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5 mg Indications: Essential hypertension, edema and ascites of CHF, liver cirrhosis, nephritic syndrome, idiopathic edema Drug Classification: Diuretic Mechanism of Action: : competes with aldosterone for receptor sites in the distal renal tubules, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions, may block the effect of aldosterone on arteriolar smooth muscle as well Dosage: Essential Hypertension 2-4 tab/day for 2 weeks or longer. Edema initially 4 tab daily then reduce to optimum dose. If adequate diuretic does not occur after 3 days, increase dose up to 8 tab daily. Children 1.65-3.3 mg of spironolactone/kg/day in divided doses Special Precautions: Acute or severe hepatic failure decompensated hepatic cirrhosis, pregnancy, lactation, concominant administration of K supplements or other K sparing agents, SLE. Monitor fluid and electrolytes. Pregnancy Risk Category D
reaction: Gynecomastia, GI symptoms, lethargy, headache and thrombocytopenia, leukopenia, agranulocytosis, cutaneous eruptions, pruritus, mental confusion, paresthesia, acute pancreatitis, jaundice, orthostatic hypertension, muscle spasm, weakness, fever, ataxia Contraindications: Acute renal insufficiency, significant impairment of renal function, anuria, hyperkalemia Form: tab 100’s Nursing Responsibilities: Educate patient to avoid hazardous activity such as driving until response to drug is known. Take with meals or milk; avoid excessive ingestion of food high in potassium or use of salt substitutes Diuretic effect may be delayed 2-3 days and maximum hypertensive may be delayed 2-3weeks; monitor I and O ratios and daily weight, BP, serum electrolytes (K, Na) and renal function