Angiotensin Receptor Blockers Flashcards
Give 4 examples of ARBs
- Candesartan
- Irbesartan
- Losartan
- Valsartan
What is the mechanism of action of ARBs?
Block action of angiotensin II on the AT1 receptor
What does blocking the action of angiotensin 2 do?
Angiotensin 2 is a potent vasoconstrictor, hence blocking its action allows blood vessels to relax and dilate
How are ARBs administered?
Orally
What are the indications for ARBs?
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
Why are ARBs useful when ACEi’s are not tolerated?
Because they do not cause dry cough
What should be done when ARBs are used in renal impairment?
Use lower doses
What are the cautions and contraindications to ARBs?
Same as ACEi, and some ARBs are contraindicated in severe hepatic impairment
What mnemonic can be used to remember the contraindications/cautions for ARBs and ACEi?
PARK
P - pregnancy
A - allergy
R - renal artery stenosis
K - K elevated (hyperkalaemia)
What drugs can ARBs interact with?
Same as ACEi
What monitoring should be done with ARBs?
U&Es before and 1-2 weeks after starting treatment
What is a common side effect of ARBs?
1st dose hypotension
What are the less common side effects of ARBs?
- Hyperkalaemia
- Renal impairment
- Angioedema
What needs to be talked about in patient counselling when starting ARBs?
- Side effects
- NSAIDs
- Pregnancy
What needs to be talked about regarding NSAIDs in ARB counselling?
NSAIDs should not be used with this drug
