Angiotensin Receptor Blockers Flashcards

1
Q

Give 4 examples of ARBs

A
  • Candesartan
  • Irbesartan
  • Losartan
  • Valsartan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism of action of ARBs?

A

Block action of angiotensin II on the AT1 receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does blocking the action of angiotensin 2 do?

A

Angiotensin 2 is a potent vasoconstrictor, hence blocking its action allows blood vessels to relax and dilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are ARBs administered?

A

Orally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the indications for ARBs?

A

Same as ACEi, it is 2nd line if ACEi are not tolerated, so;

  • Hypertension
  • Chronic heart failure
  • Ischaemic heart disease and post-MI
  • Diabetic nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why are ARBs useful when ACEi’s are not tolerated?

A

Because they do not cause dry cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should be done when ARBs are used in renal impairment?

A

Use lower doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the cautions and contraindications to ARBs?

A

Same as ACEi, and some ARBs are contraindicated in severe hepatic impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What mnemonic can be used to remember the contraindications/cautions for ARBs and ACEi?

A

PARK

P - pregnancy
A - allergy
R - renal artery stenosis
K - K elevated (hyperkalaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drugs can ARBs interact with?

A

Same as ACEi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What monitoring should be done with ARBs?

A

U&Es before and 1-2 weeks after starting treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a common side effect of ARBs?

A

1st dose hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the less common side effects of ARBs?

A
  • Hyperkalaemia
  • Renal impairment
  • Angioedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What needs to be talked about in patient counselling when starting ARBs?

A
  • Side effects
  • NSAIDs
  • Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What needs to be talked about regarding NSAIDs in ARB counselling?

A

NSAIDs should not be used with this drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What needs to be explained regarding side effects in ARBs?

A

They do not cause dry cough, but may cause dizziness and hyperkalaemia

17
Q

Why do ARBs not cause dry cough?

A

Because unlike ACEis, they do not influence the metabolism of bradykinins (ACEis prevent metabolism of bradykinins)

18
Q

What needs to be explained regarding pregnancy with ARBs?

A

If the patient becomes pregnant, the ARB must be stopped immediately (preferably within 2 working days of notification of pregnancy) and alternatives offered

19
Q

Why should ARBs be stopped in pregnancy?

A

They are teratogenic, damaging fetal renal function and BP control

20
Q

What needs to be explained regarding side effects in ARBs?

A

They do not cause dry cough, but may cause dizziness and hyperkalaemia

21
Q

Why do ARBs not cause dry cough?

A

Because unlike ACEis, they do not influence the metabolism of bradykinins (ACEis prevent metabolism of bradykinins)

22
Q

What needs to be explained regarding pregnancy with ARBs?

A

If the patient becomes pregnant, the ARB must be stopped immediately (preferably within 2 working days of notification of pregnancy) and alternatives offered

23
Q

Why should ARBs be stopped in pregnancy?

A

They are teratogenic, damaging fetal renal function and BP control