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The representative medication in the group of angiotensin ii receptor blockers is losartan losartan is the prototype of arbs it belongs to the anti-hypertensive class losartan targets on the angiotensin ii type 1 receptors at smooth muscles in blood vessels and adrenal gland by binding on the receptors it antagonizes the effects of angiotensin ii leading to
Vasodilation and decreased level of aldosterone blood pressure is dropped cardiac preload and afterload are decreased clinically losartan is used when the patient cannot tolerate the adverse effects of previously prescribed ace inhibitors as said it is indicated for hypertension it is also indicated for heart failure clinical trial has shown that losartan can
Reduce stroke in patients with comorbid hypertension and heart failure another indication for losartan is type 2 diabetes with nephropathy as losartan decreases blood pressure hypotension especially first dose hypotension and orthostatic hypotension should be monitored hypotension can manifest as dizziness or headache nasal congestion and upper respiratory
Infection are common adverse effects diarrhea and heartburn are common gi irritation caused by losartan the musculoskeletal adverse effect of losartan is back pain unlike ace inhibitor an angiotensin ii receptor blocker does not affect kindness therefore angioedema and cough are rarely reported with losartan the major contraindications are pregnancy and
Breastfeeding losartan should be used with precaution if the patient has renal impairment or if the patient is using losartan with other therapy in combination for hypertension patient education is the focus of nursing care for the patients who use society patients should be taught to monitor and report adverse effects instruct the client to monitor blood
Pressure and heart rate regularly prevention of orthostatic hypotension by changing positions slowly and allowing transitional adaptation is important to keep patients safe let the patient know that the first dose hypotension should last a few days and it will disappear instruct the female patient to report pregnancy and or decide to breastfeed losartan is
Contra indicated during pregnancy and breastfeeding the physician will need to prescribe other antihypertensives for long-term management help the patient establish a medication list this medication list is very useful for preventing drug to drug or drug to food and drug to herb interactions we will briefly go over these interactions later although less
Likely losartan can still cause hyperkalemia therefore salt substitute or potassium-sparing diuretics are not a good idea as a medication that works on rest losartan can lead to fluid and electrolyte imbalance monitoring cbc electrolytes and renal function and urine analysis regularly is a good idea patients who use losartan are known to have cardiovascular
Issues they should be instructed to call if experiencing any symptoms of advanced cardiac distress four major drug-to-drug interactions that we should note about losartan are moleskering lithium nsaids and potassium-sparing diuretics as losartan can lead to hyperkalemia use potassium-sparing diuretics in combination is not recommended because this combination
Increases risk for hyperkalemia nsaids can decrease the antihypertensive effect of losartan when using lithium and losartan together patient is at risk for lithium toxicity a little scarring the active remnant inhibitor can add to risk for hypotension hyperkalemia and renal impairment in diabetic patients or those who have severe renal insufficiency it is
Not recommended to use both eliscarin and losartan for a diabetic patient when ma huang ephedra synagogue increases blood pressure and heart rate it can compromise the antihypertensive effect of losartan this herb is not to be used while the patient is on losartan patients should be taught to use salt substitute carefully to prevent hyperkalemia thank you
For spending time with me i look forward to seeing you in the next lecture you
Transcribed from video
ARB- Losartan By Apricad Courses of Nursing
