This study evaluated the inhibitory effects of spironolac-tone, a non-selective aldosterone receptor antagonist, on hypertension-induced myocardial fibrosis. Collagen I and III contents was detected in the myocardial tissue of spontaneously hypertensive rats (SHRs) after spironolactone administration. Twenty male SHRs were assigned to the spironolactone group or control group (N = 10 each); 7 Wistar-Kyoto rats (WKY) were also used. Spironolactone dissolved in ddH2O was administered via gavage at a dosage of 20 mg·kg(-1)·day(-1). Meanwhile, the control and WKY groups were administered equivalent volumes of ddH2O for 16 weeks. Western blotting was used to detect the contents of collagen I in myocardial tissue; observations were performed using polarizing microscopy, and the area integration and ratio of collagen I/III were subsequently calculated. Compared to the WKY group, col-lagen I synthesis was significantly higher in the control group (1.87 ± 0.2 vs 1.21 ± 0.7, P < 0.05). After 16 weeks of treatment, collagen I contents were significantly lower in the spironolactone group than in the control group (1.42 ± 0.05 vs 1.87 ± 0.2, P < 0.05). The ar-eas of collagen I and collagen I/III ratio were significantly smaller in the spironolactone group than in the control group (6400 ± 259 vs 12,019 ± 734 pixels, 15.64 ± 1.34 vs 20.8 ± 3.04 pixels, respec-tively; P < 0.05). However, there were no significant differences in the area of collagen III among the three groups. In conclusion, spi-ronolactone improves myocardial collagen deposition, preventing myocardial fibrosis in SHRs.
aldactone drug class
Administration of an aldosterone receptor antagonist in addition to double RAAS blockade with an ACE inhibitor and ARB may slow the progression of chronic kidney disease. Additional studies are necessary to confirm this result.
aldactone generic name
This was an observational, retrospective secondary analysis of a study including 100 patients with ADCHF.
aldactone reviews ascites
1. The metabolism of [1-3H]canrenone, a primary metabolite of spironolactone and potassium canrenoate, by rat liver preparations in vitro has been investigated. 2. Canrenone was metabolized by 3-oxo-delta 4-reduction to give 3 alpha-hydroxy-5 beta-spirolactones, and also by a number of O2 and NADPH-dependent microsomal hydroxylation reactions. 3. A major metabolic route requiring the presence of a microsomal fraction, but apparently independent of oxygen and NADPH, led to the formation of a number of compounds tentatively identified as trihydroxy-spirolactones.
aldactone normal dosage
The authors suggest starting the treatment with celecoxib, and replacing by ACEi if necessary, monitoring the renal function. The safety and efficacy of celecoxib need to be assessed in larger controlled studies.
aldactone 50 mg
Clinicians should be aware that vancomycin therapy, even in the presence of normal renal function, may be a reversible cause of severe hypokalaemia.
Rapid actions of aldosterone that are independent of transcription and translation have been described in a variety of cells; however, whether nongenomic pathways mediate aldosterone-induced regulation of renal tubule transport has not been determined. We report here that aldosterone induces rapid (<3.5 min) inhibition of HCO absorption in the medullary thick ascending limb (MTAL) of the rat. This inhibition is observed over the physiological range of hormone concentrations (IC(50) approximately 0.6 nM) and is not affected by pretreatment with actinomycin D (12.5 microg/ml), cycloheximide (40 microg/ml), or spironolactone (10 microM). The glucocorticoids dexamethasone, cortisol, and corticosterone (1 or 500 nM) did not affect HCO absorption in the absence or presence of carbenoxolone. Thus the specificity of rapid aldosterone action is not dependent on 11beta-hydroxysteroid dehydrogenase activity. The inhibition by aldosterone is additive to inhibition by angiotensin II and vasopressin, indicating that these factors regulate MTAL transport through distinct pathways. These results demonstrate that aldosterone inhibits HCO absorption in the MTAL via a pathway that is rapid, highly selective, independent of transcription and protein synthesis, and not mediated through the classic mineralocorticoid receptor. The results establish a role for nongenomic pathways in mediating aldosterone-induced regulation of transepithelial transport in the mammalian kidney. The novel action of aldosterone to inhibit luminal acidification in the MTAL may play a role in enabling the kidney to regulate acid-base balance independently of Na(+) balance and extracellular fluid volume.
