MCQ Pharmacology Answer 5

The correct answer is A
Explanation

Spironolactone is effective in lowering the systolic and diastolic blood pressure in patients with primary hyperaldosteronism. It is also effective in most cases of essential hypertension, despite the fact that aldosterone secretion may be within normal limits in benign essential hypertension.

Through its action in antagonizing the effect of aldosterone, spironolactone inhibits the exchange of sodium for potassium in the distal renal tubule and helps to prevent potassium loss.

Hyperkalemia: Hyperkalemia may occur in patients treated with spironolactone if the potassium intake is excessive. This can cause cardiac irregularities, some of which may be fatal. Hyperkalemia may also occur even in the absence of potassium supplementation, particularly in patients with impaired renal function, elderly patients, or patients with diabetes. Consequently, no potassium supplementation should ordinarily be given with spironolactone. Hyperkalemia can be treated promptly by rapid i.v. administration of glucose (20 to 50%) and regular insulin, using 0.25 to 0.5 units of insulin/g of glucose. This is a temporary measure to be repeated if required. Spironolactone should be discontinued and potassium intake (including dietary potassium) restricted.

Hyponatremia: During the administration of spironolactone, patients suffering from sodium depletion must be attentively monitored and signs of electrolyte imbalance must be carefully checked.
Spironolactone may, if administered concomitantly with other diuretics, cause or aggravate hyponatremia, as manifested by dryness of the mouth, thirst, lethargy, and drowsiness.

Metabolic Effects: Hyperchloremic metabolic acidosis: Spironolactone may induce or worsen hyperchloremic metabolic acidosis.

Category: Pharmacology MCQs