Aldosterone antagonists Flashcards
1
Q
MoA
A
Aldosterone increases reabsorption of sodium and osmotically associated water.
Aldosterone antagonists inhibit the effect of aldosterone, increasing sodium/water excretion and potassium retention.
- Effect is greatest when circulating aldosterone is increased e.g. primary hyperaldosteronism or cirrhosis.
2
Q
Indications
A
- Ascites and oedema due to cirrhosis (spironolactone = 1st line)
- Chronic HF
- Primary hyperaldosteronism (whilst awaiting surgery)
3
Q
Examples
A
Spironolactone
Eplerenone
4
Q
Side effects
A
- Gynaecomastia, benign breast tumours, menstrual disturvances
- Hyperkalaemia
- Hyperuricemia
- HypOnatraemia
- Liver impairment
- Jaundice
- Steven johnsons syndrome (spironolactone)
- Hypertrichosis
- Change in libido
5
Q
Contraindications
A
- Hyperkalaemia
- Adrenal insufficiency
- Severe renal impairment
6
Q
Pregnancy/BF
A
AVOID
Can cross placenta
Found in breastmilk
7
Q
Interactions
A
- Potassium supplements
- Potassium sparing diuretics
Caution with ACEi/ARB - can cause severe hyperkalaemia. However, in HF they are combined so increase monitoring required.
8
Q
MHRA (December 2016)
A
Aldosterone antagonists and ACEi/ARBs in heart failure: risk of potentially fatal/severe hyperkalaemia. Monitoring of blood electrolytes is essential.
