DRUG NAME spironolactone DOSAGE: 25mg/tab

MECHANISM OF ACTION Specific pharmacologic antagonist of aldosterone that competes with aldosterone foe cellular receptor sites in distal renal tubule. Promotes sodium and chloride excretion without loss of potassium.

INDICATION Essential hypertension, refractory edema due to CHF, hepatic cirrhosis, nephrotic syndrome, hypokalemia, and idiopathic edema. May be used to potentiate actions of other diuretics and antihypertensive agents or for its potassium-sparing effects. Also used for treatment of primary aldosteronism

ADVERSE REACTION Lethargy, mental confusion, fatigue with rapid weight loss, headache, drowsiness, ataxia.

CONTRAINDICATION Anuria, acute renal insufficiency; renal failure; diabetic neohropathy; progressing impairment of kidney function, hyperkalemia; pregnancy

ROUTE & FREQUENCY: PO 1 tab 3x/day

NURSING CONSIDERATION >Check BP before intiation of therapy and at intervals throughout therapy. >Lab tests: Monitor serum electrolytes (sodium and potassium) especially during early therapy; monitor digoxin level when used concurrently. >Assess for signs of fluid and electrolyte imbalance, and signs of digoxin toxicity. >Monitor daily I&O and check for edema; both may indicate tolerance to drug. >Weight patient under standard conditions before therapy begins and daily throughout therapy. Weight is a useful index of need for dosage adjustment. For patients with ascites, physicians may want measurement of abdominal girth. >Observe for and report immediately the onset of mental changes, lethargy, or stupor in patients with liver disease.