Angiotensin II Receptor Blockers (ARBs)

Angiotensin II Receptor Blockers prevent angiotensin II from binding to its receptors, having similar effects to ACE Inhibitors including vasodilation, prevention of kidney failure, and improving heart failure. ARBs are often used in patients who don't tolerate ACE inhibitors.

There are 7 ARBs:

Candesartan.....Atacand

Losartan.......... Cozaar

Olmesartan......Benicar

Valsartan..........Diovan

Talmisartan.....Micardis

Irbesartan........Avapro

Eprosartan.......Teveten

They are believed to be just as effective as ACE Inhibitors, and have similar side effects except cough is far less common.

The ARBs were developed to overcome several of the deficiencies of ACE inhibitors: competitive inhibition of ACE results in a reactive increase in renin and angiotensin I levels, which may overcome the blockade effect; ACE is a relatively nonspecific enzyme that has substrates in addition to angiotensin I, including bradykinin and other tachykinins, and thus, inhibition of ACE may result in accumulation of these substrates; production of angiotensin II can occur through non-ACE pathways as well as through the primary ACE pathway, and these alternative pathways are unaffected by ACE inhibition; specific adverse effects are associated with ACE inhibitor effects on the enzyme; and ARBs may offer more complete angiotensin II inhibition by interacting selectively with the receptor site (from here)

All about ACE Inhibitors

Angiotensin-Converting Enzyme inhibitors are commonly used to treat high blood pressure. The generic names end in -pril (Lisinopril, Captopril, Fosinopril)

They work primarily by lowering arteriolar resistance and increasing excretion of sodium.

They can also be used for Diabetes patients to prevent kidney disease (as research shows a correlation between ACE Inhibitor use and decreased progression of diabetic nephropathy- aside from the antihypertensive effect), and prophylactically with migraine patients (perhaps through stabilizing blood vessels and altering sympathetic activity according to Pharmacist's Letter).

Most common adverse reactions include cough and hyperkalemia. "ACE Inhibitor cough is thought to be linked to the suppression of ACE" according to this article. Hyperkalemia secondary to decreased potassium excretion can result since aldosterone acts to increase excretion of potassium, and decreased angiotensin II leads to decreased aldosterone levels. Other problems can include dizziness, rash, headaches, sleep problems.



next up:
Beta Blockers
Renin blockers
Angiotensin Receptor Blockers
other ways of making Angiotensin II without ACE
schleroderma

Renin-Angiotensin-Aldosterone System

eAG (estimated Average Glucose)

HbA1C is also called the glycolated hemoglobin test. It measures the amount of hemoglobin that has glucose attached to it as a percentage of total hemoglobin. It measures glucose control over the past 2-3 months.

Accuchecks measure the amount of glucose in the blood in milligrams per deciliter, at a particular moment in time.

New research has made it possible to calculate the Estimated Average Glucose based on A1C results. Both the A1C and the eAG indicate how well a patient is controlling blood glucose over time, the the eAG is in the same units they are used to seeing on their meter, which researchers hope will help patients better monitor their glucose management.