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106 Cards in this Set
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- Back
- 3rd side (hint)
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fludrocortisone
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Adrenal insufficiency
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Mineralocorticoid
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Adrenaline (epinephrine)
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Anaphylaxis
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Sympathomimetic
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promethazine
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Anaphylaxis
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Phenothiazine, H1 antagonist reducing histamine-related vasodilation and increased capillary permeability
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hydrocortisone
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Anaphylaxis, Adrenal insufficiency
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Glucocorticoid
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diltiazem
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Angina
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Calcium channel blocker - Diltiazem acts on both cardiac and vascular smooth muscle, but it has less effect on cardiac cells than verapamil.
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GTN
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Angina
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Nitrates -provide exogenous source of nitric oxide (which mediates vasodilator effects). Predominantly venodilators; reduce venous return and preload to the heart, reducing myocardial oxygen requirement.
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isosorbide dinitrate
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Angina
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Nitrates -provide exogenous source of nitric oxide (which mediates vasodilator effects). Predominantly venodilators; reduce venous return and preload to the heart, reducing myocardial oxygen requirement.
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phenelzine
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Anxiety/Depression
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MAOIs irreversibly inhibit monoamine oxidases A and B (MAO-A and MAO-B), increasing the synaptic concentrations of adrenaline, dopamine, noradrenaline and serotonin.
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sertraline
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Anxiety/Depression
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SSRIs selectively inhibit the presynaptic reuptake of serotonin (5-hydroxytryptamine, 5HT).
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venlafaxine
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Anxiety/Depression
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Inhibits serotonin and noradrenaline reuptake.
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Diazepam
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Anxiety/Depression, Liver Failure and Ascites - Alcohol withdrawal
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Benzodiazepines potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.
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amitriptyline
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Anxiety/Depression, overdoses
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Tricyclic antidepressant - TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors. Clomipramine has a greater effect on serotonin transport than other TCAs.
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cromoglycate
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Asthma, COPD
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Cromolyns - Act by inhibiting release of inflammatory mediators from mast cells.
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fluticasone
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Asthma, COPD
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Corticosteroid - Reduce airway inflammation and bronchial hyper-reactivity.
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ipratropium
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Asthma, COPD
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Anticholinergics - Promote bronchodilation by inhibiting cholinergic bronchomotor tone.
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montelukast
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Asthma, COPD
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Leukotriene receptor antagonist - Inhibit the cysteinyl leukotriene receptor; antagonise airway smooth muscle contraction and inflammation caused by leukotrienes.
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Salbutamol
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Asthma, COPD
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Short acting beta agonist - Relax bronchial smooth muscle by stimulating beta2 adrenoceptors.
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salmeterol
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Asthma, COPD
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Long acting beta agonist - Relax bronchial smooth muscle by stimulating beta2 adrenoceptors.
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prednisolone
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Asthma, COPD, Rheumatoid arthritis
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Corticosteroid
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Digoxin
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Atrial Fibrillation, heart failure
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Cardiac glycoside - Increases force of myocardial contraction and decreases atrioventricular (AV) nodal conduction, predominantly by its vagotonic effect on the heart which also slows the heart rate. It can increase the excitability of cardiac muscle, particularly at higher doses.
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sotalol
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Atrial Fibrillation
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A nonselective beta-blocker which also prolongs the refractory period of atria, ventricles and bypass tract. It has no significant intrinsic sympathomimetic or membrane stabilising activity at therapeutic doses.
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amiodarone
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Atrial Fibrillation, other arrhythmias
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Decreases sinus node and junctional automaticity, slows atrioventricular (AV) and bypass tract conduction and prolongs refractory period of myocardial tissues (atria, ventricles, AV node and bypass tract); also has weak beta-blocker activity.
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warfarin
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Atrial Fibrillation, Venous Thromboembolism
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Inhibits synthesis of vitamin K-dependent clotting factors (II, VII, IX, X) and the antithrombotic factors protein C and protein S.
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azathioprine
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Chronic Diarrhoeas/Inflammatory Bowel Disease
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Azathioprine is metabolised to mercaptopurine which impairs cellular immunity, depresses cell proliferation and inhibits cellular inflammatory response through alterations of purine synthesis.
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mesalazine
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Chronic Diarrhoeas/Inflammatory Bowel Disease
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5-amino salicylates - Exact mechanism unknown but exert local anti-inflammatory action in the bowel wall.
