6413721
Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
over 8 years ago
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| Question | Answer |
| Give eg's of & indications for aldosterone antagonists. | eg's: spironolactone, epleronone Indications: • Ascites & oedema due to liver cirrhosis - spironolactone is 1st line diuretic • Chronic HT failure - moderate severity or arising within 1/12 of an MI, usually as an addition to a B-blocker & an ACE-i/ARB • Primary hyperaldosteronism - whilst waiting for surgery or for those whom surgery isn't an option |
| MOA of aldosterone antagonists. | Aldosterone is a mineralocorticoid that is produced in the adrenal cortex. It acts on mineralocorticoid receptors in the distal tubules of the kidney to increase the activity of luminal ENaC's. This ^reabsorption of sodium & water (which ^BP) with the by-product of increased potassium excretion. Aldosterone antagonists inhibit the effect of aldosterone by competitively binding to the aldosterone receptor. This ^sodium & water excretion & potassium retention. Their effect is greatest in primary hyperaldosteronism or when circulating aldosterone is increased, e.g. in cirrhosis. |
| SE's of aldosterone antagonists. | • Hyperkalaemia • Gynaecomastia (spironolactone) • Liver impairment & jaundice • Stevens-Johnson syndrome - a T cell-mediated hypersensitivity reaction that causes a bullous skin eruption |
| CI's, cautions, & important interactions of aldosterone antagonists. | CI's: • Severe renal impairment • Hyperkalaemia • Addison's DS (aldosterone deficient) • Avoid where possible in pregnant or lactating women Cautions: • None Important interactions: The combination of an aldosterone antagonist with other potassium-elevating drugs, including ACEi's & angiotensin receptor blockers, increases the risk of hyperkalaemia. Nevertheless, when supported by appropriate monitoring, this may be a beneficial combination in the context of heart failure. Aldosterone antagonists should not be combined with potassium supplements except in specialist practice. |
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