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Potassium-sparing diuretics or antikaliuretics [1] refer to drugs that cause diuresis without causing potassium loss in the urine. [2] They are typically used as an adjunct in management of hypertension , cirrhosis , and congestive heart failure . [ 3 ]
For potassium-sparing diuretics, its common side effects include hyponatremia, hyperkalemia, metabolic acidosis and sexual dysfunction specifically for spironolactone. [4] [5] The use of diuretics should be avoided in patients with severe dehydration, anuria (absence of urine production). [4]
[1] [2] Amiloride is classified as a potassium-sparing diuretic. Amiloride is often used together with another diuretic, such as a thiazide or loop diuretic. [2] It is taken by mouth. [1] Onset of action is about two hours and it lasts for about a day. [2] Common side effects include high blood potassium, vomiting, loss of appetite, rash, and ...
Side effects of spironolactone which may be indicative of hyperkalemia and if persistent could justify serum potassium testing include nausea, fatigue, and particularly muscle weakness. [64] Notably, non-use of routine potassium monitoring with spironolactone in young women would reduce costs associated with its use.
The thiazide diuretics also deplete circulating potassium unless combined with a potassium-sparing diuretic or supplemental potassium. Some authors have challenged thiazides as first line treatment. [55] [56] [57] However, as the Merck Manual of Geriatrics notes, "thiazide-type diuretics are especially safe and effective in the elderly." [58]
The thiazides and potassium-sparing diuretics are considered to be calcium-sparing diuretics. [6] The thiazides cause a net decrease in calcium lost in urine. [7] The potassium-sparing diuretics cause a net increase in calcium lost in urine, but the increase is much smaller than the increase associated with other diuretic classes. [7]
Hans Selye, a Hungarian-Canadian endocrinologist, studied the effects of aldosterone antagonists on rats and found that the use of one of the first aldosterone antagonists, spironolactone, protected them from aldosterone-induced cardiac necrosis. The same year, 1959, spironolactone was launched as a potassium-sparing diuretic.
The most common side effect is headache (about 8% of people taking it) and nausea, loss of appetite, weakness, rash and dizziness (each about 3%). [2] Common side effects (1/10 - 1/100) include: [2] General: weakness, fatigue, loss of appetite, headache, dizziness. Circulatory system: arrhythmia. Gastrointestinal: nausea, diarrhea, abdominal pain.
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