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Prednisolone (enemas+oral)
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Chronic Diarrhoeas/Inflammatory Bowel Disease
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Corticosteroid
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infliximab
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Chronic Diarrhoeas/Inflammatory Bowel Disease, Rheumatoid arthritis
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TNF alpha antagonists - Bind to TNF alpha and inhibit its activity. TNF alpha is a cytokine involved in inflammatory and immune responses and in the pathogenesis of rheumatoid arthritis, psoriasis and inflammatory bowel disease.
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Bran
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Constipation
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bulk-forming
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lactulose
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Constipation
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osmotic laxative
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senna
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Constipation
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stimulant laxative - Act by direct stimulation of nerve endings in colonic mucosa to increase intestinal motility. May also cause accumulation of water and electrolytes in the colonic lumen.
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Gliclazide
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Diabetes Mellitus
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sulfonylureas - Increase pancreatic insulin secretion; may decrease insulin resistance.
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insulins - short, intermediate and long acting
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Diabetes Mellitus
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Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.
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metformin
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Diabetes Mellitus
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Biguanide - Reduces hepatic glucose production; increases peripheral utilisation of glucose.
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Glucagon
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Diabetic Comas
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Increases blood glucose concentration by activating hepatic glucose production; decreases GI motility.
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low-dose insulin infusion
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Diabetic Comas
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Increase or restore ability to metabolise glucose by enhancing cellular glucose uptake; inhibit endogenous glucose output and lipolysis.
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potassium
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Diabetic Comas
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Increases or decreases in serum potassium alter the resting membrane potential of excitable tissues and mainly cause arrhythmias and muscle dysfunction.
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saline
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Diabetic Comas
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Fluid replacement
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methadone
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Drugs for Dependence
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Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia, respiratory depression, sedation and constipation. They reduce transmission of the pain impulse by acting pre- and post-synaptically in the spinal cord, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.
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Naltrexone
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Drugs for Dependence
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Opioid antagonist; in alcohol dependence, it reduces craving for alcohol and possibly reduces some of the pleasurable effects, by blocking the effects of endogenous opioids. In maintenance of opioid abstinence, reversibly blocks opioid receptors (for 24–72 hours), preventing opioid effects, eg euphoria.
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nicotine
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Drugs for Dependence
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Nicotine replacement reduces the severity of tobacco withdrawal symptoms and increases the likelihood of smoking cessation.
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carvedilol
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Heart Failure
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Beta blocker, mixed beta-blocking and alpha1-blocking activity (eg labetalol, carvedilol) provide additional arteriolar vasodilating action.
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Frusemide
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Heart Failure
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"Loop diuretic - Inhibit reabsorption of sodium and chloride in the ascending limb of the loop of Henle. This site accounts for retention of approximately 20% of filtered sodium; therefore, these are potent diuretics.
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spironolactone
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Heart failure, Liver Failure and Ascites - Alcohol withdrawal
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Aldosterone antagonist - Inhibit sodium absorption in the distal tubule by antagonising aldosterone. As a result, they interfere with sodium/potassium exchange and reduce urinary potassium excretion. Weak diuretics when used alone, but may cause severe hyperkalaemia, especially in the presence of renal impairment or if used with ACE inhibitors, sartans, potassium-sparing diuretics or potassium supplements.
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Atorvastatin
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High Blood Cholesterol
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Competitively inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (a rate-limiting enzyme in cholesterol synthesis). Increase hepatic cholesterol uptake from blood, reduce concentrations of total cholesterol, LDL and triglyceride (modest), and produce a small increase in HDL concentrations.
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ezetimibe
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High Blood Cholesterol
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Reduces absorption of dietary and biliary cholesterol by inhibiting its transport across the intestinal wall. This leads to an increased demand for cholesterol, an increase in LDL uptake and its removal from the plasma.
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fenofibrate
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High Blood Cholesterol
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Fibrates - Activate peroxisome proliferator-activated nuclear receptors and modulate lipoprotein synthesis and catabolism. They reduce plasma triglyceride, moderately increase HDL and have a variable effect on LDL concentrations.
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Efavirenz + zidovudine + lamivudine (treatment is complex and updated reqularly see http://www.ashm.orq.au/austguidelines/)
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HIV
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complex
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Oestradiol (natural)
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Hormone Replacement Therapy
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Oestrogen relieves symptoms (eg hot flushes, night sweats and urogenital atrophy), caused by reduced endogenous oestradiol production. Progestogen reduces risk of endometrial cancer associated with unopposed oestrogen.
