ARBs on the NCLEX
ARB class: -sartan ending, when to use over ACE inhibitor, hyperkalemia, pregnancy contraindication.
ARBs end in -sartan. Similar effects to ACE inhibitors but block at the receptor instead of the enzyme. The NCLEX often presents them as the swap for ACE inhibitor cough.
Common drugs
Losartan, valsartan, irbesartan, candesartan, telmisartan.
Action and use
Block angiotensin II at AT1 receptor → vasodilation + less aldosterone. Used for HTN, HF, diabetic nephropathy.
Side effects
Hyperkalemia. Dizziness/hypotension. Renal effects similar to ACE. No dry cough (advantage).
Contraindications
Pregnancy (same as ACE, teratogenic). Bilateral renal artery stenosis.
Teaching
Same as ACE except no cough warning. Avoid K+ supplements. Monitor BP and renal function.
Frequently asked
Why switch from ACE to ARB?
Persistent dry cough on ACE. Same therapeutic class, different receptor target.
Can I combine ACE + ARB?
Generally avoided, increased hyperkalemia and AKI risk without significant added benefit.
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