Spironolactone
Trade names: Aldacton
Class: Potassium-sparing diuretics
Pregnancy:
(Category C/ D if used in pregnancy-induced hypertension) Action:
ý Is a mild diuretic that acts on the distal tubule to inhibit
sodium exchange for potassium which results in increased secretion of sodium
and water & conservation of potassium .
ý It is also aldosterone antagonist.
ý It has slight antihypertensive effect .
Uses:
ý Edema due to congestive heart failure ý liver
cirrhosis.
ý Nephrotic syndrome .
ý Essential hypertension.
ý Primary hyperaldosteronism.
ý Hypokalemia (as in CHF) .
Dose:
§ 100–200 mg daily, increased to 400 mg if required; CHILD
initially 3 mg/kg daily in divided doses
§ Heart failure low doses of spironolactone (usually 25 mg) daily
" already receiving an ACE inhibitor and a diuretic " Contraindications:
ý Acute renal insufficiency .
ý Progressive renal failure .
ý Patients receiving potassium supplement.
ý Hyperkalemia.
Side effects:
ý Hyperkalemia, hyponatremia ( dry mouth , lethargy, thirst &
easy fatigability).
ý Vomiting , diarrhea, cramps.
ý Menstrual irregularities, gynecomastia, hirsutism & deeping
of voice , impotence.
ý Skis rashes & breast carcinoma .
Nursing
considerations:
protect drug from light.
Food may increase absorption of aldactone.
Obtain serum electrolyte levels prior to
starting therapy.
Record vital signs, intake & out put &
body weight. Advise the client to avoid food high in
potassium.
