Abstract
1 The pharmacological properties of atenolol suggest its possible usefulness in pregnancy-induced hypertension. The pharmacokinetics of atenolol in the pregnant woman, concentrations in cord blood, and its effects on maternal blood pressure and the foetus, are evaluated. 2 We studied 13 pregnant women with hypertension, most of them uncontrolled on methyldopa. Whole blood concentrations and urinary excretion of the drug were measured over 24 h following a 100 mg dose. Effects on maternal blood pressure, pulse rate and foetal heart rate and cardiotocograph were compared for the 4 days before treatment and the first 4 days of treatment. The birth weights and Apgar scores of the babies were recorded. 2 The pharmacokinetics of atenolol (plasma half-life of about 8 h) in pregnant women do not differ from the findings in the non-pregnant. The levels of atenolol in the cord blood were confirmed as approximately equal to those in the maternal blood. 4 In the ten women in whom blood pressure was assessed a small significant fall in blood pressure was observed. 5 A 5% mean fall in foetal heart rate resulted but in one case was a rate below 120 beats/min recorded. There was no evidence of depression of the stress response of the foetal heart. Apgar scores 5 min post partum were satisfactory. 6 Atenolol appears to be safe for use in hypertensive pregnancies. Its effectiveness as an antihypertensive agent in pregnancy requires further controlled evaluation.
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Selected References
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- Barber H. E., Hawksworth G. M., Kitteringham N. R., Petersen J., Petrie J. C., Swann J. M. Protein binding of atenolol and propranolol to human serum albumin and in human plasma [proceedings]. Br J Clin Pharmacol. 1978 Nov;6(5):446P–447P. [PubMed] [Google Scholar]
- Brown H. C., Carruthers S. G., Johnston G. D., Kelly J. G., McAinsh J., McDevitt D. G., Shanks R. G. Clinical pharmacologic observations on atenolol, a beta-adrenoceptor blocker. Clin Pharmacol Ther. 1976 Nov;20(5):524–534. doi: 10.1002/cpt1976205524. [DOI] [PubMed] [Google Scholar]
- Conway F. J., Fitzgerald J. D., McAinsh J., Rowlands D. J., Simpson W. T. Human pharmacokinetic and pharmacodynamic studies on the atenolo (ICI 66,082), a new cardioselective beta-adrenoceptor blocking drug. Br J Clin Pharmacol. 1976 Apr;3(2):267–272. doi: 10.1111/j.1365-2125.1976.tb00602.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cottrill C. M., McAllister R. G., Jr, Gettes L., Noonan J. A. Propranolol therapy during pregnancy, labor, and delivery: evidence for transplacental drug transfer and impaired neonatal drug disposition. J Pediatr. 1977 Nov;91(5):812–814. doi: 10.1016/s0022-3476(77)81049-4. [DOI] [PubMed] [Google Scholar]
- Dollery C. T. Dose-response in hypertension. Proc R Soc Med. 1977;70(Suppl 5):9–10. doi: 10.1177/00359157770700S504. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eliahou H. E., Silverberg D. S., Reisin E., Romem I., Mashiach S., Serr D. M. Propranolol for the treatment of hypertension in pregnancy. Br J Obstet Gynaecol. 1978 Jun;85(6):431–436. doi: 10.1111/j.1471-0528.1978.tb14909.x. [DOI] [PubMed] [Google Scholar]
- Gallery E. D., Saunders D. M., Hunyor S. N., Györy A. Z. Randomised comparison of methyldopa and oxprenolol for treatment of hypertension in pregnancy. Br Med J. 1979 Jun 16;1(6178):1591–1594. doi: 10.1136/bmj.1.6178.1591. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gladstone G. R., Hordof A., Gersony W. M. Propranolol administration during pregnancy: effects on the fetus. J Pediatr. 1975 Jun;86(6):962–964. doi: 10.1016/s0022-3476(75)80236-8. [DOI] [PubMed] [Google Scholar]
