DRUG NAME MECHANISM OF ACTION INDICATIONADVERSEREACTIONCONTRAINDICATIONNURSINGCONSIDERATIONspironolactoneDOSAGE: 25mg/tabROUTE & FREQUENCY:PO 1 tab 3x/daySpecific pharmacologicantagonist of aldosteronethat competes withaldosterone foe cellularreceptor sites in distal renaltubule. Promotes sodium andchloride excretion withoutloss of potassium.Essential hypertension,refractory edema due to CHF,hepatic cirrhosis, nephroticsyndrome, hypokalemia, andidiopathic edema. May beused to potentiate actions of other diuretics andantihypertensive agents or forits potassium-sparing effects.Also used for treatment of primary aldosteronismLethargy, mental confusion,fatigue with rapid weight loss,headache, drowsiness, ataxia.Anuria, acute renalinsufficiency; renal failure;diabetic neohropathy;progressing impairment of kidney function,hyperkalemia; pregnancy>Check BP beforeintiation of therapy andat intervals throughouttherapy.>Lab tests: Monitorserum electrolytes(sodium and potassium)especially during earlytherapy; monitor digoxinlevel when usedconcurrently.>Assess for signs of fluidand electrolyteimbalance, and signs of digoxin toxicity.>Monitor daily I&O andcheck for edema; bothmay indicate tolerance todrug.>Weight patient understandard conditionsbefore therapy beginsand daily throughouttherapy. Weight is auseful index of need fordosage adjustment. Forpatients with ascites,physicians may wantmeasurement of abdominal girth.>Observe for and reportimmediately the onset of mental changes, lethargy,or stupor in patients withliver disease.