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Aldosterone antagonist

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.

Additional recommended knowledge

Essential Laboratory Skills Guide

Daily Sensitivity Test

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1 Mode of action
2 Examples
3 See also
4 References

Mode of action

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). ^[1]

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

Examples

Members of this class in clinical use include:

References

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

v • d • e Receptor antagonists: hormone antagonists
Aldosterone antagonists - Androgen antagonists - Antithyroid agents - Gonadotropin-releasing hormone antagonists - Leukotriene antagonists - Prostaglandin antagonists - Selective estrogen receptor modulator

v • d • e Antihypertensives (C02) and diuretics (C03)
Sympatholytic agents (including alpha)	centrally acting/antiadrenergics (Clonidine, Guanfacine, Methyldopa, Moxonidine, Rescinnamine, Reserpine, Rilmenidine) • ganglion-blocking/nicotinic antagonist (Mecamylamine, Trimethaphan) • peripherally acting/antiadrenergics (Prazosin, Guanethidine, Indoramin, Doxazosin)
Vasodilators	Diazoxide • Hydralazine • Minoxidil • Nitroprusside • Phentolamine
Other antihypertensives	serotonin antagonist (Ketanserin) • endothelin receptor antagonist (Bosentan, Ambrisentan, Sitaxsentan)
Low ceiling diuretics	Thiazide (Bendroflumethiazide, Chlorothiazide, Hydrochlorothiazide) • Chlortalidone • Indapamide • Quinethazone • Mersalyl • Metolazone • Theobromine • Cicletanine
High ceiling diuretics	Loop diuretic (Bumetanide, Furosemide, Torasemide)
Potassium-sparing diuretics	ESC blockers (Amiloride, Triamterene) • aldosterone antagonists (Spironolactone, Eplerenone, Potassium canrenoate, Canrenone)