- Habib A., McCarthy J. S. Effects on the neonate of propranolol administered during pregnancy. J Pediatr. 1977 Nov;91(5):808–811. doi: 10.1016/s0022-3476(77)81048-2. [DOI] [PubMed] [Google Scholar]
- Johnsson G., Regårdh C. G. Clinical pharmacokinetics of beta-adrenoreceptors blockers. Drugs. 1976;11(Suppl 1):111–121. doi: 10.2165/00003495-197600111-00026. [DOI] [PubMed] [Google Scholar]
- Lamming G. D., Symonds E. B. Use of labetalol and methyldopa in pregnancy-induced hypertension. Br J Clin Pharmacol. 1979;8(Suppl 2):217S–222S. [PMC free article] [PubMed] [Google Scholar]
- Langer A., Hung C. T., Mc A'nulty J. A., Harrigan J. T., Washington E. Adrenergic blockade. A new approach to hyperthyroidism during pregnancy. Obstet Gynecol. 1974 Aug;44(2):181–186. [PubMed] [Google Scholar]
- Lieberman B. A., Stirrat G. M., Cohen S. L., Beard R. W., Pinker G. D., Belsey E. The possible adverse effect of propranolol on the fetus in pregnancies complicated by severe hypertension. Br J Obstet Gynaecol. 1978 Sep;85(9):678–683. doi: 10.1111/j.1471-0528.1978.tb14946.x. [DOI] [PubMed] [Google Scholar]
- Lunell N. O., Persson B., Aragon G., Fredholm B. B., Aström H. Circulatory and metabolic effects of acute beta 1-blockade in severe pre-eclampsia. Acta Obstet Gynecol Scand. 1979;58(5):443–445. doi: 10.3109/00016347909154064. [DOI] [PubMed] [Google Scholar]
- Melander A., Niklasson B., Ingemarsson I., Liedholm H., Scherstén B., Sjöberg N. O. Transplacental passage of atenolol in man. Eur J Clin Pharmacol. 1978 Nov 16;14(2):93–94. doi: 10.1007/BF00607437. [DOI] [PubMed] [Google Scholar]
- Neil-Dwyer G., Bartlett J., McAinsh J., Cruickshank J. M. Beta-adrenoceptor blockers and the blood-brian barrier. Br J Clin Pharmacol. 1981 Jun;11(6):549–553. doi: 10.1111/j.1365-2125.1981.tb01169.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- O'Hare M. F., Russell C. J., Leahey W. J., Varma M. P., Murnaghan G. A., McDevitt D. G. Sotalol in the management of hypertension complicating pregnancy [proceedings]. Br J Clin Pharmacol. 1979 Oct;8(4):390P–391P. [PubMed] [Google Scholar]
- Pearson J. F., Weaver J. B. A six-point scoring system for antenatal cardiotocographs. Br J Obstet Gynaecol. 1978 May;85(5):321–327. doi: 10.1111/j.1471-0528.1978.tb14886.x. [DOI] [PubMed] [Google Scholar]
- Sandström B. Antihypertensive treatment with the adrenergic beta-receptor blocker metoprolol during pregnancy. Gynecol Invest. 1978;9(4):195–204. doi: 10.1159/000300984. [DOI] [PubMed] [Google Scholar]
- Scales B., Copsey P. B. The gas chromatographic determination of atenolol in biological samples. J Pharm Pharmacol. 1975 Jun;27(6):430–433. doi: 10.1111/j.2042-7158.1975.tb09473.x. [DOI] [PubMed] [Google Scholar]
- Truelove J. F., van Petten G. R., Willes R. F. Action of several -adrenoceptor blocking drugs in the pregnant sheep and foetus. Br J Pharmacol. 1973 Jan;47(1):161–171. doi: 10.1111/j.1476-5381.1973.tb08170.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Waal-Manning H. J., Bolli P. Cardioselective beta-blockade and renal function. Br Med J. 1979 Apr 21;1(6170):1082–1082. doi: 10.1136/bmj.1.6170.1082-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Webster J., Jeffers T. A., Galloway D. B., Petrie J. C., Barker N. P. Atenolol, methyldopa, and chlorthalidone in moderate hypertension. Br Med J. 1977 Jan 8;1(6053):76–78. doi: 10.1136/bmj.1.6053.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkinson R. Beta-blockers, blood sugar control, and renal function. Br Med J. 1979 Mar 3;1(6163):617–617. doi: 10.1136/bmj.1.6163.617-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zacharias F. J., Hayes P. J., Cruickshank J. M. Atenolol in hypertension: a double-blind comparison of the response to three different doses. Postgrad Med J. 1977;53 (Suppl 3):114–115. [PubMed] [Google Scholar]
