Item nanme:spironolactone tablets Item character:This product is white
Indication: 1. Edema diseases combined with other diuretics in the treatment of edema diseases such as congestive edema, ascites due to liver cirrhosis and renal edema. The purpose is to correct the secondary increase of aldosterone secretion associated with the above diseases and to counteract the potassium excretion effect of other diuretics. It is also used in the treatment of idiopathic edema.
2. Hypertension as an adjunctive drug in the treatment of hypertension.
3. Spironolactone can be used in the diagnosis and treatment of primary aldosteronism.
4. The prevention of hypokalemia is combined with thiazide diuretics to enhance diuretic effect and prevent hypokalemia.
Item specifications:20mg*100tab/box
Usage and dosage:1 adult [1]
In the treatment of edematous diseases, 40-120mg (2-6 tablets) per day was taken 2-4 times for at least 5 days. The dosage should be adjusted in the future.
In the treatment of hypertension, 40-80mg (2-4 tablets) should be taken daily for at least 2 weeks. After that, the dosage should be adjusted as appropriate. It is not suitable to be combined with angiotensin converting enzyme inhibitor to avoid increasing the chance of hyperkalemia.
In the treatment of primary aldosteronism, patients were given 100-400mg (5-20 tablets) daily before operation, 2-4 times. For patients who are not suitable for operation, a smaller dose is used.
Diagnosis of primary aldosteronism. Long term trial, 400mg (20 tablets) daily, 2-4 times for 3-4 weeks. In the short-term trial, 400mg (20 tablets) was taken 2-4 times a day for 4 consecutive days. The elderly are more sensitive to this drug, and the initial dosage should be smaller.
2 children
In the treatment of edematous diseases, the dosage was adjusted according to the weight of 1-3mg / kg or body surface area of 30-90mg / m2, once or in two to four times daily for 5 days. The maximum dose was 3-9mg / kg or 90-270mg / m2 per day
Adverse reactions 1. Common problems are as follows:
(1) Hyperkalemia is the most common, especially when taking medicine alone, eating high potassium diet, taking potassium or potassium containing drugs such as penicillin potassium, and there are renal function damage, oliguria, anuria; even if combined with thiazide diuretics, the incidence of hyperkalemia can still reach 8.6% - 26%, and arrhythmia is the first manifestation, so it is necessary to closely follow up the blood potassium and ECG during medication;
(2) Gastrointestinal reactions, such as nausea, vomiting, gastrospasm and diarrhea, have been reported to cause peptic ulcer.
2
(1) Hyponatremia is rare when used alone, and the incidence of hyponatremia increases when combined with other diuretics;
(2) Long term use of this drug can cause breast development, impotence and low sexual function in men, and can cause breast swelling and pain, voice coarsening, increased hair, menstrual disorders and decreased sexual function in women;
(3) Central nervous system manifestations, long-term or large dose of this drug can occur walking uncoordinated, headache and so on.
3
(1) Allergic reaction, rash and even dyspnea;
(2) The temporary increase of plasma creatinine and urea nitrogen is mainly related to excessive diuresis, insufficient effective blood volume and decrease of glomerular filtration rate;
(3) Mild perchloric acidosis;
(4) 5 cases of breast cancer were reported after long-term use of this drug and hydrochlorothiazide.
Taboo: Hyperkalemia is forbidden
Matters needing attention: 1. Use with caution in the following situations:
(1) No urine.
(2) Renal insufficiency.
(3) Liver function is not complete, because this medicine causes electrolyte disorder, can induce liver coma.
(4) Hyponatremia.
(5) On the other hand, it can aggravate the hyperacidosis.
(6) Breast enlargement or menstrual disorder.
2. The administration should be individualized, starting from the minimum effective dose, so as to reduce the occurrence of side effects such as electrolyte disturbance. If you take medicine once a day, you should take medicine in the morning to avoid the increase of urination at night.
3. The blood potassium concentration of patients should be known before medication, but in some cases, the blood potassium concentration does not represent the total amount of potassium in the body. For example, when acidosis occurs, potassium is transferred from intracellular to extracellular and hyperkalemia is easy to occur. After acidosis is corrected, the blood potassium can be decreased.
4. The action of this drug is slow and the maintenance time is long, so the first day dose can be increased to 2-3 times of the conventional dose, and the dose can be adjusted as appropriate later. When combined with other diuretics, it can be taken 2-3 days before other diuretics. The dosage of other diuretics can be reduced by 50% in the first 2-3 days, and the dosage can be adjusted accordingly. At the time of withdrawal, the drug should be stopped 2-3 days before other diuretics.
5. In case of hyperkalemia, the drug should be stopped immediately.
6. The drug should be taken at the time of eating or after meals to reduce gastrointestinal reactions and possibly improve the bioavailability of the drug.
7. Interference to diagnosis
(1) The concentration of plasma cortisol measured by fluorescence method is increased, so the drug should be stopped or other methods should be used 4-7 days before blood collection.
(2) When the following measured values are increased, plasma creatinine and urea nitrogen (especially when the original renal function is damaged), plasma renin, serum magnesium and potassium, urinary calcium excretion may be increased, while urinary sodium excretion may be decreased.
8. Athletes should use it carefully.
Medication for pregnant and lactating women: The drug can pass through the placenta, but its effect on the fetus is unclear. Pregnant women should use drugs under the guidance of doctors, and the medication time should be as short as possible
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