RN Nursing · Medications Affecting the Cardiovascular System
Angiotensin II Receptor Blockers (ARBs): Nursing Study Guide
A focused review of ARBs covering common drugs, indications, mechanism, side effects, monitoring, and key nursing safety considerations for exam prep.
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Angiotensin II Receptor Blockers (ARBs) are a core antihypertensive drug class that nursing students must master. This guide reviews the key drugs, mechanism, indications, adverse effects, and safety priorities — including the important distinctions from ACE inhibitors.
Drug Identification
| Drug | Class |
|---|---|
| Losartan | ARB |
| Valsartan | ARB |
| Candesartan | ARB |
| Irbesartan | ARB |
Mnemonic: ARBs end in -sartan.
Indications
- Hypertension
- Heart failure
- Post-myocardial infarction
- Diabetic nephropathy
- ACE inhibitor intolerance (especially due to cough)
Mechanism of Action
- Block angiotensin II receptors
- Cause vasodilation
- Decrease aldosterone secretion
- Result: lower blood pressure and reduced fluid retention
Common Side Effects
| Side Effect | Why It Matters |
|---|---|
| Hypotension | First-dose effect |
| Hyperkalemia | Due to decreased aldosterone |
| Dizziness | Fall risk |
Key difference from ACE inhibitors: ARBs do not cause a dry cough.
Adverse Effects
- Angioedema (rare but life-threatening)
- Severe hypotension
- Acute kidney injury
Labs to Monitor
| Lab | Reason |
|---|---|
| Potassium | Risk of hyperkalemia |
| Creatinine | Renal function |
| BUN | Renal perfusion |
Nursing Safety Rules
- Check blood pressure before administration
- Hold the medication if the patient is hypotensive
- Monitor potassium and renal labs
- Contraindicated in pregnancy
- Teach the patient to report facial or tongue swelling immediately
Common Exam Traps
- Assuming ARBs cause a dry cough (they do not)
- Administering during pregnancy
- Ignoring elevated potassium levels
- Confusing ACE inhibitors with ARBs
- Missing early signs of angioedema
Key takeaways
- ARBs end in -sartan and work by blocking angiotensin II receptors.
- They lower blood pressure and provide renal protection, especially in diabetic nephropathy.
- Unlike ACE inhibitors, ARBs do not cause a dry cough.
- Monitor for hyperkalemia and watch renal labs (creatinine, BUN).
- Angioedema is a medical emergency — teach patients to report facial/tongue swelling.
- Never administer during pregnancy.
Test yourself on Antihypertensive Medications
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