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Hydrochlorothiazide
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Hypertension
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Thiazide diuretic - Moderately potent diuretics; they inhibit reabsorption of sodium and chloride in the proximal (diluting) segment of the distal convoluted tubule and produce a corresponding increase in potassium excretion. When used in recommended low doses for hypertension, thiazides lower BP mostly by a vasodilator effect.
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prazosin
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Hypertension
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"Selective alpha blockers - Arterial and venodilators due to blockade of postsynaptic alpha1 receptors and therefore inhibition of catecholamine-mediated vasoconstriction. Have little effect on presynaptic alpha2 receptors and are therefore less likely to cause reflex tachycardia than the nonselective alpha-blockers.
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amlodipine
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Hypertension, angina
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Calcium channel blocker - Block inward current of calcium into cells in vascular smooth muscle, myocardium and cardiac conducting system via L-type calcium channels.
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verapamil
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Hypertension, angina, other arrhythmias
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Calcium channel blocker - Verapamil has greater cardiac effects, reducing contractility, heart rate and conduction with less effect on vascular smooth muscle.
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irbesartan
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Hypertension, Heart Failure
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Sartans - angiotensin receptor blockers. Competitively block binding of angiotensin II to type 1 angiotensin (AT1) receptors. They reduce angiotensin-induced vasoconstriction, sodium reabsorption and aldosterone release.
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ramipril
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Hypertension, Myocardial Infarction/Acute Coronary Syndromes, Heart failure
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ACE inhibitors block conversion of angiotensin I to angiotensin II and also inhibit the breakdown of bradykinin. They reduce the effects of angiotensin II-induced vasoconstriction, sodium retention and aldosterone release. They also reduce the effect of angiotensin on sympathetic nervous activity and as a growth factor.
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ranitidine
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Liver Failure and Ascites - Alcohol withdrawal
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Competitively block H2 receptors on parietal cells, reducing gastric acid secretion.
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Vit B
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Liver Failure and Ascites - Alcohol withdrawal
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vitamin replacement
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ceftriaxone
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Meningitis, pneumonia
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Cephalosporin antibiotic - interferes with bacterial cell wall peptidoglycan synthesis.
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clopidogrel
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Myocardial Infarction/Acute Coronary Syndromes
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Anti-platelet - Inhibits binding of adenosine diphosphate (ADP) to its platelet receptor, and the subsequent ADP-mediated activation of the glycoprotein IIb/IIIa complex, thereby inhibiting platelet aggregation.
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streptokinase
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Myocardial Infarction/Acute Coronary Syndromes
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Thrombolytic - Convert plasminogen to plasmin, which catalyses the breakdown of fibrin.
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atenolol
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Myocardial Infarction/Acute Coronary Syndromes, Angina, Hypertension
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Beta blocker
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aspirin
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Myocardial Infarction/Acute Coronary Syndromes, Atrial fibrillation, angina
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Anti-platelet - Inhibits platelet aggregation by irreversibly inhibiting cyclo-oxygenase, reducing the synthesis of thromboxane A2 (an inducer of platelet aggregation) for the life of the platelet.
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heparin
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Myocardial Infarction/Acute Coronary Syndromes, Venous Thromboembolism
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Inactivate clotting factors IIa (thrombin) and Xa by binding to antithrombin III; LMWHs and danaparoid have a much greater effect on factor Xa than on thrombin. Danaparoid is a more selective inhibitor of factor Xa than LMWHs.
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domperidone
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Nausea and Vomiting
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Dopamine antagonist - anti-emetic
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ondansetron
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Nausea and Vomiting
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Central and peripheral 5HT3 receptor blockade. mainly used to prevent or treat nausea and vomiting following cancer chemotherapy, radiotherapy or surgery
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Metoclopramide
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Nausea and Vomiting, migraine
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widely used to treat nausea and vomiting. They also have prokinetic activity which may be useful in nausea and vomiting due to gastroparesis
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Combined oestrogen (synthetic)-progestogen [ethinyloestradiol-norethisterone]
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Oral Contraceptives
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All COCs contain an oestrogen and progestogen. They inhibit ovulation, reduce receptivity of endometrium to implantation and thicken cervical mucus to form a barrier to sperm.
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progestogen only pill
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Oral Contraceptives
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When used as contraceptives, progestogens thicken cervical mucus to impede the passage of sperm and change endometrium reducing the potential for implantation. They act on hypothalamus and suppress pituitary LH surge and may inhibit ovulation. Depot injection and implant reliably suppress ovulation; oral progestogen-only contraceptive suppresses ovulation in <50% of women.
