II. Indications: Potassium-Sparing Diuretics only (Aldosterone independent, Amiloride and Triamterene)

  1. Hypertension
    1. Weak Diuretics primarily used to counter urinary Potassium loss with other Diuretics

III. Indications: Aldosterone Antagonists (Spironolactone, Eplerenone)

  1. Congestive Heart Failure
    1. Counter Aldosterone adverse effects on myocardial remodeling

IV. Mechanism

  1. Weak Diuretics (compared with Loop Diuretics or Thiazide Diuretics)
  2. Potassium-Sparing Diuretics only
    1. Primarily used to counter urinary Potassium loss with other Diuretics (e.g. Thiazide Diuretics)
    2. Act directly at the distal convoluted tubule (Aldosterone independent)
      1. nephron.png
      2. Increase Sodium excretion
      3. Decrease Potassium secretion
  3. Aldosterone Antagonists (Spironolactone and Eplerenone)
    1. Commonly used as adjunctive in Congestive Heart Failure management
    2. Counter Aldosterone adverse effects on myocardial remodeling

V. Medications

  1. Potassium-Sparing Diuretics only (Aldosterone independent)
    1. Amiloride (Midamor)
    2. Triamterene (Dyrenium)
  2. Potassium-Sparing Diuretic and Aldosterone Antagonists
    1. Spironolactone (Aldactone)
    2. Eplerenone (Inspra)

VI. Precautions

  1. Monitor Serum Potassium after starting a Potassium-Sparing Diuretic in those at Hyperkalemia risk
    1. Obtain Serum Potassium at 3 days, 7 days and then monthly for the first 3 months

VII. Adverse Effects: Potassium-Sparing Diuretics (Amiloride and Triamterene)

  1. Hyperkalemia
    1. Risk factors
      1. Renal Insufficiency
      2. Concurrent use with agents that raise Potassium (e.g. ACE Inhibitors, Potassium supplements)
  2. Blue Urine Color
    1. Specific to Triamterene
  3. Decreased renal perfusion (if Sodium and water depletion)
  4. Glucose Intolerance
    1. Potassium-Sparing Diuretics

VIII. Drug Interactions

  1. Potassium supplements (risk of Hyperkalemia)

IX. References

  1. Olson (2020) Clinical Pharmacology, Medmaster, Miami, p. 62-3
  2. Hamilton (2010) Tarason Pocket Pharmacopeia, p. 100

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Related Studies

Ontology: Potassium Sparing Diuretics (C0304490)

Definition (MSH) A subclass of diuretics that limits the secretion of POTASSIUM into the URINE.
Definition (NCI) Any diuretic agent that produces diuresis without increasing potassium excretion. Potassium sparing diuretics are generally either aldosterone antagonists and thus prevent the aldosterone-mediated promotion of sodium and water retention, or are epithelial sodium channel blockers and prevent the exchange of potassium for sodium in the distal convoluted tubule. These agents cause diuresis without increasing potassium secretion and thus do not cause hypokalemia.
Concepts Pharmacologic Substance (T121)
MSH D062865
SnomedCT 371337002, 372753003, 47755009
English Potassium-Sparing Diuretic, K-sparing diuretics, potassium-sparing diuretics (medication), potassium-sparing diuretics, diuretics potassium sparing, potassium-sparing diuretic, potassium sparing diuretic, Diuretics, Potassium Sparing, POTASSIUM-SPARING DIURETICS, POTASSIUM-SPARING AGENTS, Potassium-sparing diuretic product (product), Potassium Sparing Diuretics, Potassium-sparing diuretic (substance), Potassium-sparing diuretic, Potassium sparing diuretic, Potassium-sparing diuretic (product), Potassium-sparring diuretic product, Potassium-sparing diuretic, NOS, Potassium-sparing Diuretics
Czech diuretika šetřící draslík, draslík šetřící diuretika, kalium šetřící diuretika
French Diurétiques épargneurs de potassium, Diurétiques d'épargne de potassium, Diurétiques d'épargne potassique, Diurétiques hyperkaliémiants, Diurétiques épargnant le potassium
German Diuretika, kaliumsparende, Kaliumsparende Diuretika
Italian Diuretici a risparmio di potassio
Spanish Diuréticos Conservadores de Potasio, producto con diurético ahorrador de potasio, producto con diurético ahorrador de potasio (producto), diurético ahorrador de potasio (sustancia), diurético ahorrador de potasio, producto (producto), diurético ahorrador de potasio, producto, diurético ahorrador de potasio, diurético ahorrador de potasio (producto)
Polish Diuretyki oszczędzające potas, Leki moczopędne oszczędzające potas
Russian КАЛИЙСБЕРЕГАЮЩИЕ МОЧЕГОННЫЕ СРЕДСТВА, ДИУРЕТИКИ КАЛИЙСБЕРЕГАЮЩИЕ, KALIISBEREGAIUSHCHIE MOCHEGONNYE SREDSTVA, DIURETIKI KALIISBEREGAIUSHCHIE
Croatian Not Translated[Diuretics, Potassium Sparing]
Norwegian Not Translated[Diuretics, Potassium Sparing]
Portuguese Diurético Poupador de Potássio