ARB

Question 1

ARB indication

Answer 1

When ACE not tolerated due to cough for hypertension, chronic heart failure, ischaemic heart disease, CKD with proteinuria and diabetic nephropathy

Question 2

ARB MOA

Answer 2

Similar to ACE but block angiotensin II on AT1 receptor rather than 1 to 2 . Angiotensin 2 is a vasoconstrictor that stimulates aldosterone secretion so blocking its action reduces peripheral vascular resistance which lowers blood pressure and dilates efferent glomerular arteriole which reduces intraglomerular pressure thus slowing CKD progression, reducing aldosterone promotes sodium and water excretion helping with heart failure

Question 3

ARB adverse effects

Answer 3

hypotension especially after first dose, hyperkalaemia and renal failure less dry cough that ACEi because they do not affect bradykinin so also less likely to cause angioedema

Question 4

Losartan heart failure dose

Answer 4

12.5mg daily

Question 5

Losartan dose except heart failure

Answer 5

50mg

Question 6

How and when to take doses

Answer 6

first dose should be taken before bed to avoid hypotension

Question 7

ARB interactions

Answer 7

pharmacodynamic with other potassium increasing drugs like potassium sparing diuretics and avoid use with NSAIDs due to renal failure risk