Aldosterone antagonist refers to drugs which antagonise the action of aldosterone at mineralocorticoid receptors. This group of drugs is often used as adjunctive therapy, in combination with other drugs, for the management of chronic heart failure. Spironolactone, the first member of the class, is also used in the management of hyperaldosteronism (including Conn's syndrome) and female hirsutism.

Mode of action

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Aldosterone antagonists are, as the name suggests, receptor antagonists at the mineralocorticoid receptor. Antagonism of these receptors inhibits sodium resorption in the distal tubule of the nephron in the kidneys. This interferes with sodium/potassium exchange, reducing urinary potassium excretion and weakly increasing water excretion (diuresis). (Rossi, 2006)

Their adjunctive use in congestive heart failure relates to their additive diuretic effect in combination with other drugs, reducing oedema and decreasing the cardiac workload.

Examples

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Members of this class in clinical use include:

• Spironolactone
• Eplerenone

See also

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• Potassium-sparing diuretic

References

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• Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006.

Aldosterone antagonists | Potassium-sparing diuretics | Steroids