Description
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How to use: dosage and course of treatment
Inside. With cirrhosis of the liver with a coefficient of Na + / K + less than 1, the daily dose is 100 mg, if the coefficient is more than 1 – 200-400 mg / day. In nephrotic syndrome: 100-200 mg / day in combination with thiazide diuretics. With edematous syndrome: 100-200 mg / day in 2-3 doses, in combination with a “loop” or thiazide diuretic. It is prescribed daily for 5 days, then, depending on the effect, the daily dose is reduced to 25-35 mg or gradually increased to 200-400 mg in 2-4 doses. With arterial hypertension: 50-100 mg / day, once, or in 2-4 doses for 2 weeks in combination with hypotensive drugs, and then the dose is gradually increased every 2 weeks to 200 mg / day. With hypokalemia: 25-100 mg, once, or in several doses (the maximum daily dose is 400 mg). With primary hyperaldosteronism: in the period of preparation for surgery – 100-400 mg / day in 2-4 doses; if it is impossible (or refused) to perform surgery – long-term treatment with minimal effective doses. As a diagnostic tool: 400 mg / day in several doses for 4 days (short test) or for 3-4 weeks (long test). Idiopathic hyperaldosteronism – 100 mg / day. Correction of the dosage regimen is carried out taking into account the concentration of K + in plasma. With severe hyperaldosteronism and a reduced K + content in plasma, a daily dose of 300 mg is prescribed in 2-3 doses (up to 400 mg / day), with an improvement in the condition, the dose is gradually reduced to 25 mg / day. With polycystic ovary syndrome and hirsutism – 100 mg 2 times a day. Children with edematous syndrome: 1-3.3 mg / kg or 30-90 mg / sq.m per day, once or in 1-4 doses. After 5 days, the dose is adjusted and, if necessary, increased 3 times from the initial dose.
Pharmacological action
A potassium-sparing diuretic, the effect of which is due to antagonism with aldosterone (MKS hormone of the adrenal cortex), which promotes the reabsorption of Na+ in the renal tubules and the excretion of K+. Spironolactone (the active substance of the drug) is a competitive antagonist of aldosterone in its effect on the distal parts of the nephron (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permeases in the aldosterone-dependent site of collecting tubules and distal tubules), increases the excretion of Na+, Cl- and water and reduces the excretion of K+ and urea, reduces the titrated acidity of urine. Increased diuresis causes a hypotensive effect, which is unstable. The diuretic effect manifests itself on day 2-5 of treatment.
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