A patient has been started on losartan (Cozaar), an angiotensin II–receptor blocker (ARB), for hypertension. After 6 weeks of therapy, it is decided that the losartan alone is not controlling the patient's hypertension
What does the nurse anticipate will be added to the losartan regimen for better control of this patient's hypertension? A) Candesartan (Atacand)
B) Hydrochlorothiazide (Hyzaar)
C) Captopril (Capoten)
D) Antidiuretic hormone (ADH)
B
Feedback:
When losartan therapy is started, maximal effects on blood pressure usually occur within 3 to 6 weeks. If losartan alone does not control blood pressure, a low dose of a diuretic may be added. A combination product of losartan and hydrochlorothiazide (Hyzaar) is available. Adding a second ARB such as candesartan or captopril would risk causing toxic adverse effects. ADH causes retention of water in the nephrons, which would further increase blood pressure.
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