diuretics 4

Question 1

AT-1 blocker (ARB) drugs

Answer 1

• sartan
  1. Valsartan
  2. Valsartan-HCTZ
  3. Losartan
  4. Olmesartan
  5. Losartan-HCTZ
  6. Irbesartan
  7. Olmesartan-HCTZ

Question 2

ARB mechanism of action in HF

Answer 2

1. Selective inhibition of Angiotensin II receptor AT1

2. Similar to ACEIs, ARBs prevent remodeling and reduce sympathetic activity

Question 3

ARB Advantage vs ACEIs

Answer 3

1. More complete inhibition of Ang II since alternative pathways to form Ang II are NOT blocked by ACEIs
2. No side effects mediated by increased bradykinin levels, lead to cough, angioedema

Question 4

ARB disadvantage vs ACEIs

Answer 4

1. Loss of increased BK vasodilation seen with ACEIs

2. Only Ang II actions at AT-1 receptors are blocked - uncertain role of AT-2 receptors in CV disease

Question 5

ARB absorption

Answer 5

oral

once daily dosing (except losartan, which is twice daily)

Question 6

ARB decreased losartan dose needed in

Answer 6

hepatic dysfunction

Question 7

ARB side effects

Answer 7

1. similar to ACEI
2. contraindicated in pregnancy
3. no angioedema or cough
   (those are thought to be bradykinin-mediated)