HF MRAs

Question 1

What is the initial dose of eplerenone if the pt CrCl >= 50 and K <= 5?

Answer 1

25 mg once daily

Question 2

What is the initial dose of eplerenone if the pt CrCl 30-49 and K <= 5?

Answer 2

25 mg every other day

Question 3

What is the maintenance dose of eplerenone if the pt CrCl >= 50 and 4 weeks of K <= 5?

Answer 3

50 mg once daily

Question 4

What is the maintenance dose of eplerenone if the pt CrCl 30-49 and 4 weeks of K <= 5?

Answer 4

25 mg once daily

Question 5

What is the initial dose of spironolactone if the pt CrCl >= 50 and K <= 5?

Answer 5

12.5-25 mg once daily

Question 6

What is the initial dose of spironolactone if the pt CrCl 30-49 and K <= 5?

Answer 6

12.5 mg once daily or every other day

Question 7

What is the maintenance dose of spironolactone if the pt CrCl >= 50 and 4 weeks of K <= 5?

Answer 7

25 mg once daily

Question 8

What is the maintenance dose of eplerenone if the pt CrCl 30-49 and 4 weeks of K <= 5?

Answer 8

12.5-25 mg once daily

Question 9

What are the monitoring parameters of MRAs?

Answer 9

Renal fx and K: within 3 days- 1 wk after any change or addition, diseases, or acute illnesses that may influence K conc, then every month for 3 months, then every q3-4 months and w increase/restart of ACEi/ARBs

Question 10

What are counseling points of MRAs for pts?

Answer 10

• Avoidance of salt substitutes
• Close questioning for all other sources of K