DRUG STUDY# 1: Spironolactone (Aldactone)

NAME OF THE
DRUG
(GENERIC AND
BRAND NAME)
GENERIC NAME:
Spironolactone

BRAND NAME:
Aldactone

Novospiroton

Classification
Therapeutic: diuretics
Pharmacologic:
Potassium-sparing
diuretics
Pregnancy Category C

DOSAGE,
ROUTE ,
FREQUENCY
PO:(Adults):
Edema 25-200 mg/ day
in 1-2 divided doses.
HTN50-100 mg/ day in
1-2 divided doses.
Diuretic-induces
hypokalemia 25-100 mg/
day in 1-2 divided doses.
Diagnosis of primary
hyperaldosteronism 100400 mg/day in 1-2 divided
doses.
CHF12.5- 25 mg/ day
(unlabeled use).
PO (children 1-17 yr.):
Diuretics, HTN 1 mg/kg/
day in 1-2 divided doses
(should not exceed 3.3 mg/

NURSING
INDICATION/ CONTRAINDICATION ADVERSE RESPOSIBILITY
EFFECT
ACTION
WITH
RATIONALE
INDICATIONS:
Counteract
potassium loss
caused by other
diuretics. Used with
other agents
(thiazides) to treat
edema or
hypertension.
Primary
hyperaldosteronism
(spironolactone
only).
Unlabeled Used:
Spironolactone:
Management of CHF
(low doses).
ACTION:

Contraindicated in:
Hypersensitivity; Hyperkalemia;
Anuria; Acute Renal Insufficiency;
Significant Renal dysfunction
Used Cautiously in: Hepatic
dysfunction; Geri: Presence of
age-related renal dysfunction may
lead to increase risk of
hyperkalemia; Diabetes (increase
risk of hyperkalemia); Concurrent
use of potassium supplements or
potassium-containing salt
substitutes;OB, lactation, Pedi:
Safety not established.

CNS: dizziness,
clumsiness,
headache
CV:
arrhythmias
GU: erectile
dysfunction
ENDO: breast
tenderness,
gynecomastia,
irregular
menses, voice
deepening
F and E:
hyperkalemia,
hyponatremia
Hemat:
agrunulocytosis

Monitor intake
and output ratios
and daily weight
during therapy.

Monitor response
of signs and
symptoms of
hypokalemia
(weakness,
fatigue,
arrhythmias,
polyuria, and
polydipsia).
Assess patient
frequently for
development of
hyperkalemia
(fatigue,

kg/ day) (unlabeled use).

Diagnostic of primary
hyperaldosteronism125375 mg/ m2/ day in 1-2
divided doses (unlabeled
use).
PO (Neonates): 1-3 mg/
kg/ day in 1-3 divided
doses.

Availability:
Tablets: 25 mg, 50 mg,
100 mg.
In combination with:
hydrochlorothiazide
(Aldactasize, {ApoSpirozide}).

Inhibition of sodium
reabsorption in the
kidney while saving
potassium and
hydrogen
ions(spironolactone
achieves this effect
by antagonizing
aldosterone
receptors).
Therapeutic
Effects: Weak
diuretic and
antihypertensive
response when
compared with other
diuretics.
Conservation of
potassium.

MS: muscle
cramps
MISC: allergic
reaction

paresthesia,
confusion,
dyspnea, and
cardiac
arrhythmias).
Patients who have
diabetes mellitus
or kidney disease
and geriatric
patients are at
increased risk of
developing these
symptoms.
Emphasize the
importance of
continuing to take
this medication,
even if feeling
well. Instruct the
patient to take
medication at
same time each
day. Take the
missed doses as
soon as
remembered
unless almost time
to the next dose.
Do not overdose.

For effectiveness
of medication.
Caution the
patient to avoid
salt substitutes
and foods that
contain high
levels of
potassium or
sodium unless
prescribed by
health care
provider.
May cause
dizziness. Caution
patient to avoid
driving or other
activities requiring
alertness until
response to
medication is
known. To prevent
accident and
injury.
Instruct the patient
to notify health
care professional
of medication
regimen before

treatment or
surgery.
Advise the patient
to notify health
care professional
if muscle
weakness or
cramps; fatigue or
severe nausea,
vomiting, or
diarrhea occurs.
Emphasize the
need of follow-up
exams to monitor
progress.