potassium-sparing diuretics

関

Mineralocorticoid receptor antagonists; Sodium channel inhibitors

WordNet

1. a light soft silver-white metallic element of the alkali metal group; oxidizes rapidly in air and reacts violently with water; is abundant in nature in combined forms occurring in sea water and in carnallite and kainite and sylvite (同)K, atomic number 19

PrepTutorEJDIC

1. ポタシウム,カリウム(金属元素;化学記号はK)
2. 禁約な,つましい,控え目な
3. 排尿促進の,利尿の / 利尿剤

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/28 00:56:49」(JST)

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Structural formulae of the potassium-sparing diuretics. Click to enlarge.

Potassium-sparing diuretics are diuretic drugs that do not promote the secretion of potassium into the urine.

They are used as adjunctive therapy, together with other drugs, in the treatment of hypertension and management of congestive heart failure. However, at low doses the use of potassium-sparing diuretics has not been found to produce a clinically significant reduction in blood pressure.

Indications

Potassium-sparing diuretics are generally used in combination with other diuretic drugs (e.g. loop diuretics) that would otherwise tend to lower the potassium levels to potentially dangerous low levels (hypokalemia). The combination therefore helps maintain a normal reference range for potassium.

Adverse effects

On their own this group of drugs may raise potassium levels beyond the normal range, termed hyperkalemia, which risks potentially fatal arrhythmias.

Mechanism of action

The potassium-sparing diuretics are competitive antagonists that either compete with aldosterone for intracellular cytoplasmic receptor sites, or directly block sodium channels (specifically epithelial sodium channels (ENaC) by amiloride). The former prevents the production of proteins that are normally synthesized in reaction to aldosterone. These mediator proteins are not produced, and so stimulation of sodium-potassium exchange sites in the collection tubule does not occur. This prevents sodium re-absorption and potassium and hydrogen ion secretion.

Chemical structure

Potassium-sparing diuretics do not share any obvious chemical similarities, except for the steroid-structure of the aldosterone antagonists. Those in clinical use include:

• Epithelial sodium channel blockers
  • Amiloride
  • Triamterene
• Aldosterone antagonists (mostly spirolactones):
  • Spironolactone
  • Eplerenone

Other Diuretics

While not classically considered potassium-sparing diuretics, ACE inhibitors (ACEi) and angiotensin receptor blockers (ARB) are anti-hypertensive drugs with diuretic effects that decrease renal excretion of potassium. They work by inhibiting either the production (ACEis) or effects (ARBs) of angiotensin 2. This results in a decrease in aldosterone release, which causes potassium-sparing-diuretic-like effects similar to those of the aldosterone antagonists, spironolactone and eplerenone.

See also

• C03D Potassium-sparing agents

References

External links

• Potassium Sparing Diuretics at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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• 1. 利尿剤の作用機序 mechanism of action of diuretics
• 2. 腎でのマグネシウム処理における利尿剤の有効性 effect of diuretics on magnesium handling by the kidney
• 3. Pharmacologic therapy of heart failure with reduced ejection fraction
• 4. Uncommon congenital adrenal hyperplasias
• 5. トリアムテレン腎毒性 triamterene nephrotoxicity

English Journal

• It is never too late for a genetic disease: 
a case of a 79-year-old man with persistent hypokalemia.

• Brambilla G, Perotti M, Perra S, Dell'oro R, Grassi G, Pincelli AI.SourceDepartment of Clinical Medicine, University of Milano-Bicocca, San Gerardo Hospital, Monza - Italy.
• Journal of nephrology.J Nephrol.2013 Mar 6:0. doi: 10.5301/jn.5000256. [Epub ahead of print]
• Background: We describe a 79-year-old man with biochemical and radiological features of Gitelman syndrome: hypokalemia, hypomagnesemia, hyperreninemic hyperaldosteronism in absence of secondary hyperaldosteronism causes, and chondrocalcinosis. 
Methods and results: The diagnosis was confirmed by s
• PMID 23475471

• Electrolyte disorders in community subjects: prevalence and risk factors.

• Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ.SourceDepartment of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
• The American journal of medicine.Am J Med.2013 Mar;126(3):256-63. doi: 10.1016/j.amjmed.2012.06.037. Epub 2013 Jan 18.
• BACKGROUND: Electrolyte disorders have been studied mainly in hospitalized patients, whereas data in the general population are limited. The aim of this study was to determine the prevalence and risk factors of common electrolyte disorders in older subjects recruited from the general population.METH
• PMID 23332973

• Aldosterone mediates its rapid effects in vascular endothelial cells through GPER activation.

• Gros R, Ding Q, Liu B, Chorazyczewski J, Feldman RD.SourceDepartment of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
• American journal of physiology. Cell physiology.Am J Physiol Cell Physiol.2013 Mar;304(6):C532-40. doi: 10.1152/ajpcell.00203.2012. Epub 2013 Jan 2.
• The importance of the rapid vascular effects of aldosterone is increasingly appreciated. Through these rapid pathways, aldosterone has been shown to regulate vascular contractility, cell growth, and apoptosis. In our most recent studies, we demonstrated the effects of aldosterone on cell growth and
• PMID 23283935

Japanese Journal

• 利尿薬

• 瀬在 明,塩野 元美
• 日大医学雑誌 72(5), 254-255, 2013
• 心不全治療において利尿薬は必要不可欠な薬剤である．現在，利尿薬には，炭酸脱水素酵素阻害薬，ル ープ利尿薬，サイアザイド利尿薬，カリウム保持 性利尿薬が一般的に使用されている．その有効性とともに問題点も指摘されており，利尿薬の適切な使用が患者の予後に影響を及ぼすともいわれている．近年，パソプレッシン V2 受容体拮抗薬のトルバプタンが新たな利尿薬として注目されている．本論文では，各種利尿薬について論 …
• NAID 130004781717

• 高血圧治療薬の日常処方における薬物間相互作用 : 2剤併用の重要度別発生頻度に関する日米間比較

• 早勢 伸正,粟屋 敏雄,大滝 康一,松原 和夫,Carter Barry L.
• 医療薬学 33(3), 213-220, 2007-03-10
• 雑誌掲載版薬剤の処方に際して用法・用量、相互作用などの処方鑑査を支援する新規チェックシステムを導入し、その薬物相互作用検出機能を評価した。高血圧治療薬との薬物相互作用が予想される併用の組合せを評価対象とし、危険な薬物相互作用が予想される併用薬の使用頻度を調査して日米間で比較した。高血圧治療薬は薬効群、薬物名、相互作用薬物名、重要度などの項目に分類し、薬物相互作用は米国の臨床的重要度基準に基づいて5 …
• NAID 110006224464

• 高血圧治療薬の日常処方における薬物間相互作用‐２剤併用の重要度別発生頻度に関する日米間比較‐:-2剤併用の重要度別発生頻度に関する日米間比較-

• 早勢 伸正,粟屋 敏雄,大滝 康一,松原 和夫,Barry L. Carter
• 医療薬学 33(3), 213-220, 2007
• … per prescription,the frequency was highest for potassium-sparing diuretics.On the other hand,at Asahikawa Medical University Hospital,the frequency of importance level 1~2 did not depend on age,but accounted for 30% of the all combinations whether the checking system was in operation or not.Further,at 0.5 times per prescription,the frequency for potassium-sparing diuretics was higher than that for the Medicaid …
• NAID 130004502314

Related Links

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NSAIDs-ibuprofen (Motrin, Advil), naproxen (Aleve and others) when taken long-term and daily for arthritis or other problems, potassium-sparing diuretics (spironolactone and others), potassium supplementation, ACE inhibitors ...

• Potassium-sparing Diuretics | Health | Patient.co.uk

Potassium-sparing diuretics are weak diuretics. They are most often prescribed in combination with thiazides or loop diuretics, to prevent hypokalaemia... ... Who cannot take potassium-sparing diuretics? There are very few people ...

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★リンクテーブル★

関連記事	「sparing」「diuretic」

「sparing」

　　[★]

• adj.

• 質素な、節約する
• (～が)乏しい、少ない(of,in)

　

「diuretic」

　　[★] 利尿薬 diuretics