Potassium Sparing Diuretics

What is the action of potassium sparing diuretics

reduce the excretion of potassium, block the reabsorption of sodium into the kidney and thereby increasing sodium and h20 in the urine and reduces excretion of K+

Why are potassium sparing diuretics given? “Reason”

Hypertension

Used with antihypertensives

To reduce edema

Glaucoma

Seizures

Neuro adverse effects

dizziness, headache, encephalopathy, lightheadedness, weakness, fatigue

EENT adverse effects

Hearing loss, tinnitus

CV adverse effects

Orthostatic hypotension

GU adverse effects

Electrolyte imbalances, glycosuria

GI adverse effects

anorexia, nausea, vomiting

DERm adverse effects

rash, photosensitivity

Endo adverse effects

hyperglycemia, hyperuricemia

F&E adverse effects

Dehydration, hypocalcemia, hypochloremia, hyperkalemia, hypomagnesemia, hyponatremia, hypokalemia, metabolic alkalosis

MS adverse effects

arthralgia, muscle cramps, myalgia

Contradictions of potassium sparing diuretics

Hypersensitivity

Electrolyte imbalances, hyperkalemia

Severe kidney or liver dysfunction

Anuria

Mannitol” active intracranial bleeding except during craniotomy

Generic: Sironolactone

Trade: Aldactone

Spironolactone safe dose

25-400mg/day as a single dose

Spironolactone Route

PO

What to monitor? (Nursing management)

BP and pulse, intake and output ratios and daily weight, take early in the morning, do not reduce fluid intake, avoid alcohol, monitor serum potassium levels

What interacts with potassium sparing diuretics

Angiotensin converting enzyme/potassium supplement (increases risks of hyperkalemia)

Nsaids/anticoagulants (decreases diuretic effect)

What to avoid?

Foods high in potassium

Avocado, spinach, sweet potato, coconut water