| Trade Name(s): |
Sectral
Capsules
200 mg
Capsules
400 mg
Apo-Acebutolol
Monitan
Novo-Acebutolol
Nu-Acebutolol
Rhotral
Indicates Canadian Trade Name.
|
| Class: |
Beta-adrenergic blocker
|
 Action: |
Blocks beta-receptors, primarily affecting heart (slows rate), vascular musculature (decreases BP), and lungs (reduces function).
|
 Indications: |
Management of hypertension and premature ventricular contractions.
|
 Contraindications: |
Hypersensitivity to beta-blockers; persistently severe bradycardia;
greater than first-degree heart block; CHF, unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; sinus bradycardia; cardiogenic shock.
|
 Route/Dosage: |
Hypertension
Adults:
PO
400 mg qd initially in single or divided doses; usual response range is 200 to 1200 mg/day.
Ventricular Arrhythmia
Adults:
PO
400 mg (200 mg bid); may be titrated up to 1200 mg qd.
|
 Interactions: |
Clonidine:
May enhance or reverse acebutolol's antihypertensive effect; potentially life-threatening situations may occur, especially on withdrawal.
NSAIDs:
Some agents may impair antihypertensive effect.
Prazosin:
May cause increase in orthostatic hypotension.
Verapamil:
Effects of both drugs may be increased.
|
 Lab Test Interferences: |
Antinuclear antibodies may develop; usually reversible on discontinuation. Acebutolol may interfere with glucose or insulin tolerance tests. May cause changes in serum lipids.
|
 Adverse Reactions: |
cardiovascular:
Hypotension; bradycardia; CHF; cold extremities; heart block.
cns:
Insomnia; fatigue; dizziness; depression; lethargy; drowsiness; forgetfulness.
dermatologic:
Rash; hives; fever; alopecia.
eent:
Dry eyes; blurred vision; tinnitus; slurred speech; sore throat.
gi:
Nausea; vomiting; diarrhea; dry mouth.
gu:
Impotence; painful, difficult or frequent urination.
hematologic:
Agranulocytosis; thrombocytopenia purpura.
respiratory:
Bronchospasm; dyspnea; wheezing.
other:
Weight changes; facial swelling; muscle weakness.
|
 Precautions: |
Pregnancy:
Category B.
Lactation:
Excreted in breast milk.
Children:
Safety and efficacy not established.
Abrupt withdrawal:
Abrupt withdrawal is associated with adverse effects; gradually decrease dose over 1 to 2 wk.
Anaphylaxis:
Serious reactions may occur; aggressive therapy may be required.
CHF:
Administer cautiously in patients taking digitalis and diuretics for CHF.
Diabetes:
Acebutolol may mask signs of hypoglycemia (eg, tachycardia, BP changes). May potentiate insulin-induced hypoglycemia.
Nonallergic bronchospasm (eg, chronic bronchitis, emphysema):
In general, do not give beta blockers to patients with bronchospastic disease.
Peripheral vascular disease:
Acebutolol may precipitate or aggravate symptoms of arterial insufficiency.
Renal/hepatic function impairment:
Reduction in daily dose is advised.
Thyrotoxicosis:
Acebutolol may mask clinical signs of developing or continuing hyperthyroidism
(eg, tachycardia). Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm.
|
 Administration/Storage: |
Before giving initial dose, take patient's pulse. If pulse is < 60 bpm, do not administer medication; notify health care provider.
During initial phase of therapy, continue taking patient's pulse before administering each dose. After initial phase, take pulse before first dose of day and measure BP twice weekly.
Store at room temperature.
|
 Assessment/Interventions: |
Obtain patient history, including drug history and any known allergies.
Monitor serum lipid levels and thyroid function.
Assess for signs of CHF (eg, shortness of breath, edema, decreased output) or respiratory involvement (eg, dyspnea, cough); if present, withhold drug and notify health care provider.
|
 Patient/Family Education: |
Teach patient to take pulse every day and record. If < 60 bpm, tell not to take medication and to notify health care provider.
Instruct diabetic patients to monitor blood sugar level q 6 hr. Drug may mask symptoms of hypoglycemia.
Caution patient not to stop taking drug suddenly because doing so may exacerbate angina and increase possibility of MI.
Explain that drug may cause dizziness. Advise patient to avoid sudden position changes to prevent orthostatic hypotension.
Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
Instruct patient not to take any
otc
medications without consulting health care provider.
|
