January 26, 2023

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The prototype drug of industrial antagonist is spironolectome first introduced in 1950s sparinolectin was and has been recognized as a potassium sparing diuretic as our understanding of its therapeutic mechanism advances it is also now categorized as an aldosterone receptor antagonist therapeutically spironolactone belongs to the category of diuretics therapeutic

Mechanism-wise spironolectome is a synthetic steroid which works directly at the intracellular level to inactivate spironolactone receptor complex as the receptor is antagonized the mediator protein that is in charge of sodium potassium exchange is inhibited which in turn prohibits the reabsorption of sodium and interrupt the excretion of potassium the therapeutic

Effects of lowering blood pressure and decreasing cardiac preload are then achieved commonly used together with thiazide spironolactone is a drug of choice for hepatic cirrhosis with edema as a hormonal antagonist it is used to detect and treat hyperaldosteronism as a diuretic spironolactone is used for edema caused by hepatic cirrhosis and heart failure as

An adjunct to ace inhibitor or loop diuretic spironolactone is used for severe heart failure resulting from its therapeutic effects spironolectome is also used for resistant hypertension and diuretic induced hypokalemia adverse effects of spironolactone are listed here gi adverse effects include stomach upset and gi bleeding hormonal adverse effects include

Gynecomastia and inability to maintain erection in male menstrual irregularities in female headache drowsiness and lethargy are central nervous system side effects metabolic adverse effects include renal failure hyperkalemia hyponatremia and dehydration agranulocytosis is a hematologic side effect adverse effects of an audacital antagonist are dose related

Medication that works on rats should not be used during pregnancy or breastfeeding spironolactone targets on the distal and collecting tubules of the nephron therefore use spironolactone with caution on patients who have renal impairment and or fluid and electrolyte imbalances spironolactone commonly used in combination with other medications it is commonly used

With thiazide for hepatic cirrhosis and with ace inhibitor and loop diuretic for heart failure when using spironolactone with other medications that can affect blood pressure precaution on hypotension should be taken as always teach the client the adverse effects and how to manage the adverse effects we also want to teach the female client to report pregnancy

And discuss with the physician if wish to breastfeed teach the client to take tablets in the morning and or early afternoon to avoid bacteria teach the client to avoid excessive potassium intake modify diet as needed teach the client to monitor blood pressure and heart rate regularly we need to inform the client to call 9-1-1 if experiencing symptoms of heart

Attack monitor potassium level and kidney function on a routine basis by checking basic metabolic panel and follow-up with the physician monitor elderly patients more closely as they are more susceptible to fluid and electrolyte imbalances teach the client prevention of orthostatic hypotension and safety measures inform patient possible breast tenderness and

Enlargement here listed on medications herbs and diet that could interact with spironolactone antihypertensives that work on rest could add to the effects and adverse effects of spironolactone use the combination with caution and monitor blood pressure and heart rate and electrolyte and kidney status acetyl silicetic acid aspirin and other salicylates decrease

Or block the therapeutic and diuretic effects of spironolactone when spironolactone is used with anticoagulants monitoring pt and inr is necessary because spironolactone could decrease the anticoagulation effect low molecule weight heparin can increase risk of hyperkalemia of spironolectome it is not recommended to use nsaids potassium-sparing diuretic and

Potassium supplement together with spironolectome because of increasing risk of hyperkalemia when used with lithium and digestion spironolactone alter the renal clearance of these two medications leading to risk of toxicity the drug levels are to be monitored closely the aldosterone-like effect of licorice could be antagonized by spironolactone the ulcer

Healing quality would be blocked and risk of hypokalemia increases with this combination spironolactone can increase bun and potassium levels and it decreased sodium levels granulocytes might be affected in patients using spironolactone thank you for spending time with me i look forward to seeing you in the next lecture

Transcribed from video
Aldosterone Antagonists- Spironolactone By Apricad Courses of Nursing