Pharm
Potassium-Sparing Diuretic
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Potassium-Sparing Diuretic
, Amiloride, Midamor, Triamterene, Dyrenium
Indications
Potassium-Sparing Diuretics only (
Aldosterone
independent, Amiloride and Triamterene)
Hypertension
Weak
Diuretic
s primarily used to counter urinary
Potassium
loss with other
Diuretic
s
Indications
Aldosterone Antagonist
s (
Spironolactone
,
Eplerenone
)
Congestive Heart Failure
Counter
Aldosterone
adverse effects on myocardial remodeling
Mechanism
Weak
Diuretic
s (compared with
Loop Diuretic
s or
Thiazide Diuretic
s)
Potassium-Sparing Diuretics only
Primarily used to counter urinary
Potassium
loss with other
Diuretic
s
Act directly at the distal convoluted tubule (
Aldosterone
independent)
Increase
Sodium
excretion
Decrease
Potassium
secretion
Aldosterone Antagonist
s (
Spironolactone
and
Eplerenone
)
Commonly used as adjunctive in
Congestive Heart Failure
management
Counter
Aldosterone
adverse effects on myocardial remodeling
Preparations
Potassium-Sparing Diuretics only (
Aldosterone
independent)
Amiloride (Midamor)
Dose: 5 mg orally daily (maximum: 20 mg/day)
Renal excretion (unchanged in urine)
Half-life: 6 hours
Triamterene (Dyrenium)
Dose: 100 mg orally twice daily (maximum: 300 mg/day)
Typically used as
Combination Medication
with
Thiazide Diuretic
Rapidly absorbed, highly metabolized in liver and
Kidney
and rapidly excreted
Preparations
Potassium-Sparing Diuretic and
Aldosterone Antagonist
s
Spironolactone
(
Aldactone
)
Eplerenone
(
Inspra
)
Precautions
Monitor
Serum Potassium
after starting a Potassium-Sparing Diuretic in those at
Hyperkalemia
risk
Obtain
Serum Potassium
at 3 days, 7 days and then monthly for the first 3 months
Adverse Effects
Potassium-Sparing Diuretics (Amiloride and Triamterene)
Hyperkalemia
Risk factors
Renal Insufficiency
Concurrent use with agents that raise
Potassium
(e.g.
ACE Inhibitor
s,
Potassium
supplements)
Blue
Urine Color
Specific to Triamterene
Decreased renal perfusion (if
Sodium
and water depletion)
Glucose Intolerance
Potassium-Sparing Diuretics
Drug Interactions
Potassium
supplements (risk of
Hyperkalemia
)
References
Olson (2020) Clinical Pharmacology, Medmaster, Miami, p. 62-3
Hamilton (2010) Tarason Pocket Pharmacopeia, p. 100
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