Question

A 76yo african american male with HFrEF stage has been complaining about a decline in his usual daily activities due to fatigue symptoms. HPI: HLD, Post MI, HTN. Meds: lisinopril 20mg daily, carvedilol 12.5mg bid, atorvastatin 40mg at bedtime. EF: 30%. The physician asks for your advice regarding the use of aldactone. The following statement is true about aldosterone antagonism that should be considered: [SELECT ALL THAT APPLY]

a. It has been shown to reduce mortality and hospitalization rates
b. It will help manage potassium levels above 5.5 mEq/dL
c. It is contraindicated in patients with increased SCr (>2.5 mg/mL)
d. It is indicated after MI in patients with left ventricular dysfunction

Answer 1

Answers

The answer is option A, B, C, and D

Aldosterone antagonist drugs also are known as mineralocorticoid drugs that will help to block the reabsorption of sodium and thereby preventing water loss. This will helps to decrease the blood pressure and reduce the fluid around the heart and thereby preventing heart failure.

The American heart association recommends aldosterone antagonist as an eligible therapy for post-myocardial infarction patients with left ventricular dysfunction.

The use of aldosterone antagonists is helpful for the reduction of mortality and hospitalization rates in post-MI patients. This aldosterone antagonist therapy is contraindicated in patients with high serum creatinine therapy of more than 2.5 mg/ml that indicates the patient has chronic kidney disease. This drug therapy will worsen the kidney function in the patients who are taking treatment for high blood pressure.

Aldosterone antagonists will increase the potassium level in the patient. Hyperkalemia is an adverse effect of the aldosterone antagonist therapy that will cause fatigue, twitching, weakness, cramping, etc. Studies showing that the use of this therapy will cause hyperkalemia above 5.5 mEq/dL in patients.