Hi Gang,
Guess this thread shows a great example of how different people react differently to the same medications.
Atenolol is a Beta Blocker and these are designed to accomplish two things, Lower your blood pressure and, to Lower you heart rate.
Atenolol is also a beta blocker that does not cross the blood/brain barrier. Ones that do can make one feel more lethargic or depressed.
I have been on this drug for 6 years now. I take 50 mg in the morning and 50 mg in the evening. I have only been taking the evening dose for the last 3/4 of a year, since my A-Flutter occurrences started happening.
I do not have any issues with taking this medication. Although at first, I did notice the tingling sensations and some dizziness.
Due to the lowering of my heart rate, my metabolism has slowed down and this has caused some slight weight gain. For example.. I can be on a treadmill walking at a 4.2 mph pace for 30 min and my heart rate will not go above 98 bpm (beats per min). It's kind of hard to burn off calories at such a slow rate. In fact, if you are on a beta blocker, you cannot use the standard rule for optimum heart rate for exercise. Below is an explanation as provided by a nurse on how to calculate this rate if you are on a beta blocker.
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtracting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most effect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerely, Laurie Anderson, RN, BSN
More information regarding Beta Blockers.
Re: beta blocker choice (by Cardiostar (WebMD) 6 days ago) 5/3/01 12:23 a.m.Hi S.M
For simplicity sake (though nothing seems to be that way in medicine today), doctors, using their overall clinical experience, try to prescribe a beta blocker that is felt to be the most appropriate one that will effectively control a particular condition or conditions (dosage must be individualized) and do so hopefully with minimal (tolerable) side effects. Contraindications, pre-existing medical conditions and drug interactions have to be taken into consideration when prescribing this particular drug as well.Beta blockers can be cardioselective; decrease in systemic side effects and only affects beta-1 receptors located primarily in the cardiac muscle or non- cardioselective; increase in systemic side effects; and affects beta-1 and the beta-2 receptors (which are located primarily in the bronchial musculature and blood vessels).Toprol-XL® (metoprolol succinate, extended release) is a beta-1 cardioselective drug. Metoprolol tartrate immediate release is available as Lopressor® and is reported to be the most widely prescribed and competitive beta-blocker in the world. In the U.S., Toprol-XL® is primarily indicated for high blood pressure (hypertension) and angina, but like other beta blockers, it can be prescribed for other conditions as determined by a qualified doctor. Since everyone is unique, and therefore the metabolism responds differently to beta blockers, if a particular beta blocker works well for one individual that does not necessarily mean that it will work well for the next.A problem with this class of drug is that some beta blockers are known to enter or cross the blood-brain-brain (BBB, actually there are two of them and is described as a protective network of blood vessels and cells that filters blood flowing to the brain) easier than others. The ones that do this seem to cause more central nervous system (CNS) side effects, such as nightmares, hallucinations, and depression than others that exhibit low penetration characteristics (LPC). If a beta blocker seems to be ineffective, doctors will either increase the dose or switch to another class of drug that is deemed appropriate.When a beta blocker dosage is increased, one has to watch out for dose delivered side effects (DDSE) which can be an increase in the severity of present (if any) side effects or the onset of entirely new ones which may or may not cause an iatrogenic condition or disease.Also, while on this class of drug, blood pressure and pulse/HR should be checked regularly and a doctor should be contacted immediately if/when pulse/HR falls below 50 BPM.You'll obviously need to discuss your current medication and health status with your cardiologist next month.
Hope you find some of this useful.
Rob
