Potassium-sparing diuretics on the NCLEX
Spironolactone and the K-sparing class for NCLEX: hyperkalemia, gynecomastia, when to use.
K-sparing diuretics retain potassium. The NCLEX tests hyperkalemia risk and the side effects of spironolactone specifically.
Common drugs
Spironolactone (aldosterone antagonist), eplerenone (cleaner side effect profile), triamterene, amiloride.
Action and use
Antagonize aldosterone or block Na channels in collecting duct. Used in HF (mortality benefit), HTN, edema, ascites, hyperaldosteronism.
Side effects
Hyperkalemia (especially with ACE/ARB combo). Spironolactone: gynecomastia, menstrual irregularities (eplerenone avoids these). GI upset.
Monitor
K+ at baseline and after dose changes. Combine cautiously with ACE/ARB/K supplements.
Frequently asked
Why does spironolactone cause gynecomastia?
It also blocks androgen receptors. Eplerenone is selective for aldosterone and avoids this.
K-sparing alone enough for HTN?
Usually not. Often combined with thiazide or loop to balance K+ loss.
Quick check
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