Spironolactone belongs to the group of potassium-sparing diuretics.
Mode of action of spironolactone
Spironolactone (or aldactone) - mechanism of action is an antagonist of aldosterone - a hormone of the adrenal cortex. Aldosterone, connecting with protein cell receptors distal parts of the nephron reduces excretion of water and sodium and increases the excretion of potassium. Spironolactone competes with the receptor for the hormone and its opposite effect - increasing the excretion of water and sodium from the body, while maintaining the potassium ions. Electrolyte balance is not disturbed. Manifested use of spironolactone acceleration and an increase in urine output.
Pharmacodynamics of the drug is well understood - it is quickly absorbed when entering the gastrointestinal tract by binding to plasma proteins, its bioavailability is 99%. Simultaneous food intake further accelerating the absorption of the drug. The drug trail to the tissues of the adrenal glands, kidneys, liver and gonads. Proceeding to the liver, spironolactone quickly it is metabolized to active metabolites, which determine its properties. Unlike their counterparts spironolactone does not increase the loss of potassium and magnesium from the body.
The therapeutic effect of the use of spironolactone on the guide comes in 2 - 5 days. To the drug started to operate, it is necessary to accumulate in the body to a predetermined concentration. This so-called cumulative effect of the drug. It penetrates well into the breast milk and through the placenta, excreted in urine and feces.
Spironolactone release tablets and capsules of 25 or 100 mg.
Spironolactone is used to treat edema with chronic heart failure, nephrotic syndrome, cirrhosis of the liver, swelling in pregnant women in the 2 and 3 trimester.
According to the feedback received spironolactone has proved itself as a diuretic in treatment of hypertension, including the hormone-producing tumors of the adrenal cortex (both long-term treatment in the case of contraindications to surgical excision of the adrenal adenoma). The drug also found use in the treatment and diagnosis of primary hyperaldosteronism, comprising pathogenetic treatment of polycystic ovary syndrome and premenstrual.
Contraindications to the use of spironolactone
Spironolactone is contraindicated in the instructions for electrolyte disturbances in the body (hyperkalemia, hypercalcemia, hyponatremia, acidosis), and liver failure, chronic renal failure and diabetes on her background in stage anurii CRF 1 trimester pregnancy, menstrual irregularities, and breast enlargement, in Addison's disease and are hypersensitive to the drug. Drug treatment must necessarily take place under the supervision of a doctor, as he will be able to advise on the compatibility with other drugs while taking.
Instructions for use of spironolactone
The dose of spironolactone for the treatment of selected individually, depending on the hormonal status of the patient and the extent of violations of water-electrolyte balance.
When edema begin reception from 100-200 mg / day for 2-3 hours every day, the course lasts 14 - 21 days. To enhance the diuretic effect of spironolactone on responses requires a joint appointment with loop or thiazide diuretics. During treatment is desired to control the level of potassium in the blood plasma, as it will optimally adjust the dose. After treatment, a break of 10 - 14 days, after which the course can be repeated again. The dose of the drug in the hyperaldosteronism and a reduced level of potassium in the blood is 300 mg / day for 2-3 hours.
Unlike their counterparts Spironolactone was well tolerated, but occasionally there are side effects such as nausea, changes in the nature of a chair, dizziness, headache, allergic reactions. In the opinion of Spironolactone can cause disturbances in the endocrine system - gynecomastia and erectile dysfunction in men, dysmenorrhea, metrorrhagia, breast tenderness in women.