Spironolactone (Diuretic)

Question 1

What is the brand name of Spironolactone?

Answer 1

Aldactone

Question 2

What strength Spironolactone tablets are available?

Answer 2

25mg, 50mg, 100mg

Question 3

What dose of Spironolactone is used to treat edema from congestive heart failure or nephrotic syndrome and cirrhosis of the liver accompanied by edema and/or ascites

Answer 3

Initially 100mg/day with adjustments at 5 day intervals to a maintenance dose of 25 to 200mg per day

Question 4

What dose of Aldactone is used to treat essential hypertension?

Answer 4

50-100mg/day

Question 5

What dose of Spironolactone is used to treat hypokalemia?

Answer 5

25-100mg/day

Question 6

What dose of Aldactone is used to diagnose primary hyperaldosteronism?

Answer 6

Long test: 400mg/day for 3-4 weeks. Correction of hypokalemia and hypertension concludes a positive test

Short Test: 400mg for 4 days. An increase in serum potassium with a subsequent decrease after the fourth day concludes a positive test

Question 7

What dose of Spironolactone is used to treat primary hyperaldosteronism in patients unsuitable for surgery?

Answer 7

100-400mg/day

Question 8

What is the mechanism of action of Aldactone?

Answer 8

Spironolactone works by competitive antagonism of aldosterone at the aldosterone-dependent Na+/K+ exchange sties in the distal convoluted renal tubule. It reaches peak plasma levels in 3-5 hours with a half life of 2-16 hours. Is excreted in the urine

Question 9

What are the drug interactions of Spironolactone?

Answer 9

• Hyperkalemia may occur when used concomitantly with captopril and other potassium-sparing medication, including potassium supplements. Variable effects may occur when used with DIGITALIS glycosides

Question 10

What are the contraindications of Aldactone?

Answer 10

• Contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal function, hyperkalemia, and in patients hypersensitive to sulfonamides or spironolactone
• Use with caution in patients with acute or severe hepatic failure
• Patients receiving this medication should be monitored periodically for fluid and electrolyte disturbances.
• Use with cautioning pregnant and in nursing women
• Pregnancy Category B

Question 11

What are the adverse effects of Spironolactone?

Answer 11

Diarrhea, drowsiness, headache, amenorrhea, weakness, paresthesia, mental confusion, dry mouth, muscle cramps, hirsutism, urticaria, impotence, gynecomastia, nausea, and vomiting

Question 12

What should the RPh tell the patient when counseling on Aldactone?

Answer 12

• Timing of dose is important because of increased diuresis. Usually given early in the morning
• Must be taken with food or milk if GI upset occurs
• May cause drowsiness. Use caution while operating machinery or when mental alertness is required
• Contact a physician if the above side effects are severe or persistent
• If a dose is missed, skip it and return to normal dosing schedule