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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Potassium-sparing diuretics include amiloride, spironolactone, and triamterene, and result in sodium and water loss while sparing potassium. Spironolactone is a competitive inhibitor of aldosterone, while amiloride and triamterene function at the level of the collecting tubules.
Body fluids and electrolytes
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Potassium-sparing diuretics, as the name suggests, work to preserve potassium. They inhibit sodium reabsorption in the concluding parts of the distal tubule and the early collecting duct. They may be used alongside another type of diuretic to preserve potassium in the body. It is important to note that these diuretics carry a risk of hyperkalaemia, especially for those with chronic kidney disease or individuals taking drugs that also increase potassium concentration, i.e., ACE inhibitors or beta-blockers (Casey 2019).
The T wave
Published in Andrew R Houghton, Making Sense of the ECG, 2019
If the diagnosis is confirmed by a raised plasma potassium level, assess the patient for symptoms and signs of an underlying cause (e.g. renal failure). In particular, review their treatment chart for inappropriate potassium supplements and potassium-sparing diuretics.
Machine learning algorithms identify hypokalaemia risk in people with hypertension in the United States National Health and Nutrition Examination Survey 1999–2018
Published in Annals of Medicine, 2023
Ziying Lin, Yuen Ting Cheng, Bernard Man Yung Cheung
The administration of renin-angiotensin system blockers (ACEIs/ARBs) is suggested by guidelines as the first approach to managing hypertension [21,32,33]. The combination of ACEIs/ARBs or potassium-sparing diuretics is a common strategy for hypertensive patients with a baseline use of diuretics, especially those with a high hypokalaemia risk or comorbid heart failure [34]. Our study showed that using potassium-sparing diuretics was associated with hypokalaemia. Although no causal relationship between potassium-sparing diuretics use and hypokalaemia could be ascertained in this study, the increased hypokalaemia risk in patients on potassium-sparing diuretics highlights the importance of a more comprehensive evaluation of the cause of hypokalaemia, including hyperaldosteronism and potential resistant hypertension [35,36]. Also, stricter blood pressure monitoring and re-evaluation of diuretics dosage are needed.
Pharmacological management of hypertension in the elderly and frail populations
Published in Expert Review of Clinical Pharmacology, 2018
Ashish Correa, Yogita Rochlani, Mohammed Hassan Khan, Wilbert S. Aronow
Potassium-sparing diuretics include sodium transport channel antagonists (triamterene and amiloride) and mineralocorticoid antagonists (spironolactone and eplerenone). Mineralocorticoid antagonists have a potent antihypertensive effect. They are useful in managing hypertension secondary to primary hyperaldosteronism. Additionally, they are effective in the setting of HF. Recent evidence from the Prevention And Treatment of Hypertension With Algorithm-based therapy 2 (PATHWAY-2) trial supports their utility in managing resistant hypertension [77]. As with all patients, care should be taken to monitor for electrolyte disturbances in elderly patients on such medications. Gynecomastia is another side effect that can occur in male patients. Triamterene and amiloride are weak antihypertensives and are only effective when used concomitantly with other diuretics.
Impact of chronic medications in the perioperative period: mechanisms of action and adverse drug effects (Part I)
Published in Postgraduate Medicine, 2021
Ofelia Loani Elvir-Lazo, Paul F White, Hillenn Cruz Eng, Firuz Yumul, Raissa Chua, Roya Yumul
All diuretics increase urination and sodium elimination but act at different receptor sites along the nephron. Loop diuretics exert their clinical effects by inhibiting the sodium-potassium-chloride cotransporters (NKCC2) in the thick ascending loop of Henle [22]. On the other hand, the thiazide diuretics block the sodium-chloride (NaCl) channels in the distal convoluted tubules [23]. Lastly, potassium-sparing diuretics (e.g. spironolactone) directly antagonize aldosterone and inhibit sodium channels in the cortical collecting tubules [24]. The primary clinical uses of diuretics include primary (essential) hypertension and edema associated with heart failure, hepatic cirrhosis, corticosteroid use, estrogen therapy, and nephrotic syndrome [24].