Aldosterone antagonist

Question 1

What is it indicated for?

Answer 1

Ascites
Oedema due to liver cirrhosis
Chronic heart failure
Primary hyperaldosteronism

Question 2

How does it work?

Answer 2

It inhibits aldosterone which plays a role in increasing the activity of luminal epithelial sodium (Na+) channels (ENaC), thereby increasing reabsorption of sodium and water, elevating blood pressure and increasing potassium excretion

Question 3

What are the contraindications of this medication?

Answer 3

Severe renal impairment
Hyperkalaemia
Adrenal insufficiency

Question 4

What are the cautions for this medication?

Answer 4

Acute porphyrias
Elderly

Question 5

What are the potential interactions of this drug class?

Answer 5

Potassium-elevating drugs such as ACEi or ARBs- increased risk of hyperkalaemia
Potassium supplements

Question 6

What are the side effects of the drug class?

Answer 6

Hyperkalaemia (discontinued)- causing muscle weakness, arrhythmias and cardiac arrest
Spironolactone causes gynaecomastia (enlargement of male breast tissue) Eplerenone is less likely to cause endocrine side effects
Liver impairment

Question 7

What are the names of the drugs in this class?

Answer 7

Spironolactone
Eplerenone