Angiotensin II Receptor Blockers (ARBs)

Question 1

What is the action of Angiotensin II Receptor Blockers (ARBs)?

Answer 1

Blocks Angiotensin II from binding to the receptor on the smooth muscle; Prevents aldosterone release

Question 2

Angiotensin II Receptor Blockers drug names?

Hint: end in “sartan”

Answer 2

Candesartan
Irbesartan
Losartan
Olmesartan
Telmisartan
Valsartan

Question 3

What are the contraindications of ARBs?

Answer 3

Allergy
Pregnancy- black box warning (1st trimester Category C; 2nd & 3rd trimester Category D)
Effects on fetus Kidneys

Question 4

What are the cautions for ARBs?

Answer 4

Hepatic/Renal dysfunction (due to alterations in metabolism & excretion)
Hypovolemia (BP goes too low)

Question 5

What are the drug-drug interactions (DDI) for ARBs?

Answer 5

NSAIDs (↓ effect of ARB drugs)

other drugs affecting RAAS

Question 6

What are the indications (use for) of ARBs?

Answer 6

HTN
CHF
Diabetic nephropathy prevention

Question 7

What are the CNS adverse effects?

Answer 7

Headache, Dizziness, syncope, weakness

Question 8

What are the CV adverse effects?

Answer 8

Hypotension, Hyperkalemia, Renal damage (BP too low-not enough blood flow to kidney)

Question 9

What are the GI adverse effects?

Answer 9

Complaints nausea & vomiting, abdominal pain

Question 10

What are the Skin adverse effects?

Answer 10

Rash

Question 11

What are the nursing implications?

Answer 11

Impaired kidney function
Salt/volume depletion
Vitals & weight
Labs: renal fxn tests, electrolytes & pregnancy tests
Lifestyle changes
Use barrier contraceptives
↓ fluid volume, dehydration, vomiting & diarrhea
Response to drug