Description medicines: Spironolactone (Spironolactonum)
Spironolactone (Spironolactonum). g lactone-3- (3-oxo-7 -tioatsetil a-17 b-hydroxy-4-androstene-17 a yl) propionic acid.
Synonyms: aldactone, Veroshpiron, Aldactone A, Spironolactone, Verospiron.
Spironolactone is a potassium-sparing diuretic, different mechanism of action from triamterene and amiloride. It turns spironolactone diuretic effect associated with antagonism towards adrenal hormones - aldosterone (See Drugs adrenal cortex and their synthetic analogues..).
Aldosterone is mineralokortikosteroidom; it participates in the regulation of the concentration of electrolytes in the body; promotes the reabsorption of sodium ions in the renal tubules, decreases sodium excretion in the urine, increases the excretion of potassium ions. As mineralokartikosteroid aldosterone significantly more active than deoxycorticosterone: their ability to delay the allocation of sodium it exceeds 25 times deoxycorticosterone and 300 times more potent than hydrocortisone (hydrocortisone).
Spironolactone is a competitive antagonist of aldosterone on the impact on the distal nephron; drug increases the excretion of sodium, but reduces the excretion of potassium and urea reduces titratable acidity of urine. Natriuretic effect causes diuresis. Due to the increased release of sodium ions, spironolactone can have a hypotensive effect, but this effect is unstable.
Apply spironolactone as a diuretic for edema associated with disorders of cardiac activity, with ascites due to liver cirrhosis, nephrotic syndrome and edema of another origin. The diuretic effect of spironolactone is expressed moderately and usually occurs in the 2 - 5-day treatment.
To accelerate and enhance the diuretic effect administered simultaneously (in normal doses) other diuretics (benzothiadiazine derivatives, furosemide, ethacrynic acid, etc.), Wherein sodium excretion is greatly enhanced, and delayed excretion of potassium. With insufficient diuretic effect can be further assigned to steroids. Nephrotic syndrome glucocorticosteroids given first, and if necessary further spironolactone.
Spironolactone is especially shown at a syndrome hypokalemia caused by other diuretics, and in case of hypersensitivity to the drug digitalis, hypokalemia due.
There is evidence of the use of spironolactone (veroshpirona) in infectious and allergic asthma. The drug is particularly indicated for patients with bronchial asthma, complicated by right heart failure.
Spironolactone is also applied at periodic paralysis. The effect may be associated with delayed release of potassium ions from the body.
It is also proposed to use spironolactone in the treatment of parkinsonism.