes, depessin, sexa imptene.
· ept diffity beathing, night gh, sweing f extemities, sw pse, nfsin, depessin, ash, feve, se that.
Advese effets in Itai ae mst mmn; thse in Bd ae ife-theatening.
(a ten' e)
Ap-Aten (AN), Gen-Aten (AN), Nv-Aten (AN), Tenin (AN), Tenmin
Pegnany ategy D
Dg asses
Beta1-seetive adenegi bking agent
Antiangina dg
Antihypetensive dg
Theapeti atins
Bks beta-adenegi eepts f the sympatheti nevs system in the heat and jxtagmea appaats (kidney), ths deeasing the exitabiity f the heat, deeasing adia tpt and xygen nsmptin, deeasing the eease f enin fm the kidney, and weing bd pesse.
Indiatins
· Teatment f angina petis de t nay athesesis
· Hypetensin, as a step 1 agent, ane with the dgs, espeiay dietis
· Teatment f myadia infatin
· nabeed ses: peventin f migaine headahes; ah withdawa syndme, teatment f ventia and spaventia ahythmias
ntaindiatins and atins
· ntaindiated with sins badyadia, send- thid-degee heat bk, adigeni shk, HF.
· se atisy with ena faie, diabetes thytxisis (aten an mask the sa adia signs f hypgyemia and thytxisis), atatin.
Avaiabe fms
Tabets--25, 50, 100 mg; injetin--5 mg10 m
Dsages
ADTS
· Hypetensin: Initiay 50 mg P ne a day; afte 1–2 wk, dse may be ineased t 100 mgday
· Angina petis: Initiay 50 mg P daiy. If ptima espnse is nt ahieved in 1 wk, inease t 100 mg daiy; p t 200 mgday may be needed.
· Ate MI: Initiay 5 mg IV given ve 5 min as sn as pssibe afte diagnsis; fw with IV injetin f 5 mg 10 min ate. Swith t 50 mg P 10 min afte the ast IV dse; fw with 50 mg P 12 h ate. Theeafte, administe 100 mg P daiy 50 mg P bid f 6–9 days nti dishage fm the hspita.
GEIATI PATIENTS PATIENTS WITH ENA IMPAIMENT
Dsage edtin is eqied bease aten is exeted thgh the kidneys. The fwing dsage is sggested:
eatinine eaane
mmin
Haf-ife (h)
Maximm Dsage
15–35
16–27
50 mgday
< 15
> 27
25 mgday
Patients n hemdiaysis: 50 mg afte eah diaysis; give ny in hspita setting; sevee hyptensin an .
Pediati patients: Safety and effiay nt estabished.
Phamakinetis
te
nset
Peak
Datin
a
Vaies
2–4 h
24 h
IV
Immediate
5 min
24 h
Metabism: T12: 6–7 h
Distibtin: sses paenta; passes int beast mik
Exetin: ine (40%–50%) and biefees (50%–60%)
IV fats
Pepaatin: May be dited in dextse injetin, sdim hide injetin, sdim hide and dextse injetin. Stabe f 48 h afte mixing.
Infsin: Initiate teatment as sn as pssibe afte admissin t the hspita; injet 5 mg ve 5 min; fw with anthe 5-mg IV injetin 10 min ate.
Advese effets
· Aegi eatins: Phayngitis, eythemats ash, feve, se that, ayngspasm, espiaty distess
· NS: Dizziness, vetig, tinnits, fatige, emtina depessin, paesthesias, seep distbanes, hainatins, disientatin, memy ss, sed speeh
· V: Badyadia, HF, adia ahythmias, sinatia AV nda bk, tahyadia, peiphea vasa insffiieny, adiatin, VA, pmnay edema, hyptensin
· Dematgi: ash, pits, sweating, dy skin
· EENT: Eye iitatin, dy eyes, njntivitis, bed visin
· GI: Gasti pain, fatene, nstipatin, diahea, nasea, vmiting, anexia, ishemi itis, ena and mesentei ateia thmbsis, etpeitnea fibsis, hepatmegay, ate paneatitis
· G: Imptene, deeased ibid, Peynie's disease, dysia, ntia, feqent inatin
· Msskeeta: Jint pain, athagia, mse amp
· espiaty: Bnhspasm, dyspnea, gh, bnhia bsttin, nasa stffiness, hinitis, phayngitis (ess ikey than with ppan)
· the: Deeased exeise teane, devepment f antinea antibdies, hypegyemia hypgyemia, eevated sem tansaminase, akaine phsphatase, and DH
Inteatins
Dg-dg
· Ineased effets with veapami, antihinegis, qinidine
· Ineased isk f thstati hyptensin with pazsin
· Ineased isk f idaine txiity with aten
· Pssibe ineased bd pesse-weing effets with aspiin, bismth sbsaiyate, magnesim saiyate, sfinpyazne, a ntaeptives
· Deeased antihypetensive effets with NSAIDs, nidine
· Deeased antihypetensive and antiangina effets f aten with ampiiin, aim sats
· Pssibe ineased hypgyemi effet f insin
Dg-ab test
· Pssibe fase ests with gse insin teane tests
Nsing nsideatins
Assessment
· Histy: Sins badyadia, send- thid-degee heat bk, adigeni shk, HF, ena faie, diabetes thytxisis, atatin
· Physia: Baseine weight, skin nditin, negi stats, P, BP, EG, espiaty stats, kidney and thyid fntin, bd and ine gse
Inteventins
· D nt disntine dg abpty afte ng-tem theapy (hypesensitivity t atehamines may have deveped, asing exaebatin f angina, MI, and ventia ahythmias). Tape dg gaday ve 2 wk with mniting.
· nst physiian abt withdawing dg if patient is t ndeg sgey (withdawa is ntvesia).
Teahing pints
· Take dg with meas if GI pset s.
· D nt stp taking this dg ness td t by a heath ae pvide.
· Avid diving danges ativities if dizziness, weakness .
· These side effets may : dizziness, ight-headedness, ss f appetite, nightmaes, depessin, sexa imptene.
· ept diffity beathing, night gh, sweing f extemities, sw pse, nfsin, depessin, ash, feve, se that.
Advese effets in Itai ae mst mmn; thse in Bd ae ife-theatening.