SPIRONOLACTONE 1. Name & class of drug – generic and trade name.

GENERIC NAME: Aldactone, Novospiroton BRAND NAME: Spironolactone CLASSIFICATION: Electrolyte and water balance agent; potassium sparing diuretic 2. Dose range and routes for adult & geriatric client. PREPARATIONS: PO – (25, 50, 100) mg tablets DOSING: Edema – 25 – 200 mg/d in divided doses, continued for atleast 5 daysd 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: a diuretic agent that promote sodium and chloride excretion without concomitant loss of K+. USES: clinical conditions associated with augmented aldosterone production, as in essential hypertension, refractory edema due to CHF, hepatic cirrhosis, nephritic syndrome and idiopathic edema 4. Major side effects & drug interactions. DRUG INTERACTIONS: combination of spironolactone and acidifying doses of ammonium chloride may produce systemic acidosis. Effects may be antagonized by aspirin and other salicylates. Digoxin should be monitored for decreased effect. Hypokalemia may result with K+ supplements, ACE inhibitors, ARBS. May alter antiocoagulant response in warfarin. Salt subs may increase risk of hyperkalemia SIDE EFFECTS: lethargy, mental confusion, fatigue, N/V, abd cramps, fluid and electrolyte imbalance

5. Nursing Implications & teaching. IMPLICATIONS: • Check blood pressure before initiation of therapy • Monitor serum electrolytes • Assess for signs for fluid electrolyte imbalance • Monitor daily I&O, check for edema • Weigh pt under standard conditions, and daily once therapy commences • Observe for and report immediately the onset of mental changes TEACHING: • Max diuretic effect may not occur until third day of therapy, diuresis may continue 2-3 days after d/c • Avoid replacing fluid losses with large amounts of free water • Weigh 2 – 3 times weekly • Avoid intake of high potassium foods and salt substitutes