Medicine & USMLE

Angiotensin II Receptor Blockers (ARBs)

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Cardiovascular Drugs
  1. Beta Blockers
  2. ACE Inhibitors
  3. Angiotensin II Receptor Blockers (ARBs)
  4. Adenosine
  5. Atropine
  6. Amiodarone
  7. DHP Calcium Channel Blockers
  8. Non-DHP Calcium Channel Blockers
  9. Clonidine
  10. Clopidogrel
  11. Digoxin
  12. Dopamine
  13. Epinephrine
  14. Hydralazine
  15. Nitroglycerin
  16. Norepinephrine
  17. Statins

Summary

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Key Points

  • Angiotensin II Receptor Blockers (ARBs)
    • Key Drugs (-sartan endings)
      • Losartan
      • Valsartan
    • Mechanism
      • Prevents angiotensin II from binding to the AT1 receptors, which are responsible for vasoconstriction and the release of aldosterone
      • Since ARBs block these receptors, the result is vasodilation and inhibition of sodium/water reabsorption at the kidney
    • Clinical Use
      • Hypertension
        • Used in patients who can’t tolerate ACE inhibitors
      • Heart failure
      • Diabetic nephropathy
    • Side Effects and Adverse Reactions
      • Teratogenic
        • Causes renal and cardiac defects or death of the fetus
      • Hyperkalemia
        • Teach patient to avoid potassium supplements, potassium salt substitute, and potassium-sparing diuretics
      • Reduces GFR
        • Monitor for elevated creatinine, BUN and decreased urine output
        • Usually avoided in patients with acute renal failure (AKI)
      • Hypotension
        • Common side effect of all antihypertensives
        • Closely monitor patient’s blood pressure
        • Instruct patient to get up slowly to avoid dizziness associated with orthostatic hypotension
      • Hypoglycemia
      • Angioedema
        • Less common than with ACE inhibitors