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Hyponatremia is an uncommon, but serious, complication of diuretic therapy. Thiazide diuretics are more likely than loop diuretics to cause hyponatremia. Loop diuretics inhibit sodium (Na+) transport in the renal medulla and prevent the generation of a maximal osmotic gradient.
Aldactone (spironolactone) is an aldosterone receptor antagonist that causes the kidneys to remove water and sodium from the body, with reduced losses of potassium. Aldactone is used to reduce edema caused by heart, liver or kidney problems, hypertension, and certain patients with hyperaldosteronism.
Mechanism Of Action. ALDACTONE (spironolactone) is a specific pharmacologic antagonist of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule.
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The pump acts to re-absorb sodium and water in exchange for potassium, which is then eliminated in the urine. Consequently, aldosterone antagonism can cause hyperkalemia. Hyperkalemia is an established adverse effect of both spironolactone and eplerenone. The symptoms of hyperkalemia begin with muscle weakness.
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