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- Pharmacology For Torasemide + Spironolactone
Torasemide + Spironolactone Pharmacology
Torasemide + Spironolactone
About Torasemide + SpironolactoneN/AMechanism of Action of Torasemide + SpironolactoneN/APharmacokinets of Torasemide + SpironolactoneN/AOnset of Action for Torasemide + SpironolactoneN/ADuration of Action for Torasemide + SpironolactoneN/AHalf Life of Torasemide + SpironolactoneN/ASide Effects of Torasemide + SpironolactoneN/AContra-indications of Torasemide + SpironolactoneN/ASpecial Precautions while taking Torasemide + SpironolactoneN/APregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationNot recommendedIndications for Torasemide + SpironolactoneOedema associated with various disorders.Interactions for Torasemide + SpironolactoneN/ATypical Dosage for Torasemide + SpironolactoneN/ASchedule of Torasemide + SpironolactoneN/AStorage Requirements for Torasemide + SpironolactoneN/AEffects of Missed Dosage of Torasemide + SpironolactoneN/AEffects of Overdose of Torasemide + SpironolactoneN/AAbout N/AMechanism of Action of N/APharmacokinets of N/AOnset of Action for N/ADuration of Action for N/AHalf Life of N/ASide Effects of N/AContra-indications of N/ASpecial Precautions while taking N/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for N/AInteractions for N/ATypical Dosage for N/ASchedule of N/AStorage Requirements for N/AEffects of Missed Dosage of N/AEffects of Overdose of N/ASpironolactone
About 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
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 Spironolactone1.Hypersensitivity to the drug
2.Hyper kalaemia
3.Anuria
4.Acute and progressive renal insufficiency
Special Precautions while taking Spironolactone1.Renal impairment
2.Hepatic impairment
3.Fluid and electrolyte imbalance
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Spironolactone1.Hypertension
2.Oedema
3.Diagnosis of primary hyperaldosteronism
4.Hirsutism
5.Premenstrual syndrome
6.Acne
7.Seborrhoeics
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.
Acne: 100mg/day.
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.
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