Chapter: Basic & Clinical Pharmacology : Antihypertensive Agents
Angiotensin Receptor-Blocking Agents
ANGIOTENSIN RECEPTOR-BLOCKING
AGENTS
Losartan and
valsartan were the first marketed blockers of theangiotensin II type 1 (AT1)
receptor. Candesartan,
eprosartan,irbesartan, telmisartan, and
olmesartan are also available. Theyhave no effect on bradykinin metabolism
and are therefore more selective blockers of angiotensin effects than ACE
inhibitors. They also have the potential for more complete inhibition of
angio-tensin action compared with ACE inhibitors because there are enzymes other
than ACE that are capable of generating angio-tensin II. Angiotensin receptor
blockers provide benefits similar to those of ACE inhibitors in patients with
heart failure and chronic kidney disease. Losartan’s pharmacokinetic parameters
are listed in Table 11–2. The adverse effects are similar to those described
for ACE inhibitors, including the hazard of use during pregnancy. Cough and
angioedema can occur but are less common with angiotensin receptor blockers
than with ACE inhibitors.
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