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Pharmacology · patient case question

What is the mechanism of action of atenolol?

Patient case: Antihypertensive Review & Gingival Enlargement

demo: 60-year-old male

chief: “My gums have been growing over my front teeth.”

history: Hypertension, benign prostatic hyperplasia, angina.

meds: Nifedipine, prazosin, terazosin, atenolol

findings: Generalized fibrotic enlargement of the interdental papillae, most marked in the anterior maxilla. Plaque index moderate. No bone loss on bitewings.

  1. Non-selective beta-1 and beta-2 antagonist
  2. Selective beta-1 adrenergic antagonist that reduces heart rate and cardiac output
  3. Alpha-2 agonist acting centrally
  4. Alpha-1 adrenergic antagonist
Show answer and explanation

Correct answer: B. Selective beta-1 adrenergic antagonist that reduces heart rate and cardiac output

  • A. Non-selective blockade describes propranolol, which is why propranolol is avoided in asthma and limits epinephrine dosing more sharply.
  • B. Correct. Atenolol is cardioselective (beta-1), which lowers heart rate and cardiac output while largely sparing bronchial beta-2 receptors.
  • C. Central alpha-2 agonism describes clonidine and methyldopa.
  • D. Alpha-1 antagonism describes prazosin, doxazosin, and terazosin.

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