Lippincotts Drugs to Know for the NCLEX

Angiotensin II receptor blockers
irbesartan
losartan potassium
olmesartan medoxomil
valsartan
INDICATIONS
Hypertension; nephropathy in type 2 diabetics (losartan and irbesartan); heart failure (valsartan);
hypertension with left ventricular hypertrophy (losartan)
ACTION
ARBs act by interfering with the RAAS. They selectively block the binding of angiotensin II to the
angiotensin II receptor. This prevents vasoconstricting and aldosterone-secreting effects of
angiotensin II (a potent vasoconstrictor), resulting in a blood pressure decrease.
ADVERSE REACTIONS
ARBs commonly cause orthostatic changes in heart rate, headache, hypotension, nausea, and
vomiting.
CONTRAINDICATIONS AND CAUTIONS
Contraindicated in patients hypersensitive to these drugs and in those with hypotension.
Use cautiously in patients with hepatic or renal dysfunction.
In pregnant women, use cautiously when potential benefits to the mother outweigh risks to the fetus.
Check each drug because some are safe only in the first trimester. In breast-feeding women, use
cautiously; some ARBs appear in breast milk. Elderly patients are more susceptible to adverse
reactions and may need lower maintenance doses; monitor these patients closely.
May increase the risk of cancer; however, the benefits continue to outweigh the risk.