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alendronate
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Osteoporosis and bone protection durinq corticosteroid use
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Bisphosphonate - Decrease bone resorption by inhibiting osteoclasts.
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Calcium supplements
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Osteoporosis and bone protection durinq corticosteroid use
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calcium metabolism…
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vitamin D
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Osteoporosis and bone protection durinq corticosteroid use
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Regulate calcium homeostasis and bone metabolism. Increase intestinal absorption and renal reabsorption of calcium and phosphate. Promote bone mineralisation.
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Adenosine
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Other arrhythmias
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Depresses sinus node activity and slows conduction through the atrioventricular node; also produces peripheral and coronary vasodilation. Adenosine has a rapid onset and short duration of action.
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atropine
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Other arrhythmias
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Atropine competitively inhibits binding of acetylcholine to muscarinic receptors in the parasympathetic and central nervous systems. In normal circumstances atropine increases heart rate, causes mydriasis, inhibits smooth muscle contraction in the GI and genitourinary systems and inhibits secretion from a variety of glands. When there is excessive acetylcholine, eg in organophosphate poisoning, the muscarinic effects of poisoning (eg miosis, salivation, sweating, bradycardia, vomiting and diarrhoea) are reversed by atropine.
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codeine
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Pain
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Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia, respiratory depression, sedation and constipation. They reduce transmission of the pain impulse by acting pre- and post-synaptically in the spinal cord, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.
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ibuprofen
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Pain
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Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic, antipyretic and anti-inflammatory actions. They inhibit synthesis of prostaglandins by inhibiting cyclo-oxygenase. Cyclo-oxygenase (COX) is present in 2 forms, COX-1 and COX-2. Inhibition of COX-1 is associated with impaired gastric cytoprotection and antiplatelet effects. Inhibition of COX-2 is associated with anti-inflammatory and analgesic action. Reduction in glomerular filtration rate and renal blood flow is associated with both COX-1 and COX-2 inhibition.
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oxycodone
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Pain
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Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia, respiratory depression, sedation and constipation. They reduce transmission of the pain impulse by acting pre- and post-synaptically in the spinal cord, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.
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Paracetamol
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Pain, migraine, Arthritis, Rheumatoid Arthritis
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Not fully determined. Mechanisms involved in its analgesic effect may include inhibition of central prostaglandin synthesis and modulation of inhibitory descending serotonergic pathways. The antipyretic effect is probably due to reduced production of prostaglandins in the hypothalamus. Paracetamol has negligible anti-inflammatory effects.
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lbuprofen
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Pain, migraine, Arthritis, Rheumatoid Arthritis
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Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic, antipyretic and anti-inflammatory actions. They inhibit synthesis of prostaglandins by inhibiting cyclo-oxygenase. Cyclo-oxygenase (COX) is present in 2 forms, COX-1 and COX-2. Inhibition of COX-1 is associated with impaired gastric cytoprotection and antiplatelet effects. Inhibition of COX-2 is associated with anti-inflammatory and analgesic action. Reduction in glomerular filtration rate and renal blood flow is associated with both COX-1 and COX-2 inhibition.
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Morphine
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Pain, Myocardial Infarction/Acute Coronary Syndromes
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Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia, respiratory depression, sedation and constipation. They reduce transmission of the pain impulse by acting pre- and post-synaptically in the spinal cord, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.
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clarithromycin
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Peptic Ulcer Disease (including helicobacter)
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Macrolide antibiotic - Bacteriostatic; inhibit bacterial protein synthesis by binding to the 50S ribosomal subunit.
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pantoprazole
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Peptic Ulcer Disease (including helicobacter)
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PPI = Irreversibly inactivate the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated and basal acid secretion. When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium ATPase.
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Ranitidine
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Peptic Ulcer Disease (including helicobacter)
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H2 antagonist - Competitively block H2 receptors on parietal cells, reducing gastric acid secretion.
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metronidazole
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Peptic Ulcer Disease (including helicobacter), pneumonia
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Antibacterial - Metronidazole and tinidazole are metabolised to active metabolites that are thought to interfere with DNA synthesis.
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Amoxycillin (amoxicillin)
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Peptic Ulcer Disease (including helicobacter), Urinary tract infections, general and respiratory tract infections, pneumonia
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Bactericidal; penicillins interfere with bacterial cell wall peptidoglycan synthesis.
