Potassium-sparing diuretic, whose action is caused by antagonism with aldosterone (ISS hormone of the adrenal cortex), which promotes the reabsorption of Na + in the renal tubules and the excretion of K +. Spironolactone is a competitive antagonist of aldosterone on the effect on the distal nephron (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permeases in the aldosterone-dependent section of the collecting tubules and distal tubules), increases the excretion of Na +, Cl – and water and reduces the excretion of K + and urine tubules) and increases the excretion of Na +, Cl – and water and reduces the excretion of K + and urine tubules) and increases the excretion of Na +, Cl – and water and reduces the excretion of K + and urine tubules. , reduces the titratable acidity of urine. Increased diuresis causes a hypotensive effect, which is not constant. The diuretic effect is manifested at 2-5 days of treatment.
Edematous syndrome: CHF, cirrhosis of the liver (especially with the simultaneous presence of hypokalemia and hyperaldosteronism), nephrotic syndrome, edema during pregnancy. Hypokalemia (prophylaxis with saluretic treatment). Primary hyperaldosteronism (Conn’s syndrome) – short-term preoperative treatment. Arterial hypertension (in combination therapy). Aldosterone-producing adrenal adenoma (long-term supportive therapy with contraindications to surgical treatment or in case of refusal from it). Myasthenia (auxiliary drugs). Diagnosis of hyper aldosteronism. Hirsutism, polycystic ovary syndrome, premenstrual syndrome.
Hypersensitivity, Addison’s disease, hyperkalemia, hypercalcemia, hyponatremia, chronic renal failure, anuria, liver failure, diabetes mellitus (with confirmed or suspected CRF), diabetic nephropathy, pregnancy (I trimester), metabolic acidosis, menstrual irregularity or an increase in the lactation glands. . AV blockade (possibility of amplification due to the development of hyperkalemia), decompensated liver cirrhosis, surgical interventions, taking drugs that cause gynecomastia, local and general anesthetics, old age.