aldactone generic cost
Eplerenone, a selective aldosterone blocker, has been shown to attenuate cardiac fibrosis and decrease cardiovascular events in both experimental and clinical studies. We examined the cardioprotective effect of eplerenone in myocardial infarction (MI) rats receiving different levels of salt in their diet. The MI rats were randomly divided into five groups: Group CL, animals received a low-salt diet (0.015%); Group EpL, a low-salt diet with eplerenone (100 mg/kg/day in food); Group CH, a high-salt diet (0.9%); Group EpH, a high-salt diet with eplerenone; and Group C, a normal salt diet (0.3%). These diets were continued for 4 weeks. Echocardiographic and histomorphological examinations revealed that the administration of eplerenone significantly improved the cardiac function, significantly suppressed compensatory cardiac hypertrophy and significantly reduced cardiac fibrosis in both the interstitial and the perivascular areas in the high-salt diet group (Group EpH). However, eplerenone had no observable effects in the low-salt diet group (Group EpL). Also, these examinations demonstrated that the left ventricular remodeling after MI was suppressed and the cardiac function was improved in the group receiving a low-salt diet without eplerenone (Group CL), even though there was a significant increase of aldosterone level in blood, in comparison to the group receiving a high-salt diet without eplerenone (Group CH). These results indicate that the cardioprotective effect of eplerenone varies depending on the salt intake.
aldactone like drug
Twenty-three hypertensive outpatients aged 18-53 yr (average: 39.8+/-10.4 yr) were classified into two groups according to body mass index (BMI). Six patients exceeded the BMI limit, set at 30 kg/m2. All were treated with 100 mg/d spironolactone and were subject to before and after measurements of their arterial pressure, efflux rate constants of zinc from lymphocytes (total ERCt-Zn and ouabain-dependent ERCos-Zn), serum zinc (Zn-s), lymphocyte zinc (Zn-l), serum aldosterone (Ald-s), plasma renin activity (PRA), serum sodium (Na-s), and potassium (K-s). After 7 d of spironolactone treatment, the ERCt-Zn change in normal-weight patients was +0.78+/-0.57, and -0.22+/-0.69 in obese patients. In the same manner, the change of ERCos-Zn was +0.59+/-0.94 and -0.025+/-0.32 in normal and obese patients, respectively. Serum Zn was increased in normal-weight patients but remained unchanged in the obese. The initial lymphocyte zinc values were significantly lower in obese patients, but increased up to normal values after spironolactone treatment.
aldactone acne dosage
The aim of this review is to assess the risks and benefits of diuretics acting on distal segments of the renal tubule (distal diuretics) in preterm infants with or developing chronic lung disease (CLD). Primary objectives are to assess changes in need for oxygen or ventilatory support and effects on long-term outcome, and secondary objectives are to assess changes in pulmonary mechanics and potential complications of therapy.
aldactone max dose
We included 4,832 CHF patients with chronic systolic dysfunction from the Norwegian Heart Failure Registry and the heart failure outpatients' clinic of the University of Heidelberg. Propensity scores for spironolactone receipt were calculated for each patient and used for matching to patients without spironolactone.
To investigate whether programmes had applied evidence-based expert clinical guidelines to optimise patient outcomes.
aldactone water pill
The antipyrine and thiosulphate spaces were measured in patients with circulatory insufficiency of the II B and III stages before and after medication with cardiac glycosides and diuretics, used in various combinations and in courses of different duration and also in 2-week long courses of treatment with ethacrine acid and aldactone in order to study the nature of changes in the water-electrolyte exchange in cardiac insufficiency following diminution of edemas occurring under the effect of an effective therapy. The main indication of cardiac insufficiency, the expansion of the extracellular space, was found to continue even after a clinically effective treatment and complete disappearance of edemas. When myocardial contractility continues to be at a low level and the aldosterone activity is high--the removal from the organism of a large quantity of fluid with the help of diuretics, while reducing the external clinical manifestations of the edematous conditions, aggravates at the same time the pathological nature of the fluid distribution between the extracellular medium and the cells, this being due, in the main, to the reduction in the amount of fluid in the cells. The differences between ethacrine acid and aldactone find their expression not only in a greater of smaller effectiveness of their diuretic action, but also in the influence which they exert on the regulation of water metabolism in cardiac insufficiency.
aldactone 30 mg
The use of beta-blockers was associated with better survival rates. The use of statins was also associated with better survival at 8 years. Randomised controlled trials are required to confirm these observations.
aldactone 75 mg
Diabetic nephropathy is the most important cause of end stage renal disease (ESRD). Aldosterone is involved in renal damage through induction of fibrosis, inflammation and necrosis in the kidney tissue. Previous studies have demonstrated that the combination of angiotensin receptor blocker (ARB) and spironolactone (an anti-aldosterone drug) are efficient for albuminuria reduction.
