DRUG STUDY# 1: Spironolactone (Aldactone) NAME OF THE DRUG (GENER! AND "RAND NAME)
GENER! NAME: •
Spironolactone
"RAND NAME: •
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Aldactone Novospiroton
!la**i+ication T,erape-tic: diuretics ',ar.acolo/ic: Potassium-sparing diuretics
DOSAGE ROUTE FRE$UEN!Y 'O:(Ad-lt*): Edema─ 25-200 Edema─ 25-200 mg/ day in 1-2 divided doses. HTN ─50-100 mg/ day in 1-2 divided doses. Diuretic-induces hypokalemia ─ 25-100 mg/ day in 1-2 divided doses. Diagnosis of primary hyperaldosteronism─ 100400 mg/day in 1-2 divided doses. CHF─ 12.512.5- 25 mg/ day unla!eled use". 'O (c,ildren 112 0r3): 0r3): Diuretics, HTN ─ 1 mg/#g/ day in 1-2 divided doses s$ould not e%ceed &.& mg/
ND!ATON% !ONTRAND!ATON A!TON
ND!ATONS: !ontraindicated in: 'ounteract ypersensitivity yper#alemia potassium loss Anuria Acute enal nsu,,iciency caused !y ot$er Signi,icant enal dys,unction diuretics. (sed )it$ U*ed !a-tio-*l0 in: epatic ot$er agents t$ia*ides" to treat dys,unction eri3 Presence o, edema or age-related renal dys,unction may $ypertension. lead to increase ris# o, Primary $yper#alemia ia!etes increase $yperaldosteronism ris# o, $yper#alemia" 'oncurrent spironolactone use o, potassium supplements or only". potassium-containing salt Unla4eled U*ed: su!stitutes67 lactation7 Pedi3 Spironolactone: Sa,ety not esta!lis$ed. +anagement o, ' lo) doses". A!TON:
NURSNG AD&ERSE RES'OS"TY EFFE!T TH RATONAE !NS: di**iness7 clumsiness7 $eadac$e !&: arr$yt$mias GU: erectile dys,unction ENDO: !reast tenderness7 gynecomastia7 irregular menses7 voice deepening F and E: $yper#alemia7 $yponatremia He.at: agrunulocytosis
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+onitor inta#e and output ratios and daily )eig$t during t$erapy.
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+onitor response o, signs and symptoms o, $ypo#alemia )ea#ness7 ,atigue7 arr$yt$mias7 polyuria7 and polydipsia". Assess patient ,re8uently ,or development o, $yper#alemia
#g/ day" unla!eled use". iagnostic o, primary $yperaldosteronism─125&95 mg/ m2/ day in 1-2 divided doses unla!eled use". 'O (Neonate*): 1-& mg/ #g/ day in 1-& divided doses.
A5aila4ilit0: Ta4let*3 25 mg7 50 mg7 100 mg. n com!ination )it$3 $ydroc$lorot$ia*ide Aldactasi*e7 :ApoSpiro*ide;".
n$i!ition o, sodium rea!sorption in t$e #idney )$ile saving potassium and $ydrogen ionsspironolactone ac$ieves t$is e,,ect !y antagoni*ing aldosterone receptors". T,erape-tic E++ect*:
MS: muscle cramps MS!: allergic reaction
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parest$esia7 con,usion7 dyspnea7 and cardiac arr$yt$mias". Patients )$o $ave dia!etes mellitus or #idney disease and geriatric patients are at increased ris# o, developing t$ese symptoms. =mp$asi*e t$e importance o, continuing to ta#e t$is medication7 even i, ,eeling )ell. nstruct t$e patient to ta#e medication at same time eac$ day. >a#e t$e missed doses as soon as remem!ered unless almost time to t$e ne%t dose.
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or e,,ectiveness o, medication. 'aution t$e
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patient to avoid salt su!stitutes and ,oods t$at contain $ig$ levels o, potassium or sodium unless prescri!ed !y $ealt$ care provider. +ay cause
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di**iness. 'aution patient to avoid driving or ot$er activities re8uiring alertness until response to medication is #no)n. >o prevent accident and in?ury. nstruct t$e patient to noti,y $ealt$ care pro,essional o, medication
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treatment or surgery. Advise t$e patient
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to noti,y $ealt$ care pro,essional i, muscle )ea#ness or cramps ,atigue or severe nausea7 vomiting7 or diarr$ea occurs. =mp$asi*e t$e need o, ,ollo)-up e%ams to monitor progress.
