Atenolol

Reactions 1490, p9-10 - 1 Mar 2014 Atenolol Hepatotoxicity: 2 case reports Two patients developed hepatotoxicity while receiving atenolol. A 55-year-old man, who had been diagnosed with both systolic and diastolic hypertension for the previous 1.5 years, received amlodipine, and later, levamlodipine, before switching to oral atenolol 50mg once daily. After receiving atenolol for 8 months, he presented with a 7-day history of gradually progressing nausea, vomiting, malaise, anorexia, fatigue, upper abdominal discomfort and jaundice. His skin was yellowish with scleral icterus, and his abdomen was soft, but diffusely tender. Tests showed an AST level of 555 U/L and an ALT level of 460 U/L. Atenolol was withdrawn. Subsequently, his symptoms completely resolved, and transaminase levels normalised. A 52-year-old woman, with a history of hypothyroidism and type 2 diabetes mellitus, presented to an emergency department with a 1-week history of crampy, mid-epigastric abdominal pain, non-bloody diarrhoea and gradually developing jaundice. She also had fever, anorexia, nausea and vomiting, and profound fatigue for the previous 1 week. Three weeks before presentation, she had been diagnosed with moderate systolic plus diastolic hypertension, and started oral tablets of atenolol 100mg once daily. Upon examination, she had marked icterus, and tests showed an AST level of 453 U/L and an ALT level of 358 U/L. Atenolol was withdrawn. Subsequently, her symptoms completely resolved, and transaminase levels normalised. Author comment: "The CIOMS/RUCAM scale indicated a ’probable’ relationship between atenolol therapy and hepatotoxicities." Mondal S, et al. Hepatotoxicity of atenolol therapy - A report of 2 cases. Journal of Acute Disease 2: 246-249, No. 3, 2013. Available from: URL: http:// doi.org/10.1016/S2221-6189%2813%2960137-7 - India 803099808 1 Reactions 1 Mar 2014 No. 1490 0114-9954/14/1490-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved

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Transcript of Atenolol

Reactions 1490, p9-10 - 1 Mar 2014

Atenolol

Hepatotoxicity: 2 case reportsTwo patients developed hepatotoxicity while receiving

atenolol.A 55-year-old man, who had been diagnosed with both

systolic and diastolic hypertension for the previous 1.5 years,received amlodipine, and later, levamlodipine, beforeswitching to oral atenolol 50mg once daily. After receivingatenolol for 8 months, he presented with a 7-day history ofgradually progressing nausea, vomiting, malaise, anorexia,fatigue, upper abdominal discomfort and jaundice. His skinwas yellowish with scleral icterus, and his abdomen was soft,but diffusely tender. Tests showed an AST level of 555 U/L andan ALT level of 460 U/L. Atenolol was withdrawn.Subsequently, his symptoms completely resolved, andtransaminase levels normalised.

A 52-year-old woman, with a history of hypothyroidism andtype 2 diabetes mellitus, presented to an emergencydepartment with a 1-week history of crampy, mid-epigastricabdominal pain, non-bloody diarrhoea and graduallydeveloping jaundice. She also had fever, anorexia, nausea andvomiting, and profound fatigue for the previous 1 week. Threeweeks before presentation, she had been diagnosed withmoderate systolic plus diastolic hypertension, and started oraltablets of atenolol 100mg once daily. Upon examination, shehad marked icterus, and tests showed an AST level of 453 U/Land an ALT level of 358 U/L. Atenolol was withdrawn.Subsequently, her symptoms completely resolved, andtransaminase levels normalised.

Author comment: "The CIOMS/RUCAM scale indicated a’probable’ relationship between atenolol therapy andhepatotoxicities."Mondal S, et al. Hepatotoxicity of atenolol therapy - A report of 2 cases. Journalof Acute Disease 2: 246-249, No. 3, 2013. Available from: URL: http://doi.org/10.1016/S2221-6189%2813%2960137-7 - India 803099808