ARB's-ATI pharm

Question 1

What does ARB stand for

Answer 1

Angiotensin II Receptor Blockers

Question 2

ARB meds

Answer 2

Prototype=Losartan

• Valsartan
• Irbesartan
• Candesartan
• Olmesartan
• Telmisartan

Question 3

Expected pharmacological action

Answer 3

Block the action of angiotensin II in the body that results in
1-Vasodilation(arterioles & veins)
2-Excretion of sodium/water(by decreasing release of aldosterone)

Question 4

Therapeutic uses

Answer 4

1-Hypertension
2-Heart failure(valsartan/candesartan)
3-Stroke prevention(losartan)
4-Delay progression of diabetic nephropathy(irbesartan/losartan)
5-Protect against MI,stroke,death from cardiac causes in individuals unable to tolerate ACE inhibitors(telmisartan)
6-Reduce mortality following an acute myocardial infarction(valsartan)
7-Slow development of diabetic retinopathy(losartan)

Question 5

Complications

Answer 5

*major difference between ARB's and ACE inhibitors is that cough & hyperkalemia are not adverse effects of ARB's
1-Angioedema
2-Fetal injury 
3-Hypotension
4-Dizziness/lightheadedness

Question 6

Angioedema

Answer 6

1-advise pts to observe for manifestations(skin wheals,swelling of tongue/pharynx) and to notify provider immediately
2-treat serious effects w/ injection of epinephrine
3-discontinue med

Question 7

Fetal injury

Answer 7

1-advise women of risk during 2nd/3rd trimester of pregnancy

2-advise women of childbearing age to use contraception

Question 8

Hypotension

Answer 8

Monitor BP and advise clients to rise slowly from sitting

Question 9

Dizziness/lightheadedness

Answer 9

Instruct pts to avoid activities of alertness until effects are known

Question 10

Contraindications/Precautions

Answer 10

Pregnancy risk cat D-ARBs cause fetal damage in 2nd/3rd trimesters;discontinue as early in pregnancy as possible
-Contraindicated in pts who:
1-have renal stenosis when present bilaterally or in a single remaining kidney because of risk for kidney injury
-Use caution in pts who:
1-experienced angioedema w/ ACE inhibitor

Question 11

Interactions

Answer 11

1-Antihypertensive meds=can have an additive effect;adjust dosage of med if ACE inhibitors are added tx regimen
2-increased risk for lithium toxicity=monitor lithium levels & adjust dosage

Question 12

Nursing Administration

Answer 12

1-administer orally
2-advise pts meds are prescribed as a single formulation or in combo w/ hydrochlorothiazide
3-take w/ or w/o food
4-advise pts who have heart failure to monitor weight and edema