Page 109 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

9- Aldosterone antagonists

➢ Patients with advanced heart disease have elevated levels of aldosterone due to

angiotensin II stimulation and reduced hepatic clearance of the hormone.

Spironolactone Eplerenone
➢ Direct antagonist of aldosterone ➔ preventing ➢ A competitive antagonist of
salt retention, myocardial hypertrophy, and aldosterone and mineralocorticoid

hypokalemia. receptors.
➢ Reserved for the most advanced cases of HF. ➢ lower incidence of endocrine
➢ Spironolactone promotes potassium retention; related side effects due to its

patients should not be taking potassium reduced affinity for glucocorticoid,
supplements. androgen, and progesterone
➢ Adverse effects include: receptors.
1- Gastric disturbances  ↓ Mortality in patients with left

[gastritis, peptic ulcer] ventricular systolic dysfunction
2- CNS [lethargy, confusion] and HF after acute myocardial
3- Endocrine abnormalities [gynecomastia, infarction

↓libido, & menstrual irregularities]

| P a g e - 93 -