aldactone 40 mg
A 78-year-old white man presented with intractable lower back pain and constipation. On day 1 of admission, the patient exhibited a diffuse urticarial rash over his trunk and extremities. History revealed that the patient had taken a combination phenolphthalein/docusate sodium (Correctol) over-the-counter laxative 1 day prior to admission. He had a similar urticarial rash 1.5 years earlier with this product and was instructed not to use it. A biopsy was performed and evidence from light microscopic analysis of the tissue led to a diagnosis of TEN. Furosemide, spironolactone, allopurinol, and hydroxyurea were considered possible causes of the reaction and were discontinued. Despite this, the lesions worsened in severity. The patient subsequently responded well to intravenous antibiotics, intravenous corticosteroids, and local wound care. Furosemide, spironolactone, hydroxyurea, allopurinol, and docusate were all reintroduced without reactivation of the lesions.
aldactone 500 mg
Rat MCs of the line HBZY-1 were cultured and divided into 5 groups: ald group, treated with aldosterone (1 micromol/L or 100 nmol/L), ald combined with spironolactone 1 nmol/L for 24 hours, and control group. Anotfher cells were cultured and treated with ald 100 nmol/L for 0, 0.5, 1, 2, 4, 6, 8, and 24 h respectively or treated with ald of the concentrations of 10(-5), 10(-6), 10(-7), 10(-8), 10(-9), 10(-10), pr 10(-11) mol/L. RT-PCR and Western blotting were used to detect the mRNA and protein expression of PAI-1. Confocal laser scanning microscopy was used to detect the ROS level in the MCs. The transforming growth factor-beta1 (TGF-beta1) level in the medium was detected by ELISA.
Randomized controlled trials demonstrate the efficacy of aldosterone receptor antagonists (spironolactone and eplerenone) as a useful pharmacologic intervention specifically in patients with New York Heart Association (NYHA) class III and IV heart failure, in patients with an ejection fraction <40% after myocardial infarction, and most recently in patients with mildly symptomatic heart failure. However, aldosterone receptor antagonists may be beneficial in a broader patient population. Aldosterone receptor antagonists can potentially serve as an antiarrhythmic pharmacologic agent for atrial and ventricular arrhythmias, an anti-ischemic medication in coronary artery disease through prevention of myocardial fibrosis and vascular damage, and as an agent in people with asymptomatic and mild heart failure (NYHA classes I and II) and diastolic heart failure. However, many clinicians remain reluctant to prescribe this highly efficacious pharmacologic therapy for a variety of reasons, including concerns about polypharmacy and hyperkalemia. Recent observational analysis demonstrates that less than one-third of eligible patients hospitalized with heart failure actually received aldosterone antagonist therapy. This article will review the current and potential future uses of aldosterone receptor antagonists across the entire spectrum of cardiovascular disease. The authors have no funding, financial relationships, or conflicts of interest to disclose.
Cardiac failure has become a major but underestimated public health problem. The EPICAL study in France confirmed the severity of this condition. In addition to the neuro-hormones, the role played by inflammatory cytokines in the progression of the disease has been emphasized. The importance of the "genetic background" in the development and evolution of cardiac failure has been demonstrated (deletion or prospective polymorphism). From the therapeutic point of view, besides the hopes raised by multisite pacing, the betablockers and spironolactone have been shown to provide major functional improvement and prolonged survival, and they take their place with the angiotensin converting enzyme inhibitors in our pharmacological arsenal. Cellular transplantation is associated with encouraging pre-clinical results which open up a new field of interest. Finally, global management, including physical rehabilitation and patient education by plury-disciplinary teams, provides medical and economic benefits. The year 1999 has been particularly rich in the field of cardiac failure from the basis of fundamental research to the organisation of health care.
aldactone name brand
To evaluate the blood pressure (BP) and cardiomyocyte nuclei hypertrophy of spontaneously hypertensive rats (SHR) treated with spironolactone and with spironolactone and an angiotensin-converting enzyme inhibitor and calcium channel blocker.
Ivabradine decreased NT-proBNP (P = 0.002) from a median of 2850 pg/mL to 1802 pg/mL, corresponding to a median absolute and percent decrease of 964 pg/mL and 44.5%, respectively. The baseline HR correlated significantly with the baseline NT-proBNP (rs = 0.411, P = 0.041). The absolute and percent HR decrease correlated with the absolute NT-proBNP decrease (rs = 0.442, P = 0.027; rs = 0.395, P = 0.05). The greater the NT-proBNP absolute decrease tertile, the greater the baseline HR (P = 0.023) and the absolute (P = 0.028) and percent (P = 0.064) HR variation.
aldactone acne reviews
The purpose of this study was to compare the effectiveness of an outpatient renal dose adjustment alert via a computerized provider order entry (CPOE) clinical decision support system (CDSS) versus a CDSS with alerts made to dispensing pharmacists.