Heart Failure

Question 1

Eplerenone (Inspra)

Spironolactone (Spiractin)

Answer 1

A) Aldosterone Antagonists

B)
1. Heart FAILURE (HF)
SPIRONOLACTONE:
2. Pirmary HYPERALODOSTERONISM
3. Refractory OEDEMA (associated with secondary hyperaldonsteronism - e.g. ascites)
4. HIRSUTISM in females

C)
EPLE: 25 - 50 mg ONCE daily
SPIR: 12.5 - 400mg (1-2 doses)

D)

1. POTASSIUM** (hyperkalaemia)
2. ELECTROLYTES (low Na+, low Cl-)
3. RENAL** (renal impairment = high K+)
4. Hepatic (hepatotoxicity- rare)

E)
Labels: 11, 12,
(18) - EPLERENONE (CYP3A4)
(16), (A), (B) - SPIRONOLACTONE
S/E
*weak diuretic effect (dizziness, headache, weakness, nausea)

Question 2

Bumetanide (Burinex)
Ethacrynic acid (Edecrin)
Frusemide (Lasix)

Answer 2

A) Loop Diuretic

B)
1. OEDEMA (assoc. with HF, Hepatic CIRRHOSIS, RENAL impairment and NEPHROTIC syndrome)
FRUSEMIDE:
2. Severe HYPERCALCAEMIA

C)
BUME: 0.5 - 4 mg ONCE or BD (max8)
ETHA: 50 - 200 mg ONCE or BD (max400)
FRUS: 20 - 1000 mg (1-2 doses)

D)
1. WEIGHT**
2. ELECTROLYTES** (low Na, low K, low Mg, low Cl, low Ca)
3 RENAL**
4. Blood PRESSURE (orthostatic hypotension)

E)
Labels: 16
#Taken in the MORNING; second dose no later than LUNCHTIME
S/E
*URINE output (dehydration, orthostatic hypotension, dizziness, fainting)
*GOUT (diuretic-induced hyperuricaemia)