Paper I
2018 July (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Losartan

Q53 marksShort Notes

Answer

Losartan is an angiotensin II receptor blocker (ARB).

Mechanism of action

  • Selectively and competitively blocks AT1 receptors, preventing the vasoconstrictive and aldosterone-secreting effects of angiotensin II
  • Unlike ACE inhibitors, does not affect bradykinin metabolism — hence no cough

Uses

  • Hypertension
  • Diabetic nephropathy (renoprotective)
  • Heart failure (in ACE inhibitor-intolerant patients)
  • Used as an alternative in patients who develop ACE inhibitor-induced cough

Adverse effects

  • Hyperkalaemia
  • Hypotension
  • Teratogenic — contraindicated in pregnancy
  • Angioedema (rare, less common than with ACE inhibitors)
  • No significant cough (main advantage over ACE inhibitors)

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