Atenolol Antacids

Calcium Acetate (PhosLo) [Calcium Supplement/ Anti arrhythmic/Mmeral/ Electrolyte] Uses ESRD-associated hyper-phos-phatemia Action Ca " supl w/o aluminum to X P04 absorption Dose 2-4 tabs PO w/ meals Caution [C, ] Contra t Ca Disp Gelcap SE Can t Ca, hypophosphatemia, constipation Interactions t Effects OF quinidine X effects W/ large intake of dietary fiber, spinach, rhubarb X effects OF atenolol, CCB, etidronate, tetracyclines, fluoroquinolones, phenytoin, Fe salts, thyroid hormones EMS Pts have reduced renal Fxn, monitor ECG for signs of electrolyte disturbances OD S/Sxs of hypercalcemia (confusion, weakness, GI upset, constipation, N, V, and cardiac arrhythmias) give IV fluid for diuresis symptomatic and supportive Calcium Carbonate (TumS/ Alka Mints) [Antacid/ Calcium Supplement/Mineral/ Electrolyte] [OTC] Uses Hyperacidity associated w/ peptic ulcer Dz, hiatal hernia, etc Action Neutralizes gastric acid Dose 500 mg—2 g PO PRN -1- in renal impair Caution [C, ] Disp Chew tabs, susp SE t -1- PO constipation Interactions X Effect OF tetracyclines, fluo-... 

Dicyclomine (Bentyl) [Anrimuscarinic, GI Anrispasmodic/ Anticholinergic] Uses Functional IBS Action Smooth-muscle relaxant Dose Adults. 20 mg PO qid T to 160 mg/d max or 20 mg EM q6h, 80 mg/d - qid then T to 160 mg/d, max 2 wk Feds. Infants >6 mo 5mg/dose tid-qid Children 10 mg/dose tid-qid Caution [B, -] Contra Infants <6 mo, NAG, MyG, severe UC, BOO Disp Caps, tabs, syrup, inj SE Anticholinergic SEs may limit dose Interactions T Anticholinergic effects W/ anticholinergics, antihistamines, amantadine, MAOIs, TCAs, phenothiazides T effects OF atenolol, digoxin X effects H7 antacids X effects OF haloperidol, ketoconazole, levodopa, phenothiazines EMS Avoid procainamide usage, may T adverse effects may T effects of digoxin, monitor... 

BETA-BLOCKERS ANTACIDS CONTAINING MAGNESIUM AND ALUMINIUM t bioavailability of metoprolol and 1 bioavailability of atenolol, which may produce mild variation in the response to metoprolol and atenolol Variations in absorption of the respective beta-blockers Clinical significance may be minimal but be aware monitor BP at least weekly until stable when initiating antacid therapy. Warn patients to report symptoms of hypotension (light-headedness, dizziness on standing, etc.)... 

Some antacids and antidiarrhoeals may cause a modest reduction in the absorption of atenolol, indenolol, propranolol, or sotalol, and possibly a slight increase in the absorption of metoprolol. However, the clinical importance of these interactions is probably minimal. 

Another study in 6 healthy subjects found that 30 mL oiNovalucolforte (an aluminium/magnesium-containing antacid) reduced the peak plasma level and AUC of a single 100-mg dose of atenolol by 37% and 33%, respectively, which was considered to be of possible significance in some patients. ... 

RegSrdh CG, Lundbo P, Persson B A The effect of antacid, metoclq>ramide and propantheline on die bioavailability of metoprolol and atenolol. Biopharm Drug Dispos (1981) 2,79-87. 

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