In this quick nursing review, we’ll cover Angiotensin Receptor Neprilysin Inhibitors (ARNIs), a key class of medications used in managing heart failure.
What Are ARNIs?
ARNIs are a combination drug that includes sacubitril and valsartan, marketed under the brand name Entresto. This medication is primarily used to treat heart failure with reduced ejection fraction (HFrEF).
How ARNIs Work
ARNIs work by inhibiting angiotensin II and neprilysin, which prevents the breakdown of ANP and BNP, which are types of natriuretic peptides. By doing this, ARNIs promote:
- Vasodilation
- Diuresis
These effects help improve symptoms in patients with heart failure.
Side Effects of ARNIs
Common side effects include:
- Hypotension
- High potassium levels
- Angioedema
- Renal insufficiency
- Cough
- Dizziness
Nursing Considerations for Angiotensin Receptor Neprilysin Inhibitors (ARNIs)
When administering ARNIs, nurses should:
- Avoid combining with ACE inhibitors! Do not give ACE inhibitors within 36 hours before or after an ARNI.
- Monitor electrolytes (especially potassium).
- Assess renal function by checking BUN and creatinine levels.
- Check blood pressure and heart rate regularly.
- Monitor intake and output and daily weights.
- Assess for swelling and signs of worsening heart failure, including:
- Crackles in the lungs
- Productive cough
- Chest pain
- Rapid weight gain
- Difficulty breathing
You may be interested in: ARNIs NCLEX-Style Practice Questions
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References:
Kizior, R. J., & Hodgson, K. (2023). Saunders nursing drug handbook (12th ed., p.1041). Elsevier. ISBN 9780323930765
U.S. Food and Drug Administration. (2021, February). Entresto® (sacubitril/valsartan) tablets, for oral use: Highlights of prescribing information (FDA label 207620s018). https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/207620s018lbl.pdf