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erythromycin
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Pneumonia
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Macrolide antibiotic - Bacteriostatic; inhibit bacterial protein synthesis by binding to the 50S ribosomal subunit.
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gentamicin
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Pneumonia, Sepsis/PID Aerobic and Anaerobic
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Aminoglycoside antibiotic - Inhibit protein synthesis by irreversibly binding to the 30S ribosomal subunit and causing cell membrane damage. Concentration-dependent bactericidal effect.
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Lignocaine
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Providing Local Anaesthesia
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Reversibly interrupt impulse conduction in peripheral nerves and stabilise excitable cell membranes by blocking sodium channels, thus inhibiting depolarisation.
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Chlorpromazine
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Psychoses/Mania
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Antipsychotic actions are thought to be mediated (at least in part) by blockade of dopaminergic transmission in various parts of the brain (in particular the limbic system).
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haloperidol
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Psychoses/Mania
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Antipsychotic actions are thought to be mediated (at least in part) by blockade of dopaminergic transmission in various parts of the brain (in particular the limbic system).
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lithium
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Psychoses/Mania
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Unknown; its actions include inhibition of dopamine release, enhancement of serotonin release and decreased formation of intracellular second messengers. Lithium has little or no psychotropic effect in normal individuals.
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risperidone
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Psychoses/Mania
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Antipsychotic actions are thought to be mediated (at least in part) by blockade of dopaminergic transmission in various parts of the brain (in particular the limbic system).
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assisted ventilation
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Respiratory Failure
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…
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Oxygen
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Respiratory Failure, COPD, Anaphylaxis
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…
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sulphasalazine
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Rheumatoid arthritis, Chronic Diarrhoeas/Inflammatory Bowel Disease
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Carbimazole
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Thyrotoxicosis and Hypothyroidism
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5-amino salicylates - Exact mechanism unknown but exert local anti-inflammatory action in the bowel wall.
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propranolol
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Thyrotoxicosis and Hypothyroidism
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Competitively block beta receptors in heart, peripheral vasculature, bronchi, pancreas, uterus, kidney, brain and liver.
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thyroxine [levothyroxine]
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Thyrotoxicosis and Hypothyroidism
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replacement of thyroid hormone
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ethambutol
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Tuberculosis
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May inhibit incorporation of mycolic acid into the mycobacterial cell wall. It is slowly bacteriostatic against M. tuberculosis.
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isoniazid
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Tuberculosis
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May involve inhibiting synthesis of mycolic acids, constituents of the mycobacterial cell wall. It is bactericidal against actively dividing M. tuberculosis and bacteriostatic against resting bacteria; it is active against intra- and extracellular organisms.
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pyrazinamide
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Tuberculosis
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Bactericidal against M. tuberculosis in acid pH (inactive against non-tuberculous mycobacteria); active against bacteria within macrophage; activity declines with time (pH increases as inflammation decreases).
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Rifampicin
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Tuberculosis
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Rifampicin (derivative of rifamycin B) and rifabutin (derivative of rifamycin S) inhibit bacterial RNA polymerase. They are bactericidal against rapidly dividing M. tuberculosis and active against those which are semi-dormant (intracellular organisms).
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cephalexin
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Urinary Tract Infection
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Cephalosporins - Interfere with bacterial cell wall peptidoglycan synthesis.
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norfloxacin
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Urinary Tract Infection
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Quinolones - Bactericidal; inhibit bacterial DNA synthesis by blocking DNA gyrase and topoisomerase IV.
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Trimethoprim
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Urinary Tract Infection
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Bacteriostatic; competitively inhibits bacterial folate production essential for bacterial growth.
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vitamin K
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Venous Thromboembolism
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Essential cofactor in the synthesis of blood clotting factors II, VII, IX and X, and proteins C and S; antagonist of oral anticoagulants.
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pioglitazone
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Diabetes Mellitus
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Thiazolidinediones - Agonists of peroxisome proliferator-activated receptor gamma which regulates genes involved in lipid and glucose metabolism. Increase the sensitivity of peripheral tissues to insulin, decrease hepatic glucose output.
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spironolactone
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Heart failure, Liver Failure and Ascites, Alcohol withdrawal
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Aldosterone antagonist - Inhibit sodium absorption in the distal tubule by antagonising aldosterone. As a result, they interfere with sodium/potassium exchange and reduce urinary potassium excretion. Weak diuretics when used alone, but may cause severe hyperkalaemia, especially in the presence of renal impairment or if used with ACE inhibitors, sartans, potassium-sparing diuretics or potassium supplements.
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