Which of the following is a contraindication for spironolactone?

Which of the following is a contraindication for spironolactone?

Spironolactone is contraindicated in patients with hyperkalemia, Addison’s disease (chronic adrenal insufficiency), or other conditions associated with hyperkalemia and should not be administered to those who are receiving other potassium-sparing agents.

What is contraindication for the administration of aldosterone antagonists?

These medications are contraindicated in patients with renal insufficiency and serum creatinine levels higher than 2.5 mg/dL and in patients with baseline serum potassium levels higher than 5.0 mmol/L.

Which diuretics are contraindicated with ACE inhibitors?

Potassium sparing diuretics have generally been avoided in patients receiving ACE inhibitors, owing to the potential risk of hyperkalaemia.

What are the contraindications of nifedipine?


  • Severe aortic stenosis.
  • Unstable angina.
  • Hypotension.
  • Heart failure.
  • Moderate to severe hepatic impairment.

How does aldosterone affect the heart?

Aldosterone plays an important role in the pathophysiology of heart failure. This substance promotes retention of sodium and loss of potassium, activates the sympathetic nervous system and myocardial and vascular fibrosis, and causes baroreceptor dysfunction.

When do you give aldosterone antagonist to heart failure?

The American Heart Association (AHA)/American College of Cardiology (ACC) Guidelines provide a Class I recommendation for aldosterone antagonist therapy among eligible post‐myocardial infarction (MI) patients with left ventricular ejection fraction (EF) ≤40% and either symptomatic heart failure (HF) or diabetes …

How do ACE inhibitors affect aldosterone?

ACE inhibitors lower the levels of aldosterone, thereby promoting potassium retention in the kidneys and bloodstream.

Can you take ACE inhibitors with diuretics?

ACE inhibitors are often prescribed with other medications and it’s something we call a synergistic effect. They work well with diuretics, which are drugs that make you pass water, and with calcium channel blockers.

Can nifedipine cause angina?

Beta-blockers are used to treat many conditions. These include high blood pressure, migraines, or heart failure. Using these drugs with nifedipine has a low risk of causing heart failure, extremely low blood pressure, or a worsening of chest pain (angina).

Why is nifedipine contraindicated in heart failure?

The authors conclude that administration of nifedipine is hazardous in patients who are stable with isosorbide therapy. In an accompanying editorial, Packer suggests that the cause of worsening heart failure may be activation of the sympathetic nervous system and the renin-angiotensin system.

What medications should not be taken with nitroglycerin?

Drugs you should not use with nitroglycerin

  • Sildenafil, tadalafil, vardenafil, and avanafil. Taking any of these drugs with nitroglycerin can cause very low blood pressure.
  • Ergotamine. Taking these drugs together can cause more chest pain.
  • Riociguat. Taking these drugs together can cause very low blood pressure.

Can you take spironolactone and propranolol together?

CONCLUSION: Spironolactone with propranolol results in a better response with a greater reduction in hepatic venous pressure gradient in the secondary prophylaxis of variceal bleeding. A greater number of patients may be protected by this combination therapy than by propranolol alone.

Does spironolactone affect heart rate?

Thirdly in our own study of CHF patients spironolactone reduced heart rate and increased heart rate variability despite also reducing blood pressure [8]. Our observation that spironolactone increased heart rate variability in CHF patients is strong evidence for aldosterone having parasympatholytic effects [8].

Does aldosterone cause vasoconstriction?

Aldosterone causes vasoconstriction in coronary arterioles, and this vasoconstrictor effect is enhanced by genetically defined hypertension. Aldosterone-induced vasoconstriction is mediated by angiotensin AT1 receptor presumably via oxidative stress.

Why is aldosterone used in heart failure?

What do aldosterone antagonists do for heart failure?

Aldosterone antagonists are an important pharmacologic therapy in the neurohormonal blockade necessary in the treatment of systolic heart failure. These drugs have been shown to decrease mortality and reduce hospital readmission rates.

What are the contraindications for nitroglycerin?

Contraindications of nitroglycerin • Hypersensitivity to the active substance, to related organic nitrates or to any of the excipients listed in section 6.1. • Noticeable anemia. • Acute circulatory failure associated with marked hypotension (shock).

Is there an antagonist to the vasodilator effects of nitroglycerin?

Hemodynamic Effects. No specific antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of nitroglycerin overdose. Because the hypotension associated with nitroglycerin overdose is the result of venodilatation and arterial hypovolemia,…

How does nitroglycerin interact with other medications or foods?

Nitroglycerin may interact with certain other medications, such as PDE-5 inhibitors. PDE-5 inhibitors are drugs that doctors give to treat erectile dysfunction. Viagra, Cialis, and Levitra are PDE-5 inhibitors. As with nitroglycerin, these drugs also cause increased blood flow and can lower blood pressure.

What should I know about nitroglycerin tablets before taking them?

If your doctor has prescribed “under-the-tongue” nitroglycerin tablets in addition to the Nitroglycerin Transdermal infusion system, you should sit down before taking the “under-the-tongue” tablet. If dizziness should occur, notify your doctor. This may be an indication that the “under-the-tongue” tablet dosage needs to be reduced.