A patient with heart failure cannot take ACE inhibitors because of cough. What drugs can be used as an alternative to ACE inhibiters?
A) Calcium channel blockers
B) Loop diuretics
C) Anti-hypertensives
D) Angiotensin II receptor blockers
Ans: D
Feedback: Although the action of ARBs is different than that of ACE inhibitors, ARBs (eg, valsartan) have similar hemodynamic effects: decreased blood pressure, decreased systemic vascular resistance, and improved cardiac output. Whereas ACE inhibitors block the conversion of angiotensin I to angiotensin II, ARBs block the effects of angiotensin II at the angiotensin II receptor. ACE inhibitors and ARBs also have similar side effects: hyperkalemia, hypotension, and renal dysfunction. ARBs are prescribed as an alternative to ACE inhibitors, especially when patients cannot tolerate ACE inhibitors because of cough. Calcium channel blockers, loop diuretics, and anti-hypertensives are not drugs of choice when the patient cannot take ACE inhibitors.
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ANS:
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