PENDIDIKAN PESAKIT Kementerian Kesihatan Malaysia
Indication
Antihypertensive
Dose
Dose are individualized depending on the patient condition. Please consult your doctor or pharmacist for the suggestion of treatment for your hypertension. Once you started your hypertension medication, take the medication regularly and accordingly.
Administration
Generally, it is advisable to be taken after meals to reduce stomach discomfort. Otherwise, refer product insert for specific instruction:
| Generic Name | Administration |
|
Losartan
|
With or without meals. |
|
Valsartan
|
With or without meals |
| Irbesartan
|
With or without meals. |
| Telmisartan | With or without food |
Mechanism Of Action
ARBs have the following actions, which are very similar to ACE inhibitors:
- Dilate arteries and veins and thereby reduce arterial pressure and preload (end- diastolic volume (EDV) at the beginning of systole / before contraction) and afterload (The tension produced by the heart muscle after contraction) on the heart.
- Down regulate sympathetic adrenergic activity by blocking the effects of angiotensin II (a substrate use to constrict the blood vessels / vasoconstrictor) on sympathetic nerve release and reuptake of norepinephrine (hormone or neurotransmitter that is used medically to constrict blood vessels and to stop bleeding).
- Promote renal excretion of sodium and water (natriuretic and diuretic effects) by blocking the effects of angiotensin II in the kidney and by blocking angiotensin II stimulation of aldosterone ( a steroid hormone that promotes the retention of sodium and therefore raises the blood pressure) secretion.
- Inhibit cardiac and vascular remodeling associated with chronic hypertension, heart failure, and myocardial infarction (some region of the heart is obstructed and necrosis).
Side Effects
Side effects for each drugs are individualized. Most common side effects for each drugs are listed below :
| Generic Name | Possible Common side effects include |
| Losartan | Abdominal pain, fatigue, chest pain, oedema (swollen due to fluid retention), palpitation, hypotension, musculoskeletal pain, headache, vertigo (feeling of imbalance) |
| Valsartan | Dizziness, hypotension, headache |
| Irbesartan | Dizziness, nausea, vomiting, fatigue, orthostatic hypotension (abnormal decrease in blood pressure when a person stands up), musculoskeletal pain |
| Telmisartan | Insomnia (sleep disturbance), hypotension, abdominal pain, dry mouth, flatulence, musculoskeletal pain, vertigo |
Consult your doctors or pharmacists if you are facing any side effects from the antihypertensive drugs that you are taking.
Storage
Advisable to be keep in the original envelopes with instructions on how to take clearly stated on labels. Keep at room temperature otherwise, refer product insert for specific temperature storage.
For further information, refer MyHealth web site ‘Cara Penyimpanan Ubat Yang Betul’.
References
- Mechanism of Action of Angiotensin Converting Enzyme http://www.cvpharmacology.com/Acilliary/search
- http://pharmacologycorner.com/mechanism-of-action-video
- British National Formulary (BNF) 61 March 2011
- MIMS 128th Edition 2012
- ‘Cara Penyimpanan Ubat Yang Betul’ (http://www.myhealth.gov.my/v2/index.php/my/ubat-a-anda/umum/cara-penyimpanan-ubat-yang-betul)
- Mechanism of Action of Angiotensin Antagonist Blocker http://www.cvpharmacology.com/Acilliary/search
| Last Reviewed | : | 2 March 2016 |
| Writer | : | Azura Binti Musa |
| Translator | : | Azura Binti Musa |
| Accreditor | : | Dr. Ainol Shareha Binti Sahar |
