aldosterone antagonists

Question 1

MOA

Answer 1

Competes with aldosterone for receptor sites in the distal renal tubules, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions; may block the effect of aldosterone on arteriolar smooth muscle as well

Question 2

Drug name

Answer 2

• Spironolactone

* Eplerenone

Question 3

Complelling indication

Answer 3

• Heart failure III- IV (spironolactone)
• Heart failure post MI (eplerenone)
• Cirrhosis (spironolactone)
• Resistant hypertension

Question 4

Adverse effect

Answer 4

• Hyperkalemia, gynecomastia, SJS, TEN (spironolactone)

Question 5

monitoring

Answer 5

• Electrolytes (hyper-K, hypo-Mg, Na, Cl)
• Fluid imbalances
• 7-14 days after initiation

Question 6

comments

Answer 6

contradiction:
• Anuria
• Eplerenone contraindicated as an anti-HTN in pts with CrCl <50ml/min (sCr 1.8 for women & 2 in men) as well as DM2 with microalbuminuria
• May use in patients with gout