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- Pharmacology For Spironolactone + Hydroflumethiazide
Spironolactone + Hydroflumethiazide Pharmacology
Spironolactone + HydroflumethiazideAbout Spironolactone + HydroflumethiazideN/AMechanism of Action of Spironolactone + HydroflumethiazideN/APharmacokinets of Spironolactone + HydroflumethiazideN/AOnset of Action for Spironolactone + HydroflumethiazideN/ADuration of Action for Spironolactone + HydroflumethiazideN/AHalf Life of Spironolactone + HydroflumethiazideN/ASide Effects of Spironolactone + HydroflumethiazideN/AContra-indications of Spironolactone + HydroflumethiazideN/ASpecial Precautions while taking Spironolactone + HydroflumethiazideN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Spironolactone + HydroflumethiazideN/AInteractions for Spironolactone + HydroflumethiazideN/ATypical Dosage for Spironolactone + HydroflumethiazideN/ASchedule of Spironolactone + HydroflumethiazideN/AStorage Requirements for Spironolactone + HydroflumethiazideN/AEffects of Missed Dosage of Spironolactone + HydroflumethiazideN/AEffects of Overdose of Spironolactone + HydroflumethiazideN/A
SpironolactoneAbout SpironolactoneSelective Aldosterone antagonist, antiandrogen, Potassium-sparing diuretic.Mechanism of Action of SpironolactoneSpironolactone is a steroid with structural similarity to aldosterone which exerts it`s pharmacological actions by acting as a competitive antagonist of aldosterone; in the distal part of nephron (late distal tubule and collecting duct). It prevents potassium secretion and decreases sodium reabsorption. It binds with minerelocorticoid receptor from the interstitial side and inhibits formation of aldosterone induced proteins competitively and thus increases sodium excretion and decreases potassium excretion. It increases Ca excretion also. It also blocks the effects of aldosterone on arteriolar smooth muscles and reduces peripheral resistance. It prevents aldosterone induced sodium and water retention and thus reduces blood volume and used as an effective diuretic in treatment of hypertension and also used to reduce potassium loss associated with the use of other diuretics. It is an effective diuretic in the management of congestive heart failure for mobilization of oedema fluid. It prevents aldosterone induced myocardial fibrosis and disease progression in patients with congestive heart failure.
Pharmacokinets of SpironolactoneSpironolactone is a steroid with structural similarity to aldosterone which exerts it`s pharmacological actions by acting as a competitive antagonist of aldosterone; in the distal part of nephron (late distal tubule and collecting duct). It prevents potassium secretion and decreases sodium reabsorption. It binds with minerelocorticoid receptor from the interstitial side and inhibits formation of aldosterone induced proteins competitively and thus increases sodium excretion and decreases potassium excretion. It increases Ca excretion also. It also blocks the effects of aldosterone on arteriolar smooth muscles and reduces peripheral resistance. It prevents aldosterone induced sodium and water retention and thus reduces blood volume and used as an effective diuretic in treatment of hypertension and also used to reduce potassium loss associated with the use of other diuretics. It is an effective diuretic in the management of congestive heart failure for mobilization of oedema fluid. It prevents aldosterone induced myocardial fibrosis and disease progression in patients with congestive heart failure.Onset of Action for Spironolactone1 to2 daysDuration of Action for Spironolactone2 to 3daysHalf Life of SpironolactoneN/ASide Effects of Spironolactone1.Headache
4.Duodenal and gastric bleeding
16.Altered levels of blood urea nitrogen
17.Gastro intestinal disturbances
Contra-indications of Spironolactone1.Hypersensitivity to the drug
4.Acute and progressive renal insufficiency
Special Precautions while taking Spironolactone1.Renal impairment
3.Fluid and electrolyte imbalance
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Spironolactone1.Hypertension
3.Diagnosis of primary hyperaldosteronism
Interactions for SpironolactoneACE Inhibitors: Enhanced hypotensive effect; significant hyperkalaemia may occur.
Digitalis glycosides: Interaction is complex and may result in increased serum digoxin levels & subsequent digitalis toxicity.
Cyclosporin: Increased risk of hyperkalaemia.
Potassium Preparations: May result in hyperkalaemia, possibly with cardiac arrhythmias or cardiac arrest, especially in patients with impaired renal functions.
Salicylates: Diuretic effects reduced by salicylates.
Carbenoxolone: Ulcer healing effect antagonised by spironolactone.
Food: Increased absorption of spironolactone.
Lab tests: Interferes with radio-immuno assay for measuring digoxin, resulting in falsely elevated serum digoxin.
Typical Dosage for SpironolactoneHypertension: 50 to 100mg/day in divided doses.
Oedema: 25 to 200mg/day in divided doses.
Diagnosis of primary hyperaldosteronism: 400mg/day (short test) or up to four weeks (long test)
Hirsutism: 25 to 200mg/day in divided doses.
Premenstrual syndrome: 25mg four times on fourteenth day of menstrual cycle.
Schedule of SpironolactoneHStorage Requirements for SpironolactoneStore at room temperature in a well closed container and protects from light.Effects of Missed Dosage of SpironolactoneTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of SpironolactoneTreatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and support electrolyte balance. Reduce serum potassium with I.V. sodium bicarbonate or glucose with insulin. Potassium level is also reduced by a cation exchange resins like sodium polystyrene sulfonate given orally or as retention enema.
HydroflumethiazideAbout HydroflumethiazideAn thiazide (benzothiadiazide) diuretic, Symporter inhibitor, Antihypertensive(Diuretic).Mechanism of Action of HydroflumethiazideIt is thiazide diuretic which exerts its action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.Pharmacokinets of HydroflumethiazideN/AOnset of Action for Hydroflumethiazide2 hoursDuration of Action for Hydroflumethiazide12-24 hoursHalf Life of HydroflumethiazideN/ASide Effects of Hydroflumethiazide1.Hypokalemia
11.Increase in blood sugar and uric acid levels
Contra-indications of Hydroflumethiazide1.Hypersensitivity to Hydroflumethiazide
Special Precautions while taking Hydroflumethiazide1.Severe renal impairment
2.Electrolyte disturbances (hypokalemia, hypochloremic alkalosis, hyponatremia)
3.Severe hepatic impairment
6.SLE exacerbation or activation.
9.Correct hypokalemia before initiating therapy.
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Hydroflumethiazide1.Edema associated with congestive heart failure, hepatic cirrhosis, nephrotic syndrome, corticosteroid and oestrogen therapy
Interactions for HydroflumethiazideN/ATypical Dosage for HydroflumethiazideOral:
Initial dose: 50 mg to be taken 1-2 times a day
Maintenance dose: 25-200 mg / day
Initial dose: 50 mg to be taken 2 times daily
Maintenance dose: 50-100 mg / day; maximum: 200 mg/day
Children: 1 mg / kg /daySchedule of HydroflumethiazideN/AStorage Requirements for HydroflumethiazideStore at room temperature in a well closed container and protected from light.Effects of Missed Dosage of HydroflumethiazideTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.Effects of Overdose of HydroflumethiazideGive supportive measures and symptomatic treatment.After gastric lavage, give I.V fluids, electrolyte and I.V.pressor if needed.
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