Sartans

Question 1

Sartans are also known as?

Answer 1

ARBs. Angiotensin II receptor blockers

Question 2

Explain the MOA of Sartans

Answer 2

A competitive antagonist to type 1 angiotensin receptors. Prevents the angiotensin II mediated vasoconstriction and aldosterone release

Question 3

Use of Sartans in renal impairment?

Answer 3

Can worsen renal impairment, especially when in combination with NSAIDs

Question 4

Why should you start elderly patients on a lower dose of Sartans?

Answer 4

They are predisposed to first dose hypotension, hyperkalaemia and renal impairment. Close monitoring of renal function is required

Question 5

Use of Sartans in pregnancy?

Answer 5

Contraindicated. Can be teratogenic. Not enough evidence

Question 6

Monitoring required on Sartans?

Answer 6

Check renal function and electrolyte levels before starting and 1-2 weeks after.

Question 7

Common ADRs of Sartans?

Answer 7

Dizziness, headache

Question 8

Less common, but severe ADRs of Sartans?

Answer 8

First dose hypotension, orthostatic hypotension, hyperkalaemia

Question 9

What supplements / medications do you need to stop when starting a SARTAN or ACE-I?

Answer 9

Potassium supplements and potassium sparing diuretics and review use of NSAIDs

Question 10

Other than hypertension, what is an indication for irbesartan use?

Answer 10

Reduction of renal disease progression in diabetic patients

Question 11

Starting dose for irbesartan?

Answer 11

150mg daily

Question 12

Maximum dose for irbesartan?

Answer 12

300mg daily

Question 13

Reasons for dose reduction of Sartans?

Answer 13

Elderly, renal impairment

Question 14

Why use a sartan over an ACE-I?

Answer 14

If ace-i are not tolerated due to cough