Spironolactone + Hydroflumethiazide Pharmacology

Spironolactone + Hydroflumethiazide

About Spironolactone + Hydroflumethiazide
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Mechanism of Action of Spironolactone + Hydroflumethiazide
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Pharmacokinets of Spironolactone + Hydroflumethiazide
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Onset of Action for Spironolactone + Hydroflumethiazide
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Duration of Action for Spironolactone + Hydroflumethiazide
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Half Life of Spironolactone + Hydroflumethiazide
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Side Effects of Spironolactone + Hydroflumethiazide
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Contra-indications of Spironolactone + Hydroflumethiazide
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Special Precautions while taking Spironolactone + Hydroflumethiazide
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Spironolactone + Hydroflumethiazide
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Interactions for Spironolactone + Hydroflumethiazide
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Typical Dosage for Spironolactone + Hydroflumethiazide
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Schedule of Spironolactone + Hydroflumethiazide
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Storage Requirements for Spironolactone + Hydroflumethiazide
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Effects of Missed Dosage of Spironolactone + Hydroflumethiazide
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Effects of Overdose of Spironolactone + Hydroflumethiazide
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Spironolactone

About Spironolactone
Selective Aldosterone antagonist, antiandrogen, Potassium-sparing diuretic.
Mechanism of Action of Spironolactone
Spironolactone 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 Spironolactone
Spironolactone 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 Spironolactone
1 to2 days
Duration of Action for Spironolactone
2 to 3days
Half Life of Spironolactone
N/A
Side Effects of Spironolactone
1.Headache
2.Drowsiness
3.Nausea
4.Duodenal and gastric bleeding
5.Ulceration
6.Gynecomastia
7.Menstrual irregularities
8.Testicular atrophy
9.Ataxia
10.Impotence
11.Diarrhoea
12.Vomiting
13.Hyper kalemia
14.Hyponatraemia
15.Agranulocytosis
16.Altered levels of blood urea nitrogen
17.Gastro intestinal disturbances
18.Rashes
19.Ototoxicity



Contra-indications of Spironolactone
1.Hypersensitivity to the drug
2.Hyper kalaemia
3.Anuria
4.Acute and progressive renal insufficiency

Special Precautions while taking Spironolactone
1.Renal impairment
2.Hepatic impairment
3.Fluid and electrolyte imbalance



Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Spironolactone
1.Hypertension
2.Oedema
3.Diagnosis of primary hyperaldosteronism
4.Hirsutism
5.Premenstrual syndrome
6.Acne
7.Seborrhoeics

Interactions for Spironolactone
ACE 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 Spironolactone
Hypertension: 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.
Acne: 100mg/day.

Schedule of Spironolactone
H
Storage Requirements for Spironolactone
Store at room temperature in a well closed container and protects from light.
Effects of Missed Dosage of Spironolactone
Take 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 Spironolactone
Treatment 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.

Hydroflumethiazide

About Hydroflumethiazide
An thiazide (benzothiadiazide) diuretic, Symporter inhibitor, Antihypertensive(Diuretic).
Mechanism of Action of Hydroflumethiazide
It 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 Hydroflumethiazide
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Onset of Action for Hydroflumethiazide
2 hours
Duration of Action for Hydroflumethiazide
12-24 hours
Half Life of Hydroflumethiazide
N/A
Side Effects of Hydroflumethiazide
1.Hypokalemia
2.Dizziness
3.Fatigue
4.Frequent urination
5.Dry mouth
6.Anxiety
7.Muscle cramps
8.Nervousness
9.Nausea
10.Vomiting
11.Increase in blood sugar and uric acid levels
12.Allergic reactions
13.Abdominal disturbances
14.Anorexia
15.Constipation
16.Cough
17.Depression
18.Diarrhoea
19.Drowsiness
20.Hives
21.Impotence
22.Indigestion
23.Light-headedness
24. Rash
Contra-indications of Hydroflumethiazide
1.Hypersensitivity to Hydroflumethiazide
2.Anuria
3.Renal decompensation
Special Precautions while taking Hydroflumethiazide
1.Severe renal impairment
2.Electrolyte disturbances (hypokalemia, hypochloremic alkalosis, hyponatremia)
3.Severe hepatic impairment
4.Gout
5.Diabetics
6.SLE exacerbation or activation.
7.Hypercholesterolaemia
8.Photosensitization
9.Correct hypokalemia before initiating therapy.
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Hydroflumethiazide
1.Edema associated with congestive heart failure, hepatic cirrhosis, nephrotic syndrome, corticosteroid and oestrogen therapy
2.Hypertension
Interactions for Hydroflumethiazide
N/A
Typical Dosage for Hydroflumethiazide
Oral:
Adults:
Edema:
Initial dose: 50 mg to be taken 1-2 times a day
Maintenance dose: 25-200 mg / day
Hypertension:
Initial dose: 50 mg to be taken 2 times daily
Maintenance dose: 50-100 mg / day; maximum: 200 mg/day
Children: 1 mg / kg /day
Schedule of Hydroflumethiazide
N/A
Storage Requirements for Hydroflumethiazide
Store at room temperature in a well closed container and protected from light.
Effects of Missed Dosage of Hydroflumethiazide
Take 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 Hydroflumethiazide
Give supportive measures and symptomatic treatment.After gastric lavage, give I.V fluids, electrolyte and I.V.pressor if needed.

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Spironolactone + Hydroflumethiazide is a generic medicine name and there are several brands available for it. Some of the brands for spironolactone + hydroflumethiazide might be better known than spironolactone + hydroflumethiazide itself. If the pharmacy that's willing to deliver medicines to your home doesn't have spironolactone + hydroflumethiazide in stock, you can ask for one of the branded alternatives for spironolactone + hydroflumethiazide.