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PEBC: What You Need to Know: Potassium Sparing Diuretics

Examples: Spironolactone, eplerenone, amiloride, triamterene

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Indications:

-Hypertension (second-line), but specifically heart failure for spironolactone and eplerenone

-Spironolactone is also used for hyperaldosteronism, acne, liver cirrhosis

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Dosing:

-Usually once daily in the morning (due to diuresis effect)

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Adverse Effects:

-Hyperkalemia (hence triamterene and amiloride are often combined with hydrochlorothiazide to balance potassium)

-Hyponatremia

-Increased serum creatinine

-Breast tenderness, menstrual irregularities, impotence (only spironolactone, not eplerenone)

-dizziness, diarrhea, nausea

-muscle cramps

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Drug Interactions:

-Anything that increases potassium levels: ACE inhibitors, ARBs, potassium supplements, NSAIDs, sulfamethoxazole-trimethoprim

-Eplerenone is metabolized via CYP3A4 so caution with strong inhibitors

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