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Cardiovascular Drugs

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Angiotensin II Receptor Blockers (ARBs)

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Summary

Angiotensin II Receptor Blockers (ARBs) are a class of medications that end in -sartan, including valsartan, candesartan, and losartan. These medications are used to treat hypertension and heart failure, especially in patients who cannot tolerate the side effects of ACE inhibitors. Side effects to note include hypotension and hyperkalemia. ARBs are teratogenic and should not be used during pregnancy.

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