Amiloride, spironolactone, and potassium chloride in thiazide-treated hypertensive patients.
Article Details
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Ramsay LE, Hettiarachchi J, Fraser R, Morton JJ
Amiloride, spironolactone, and potassium chloride in thiazide-treated hypertensive patients.
Clin Pharmacol Ther. 1980 Apr;27(4):533-43.
- PubMed ID
- 7357812 [ View in PubMed]
- Abstract
Dose-response curves for amiloride and spironolactone were defined in 15 hypertensive patients treated with bendroflumethiazide (bendrofluazide). The relative potency amiloride:spironolactone in correcting hypokalemia was 2.8:1, an estimate significantly lower than the 5:1 potency currently accepted. The relative potency for reduction of plasma sodium was 3.9:1 (amiloride:spironolactone). Amiloride was disproportionately potent in lowering serum bicarbonate, and the data do not suggest that these drugs elevate plasma potassium simply by correcting metabolic alkalosis. Changes in blood pressure were confounded by the presence of carryover effect between treatment phases. Both drugs increased plasma angiotension II and aldosterone, but the rise in aldosterone with spironolactone was smaller than expected from concurrent plasma angiotension II and potassium concentrations. This was consistent with a partial block of aldosterone biosynthesis by spironolactone. The activity of spironolactone did not require the presence of hyperaldosteronism. In a smaller study potassium chloride induced a significant log dose-response on plasma potassium, but the effect was small in absolute terms. At least 64 mmole potassium chloride was needed to match the effect of 20 mg amiloride or 56 mg spironolactone.
DrugBank Data that Cites this Article
- Pharmaco-metabolomics
Drug Drug Groups Metabolite Change Description Amiloride Approved Aldosterone increased Amiloride increases the level of Aldosterone in the blood Amiloride Approved Potassium increased Amiloride increases the level of Potassium in the blood Spironolactone Approved Urea increased Spironolactone increases the level of Urea in the blood Spironolactone Approved Bicarbonate decreased Spironolactone decreases the level of Bicarbonate in the blood Spironolactone Approved Aldosterone increased Spironolactone increases the level of Aldosterone in the blood Amiloride Approved Sodium decreased Amiloride decreases the level of Sodium in the blood Amiloride Approved Bicarbonate decreased Amiloride decreases the level of Bicarbonate in the blood Spironolactone Approved Potassium increased Spironolactone increases the level of Potassium in the blood Spironolactone Approved Sodium decreased Spironolactone decreases the level of Sodium in the blood - Pharmaco-proteomics
Drug Drug Groups Gene Gene ID Change Interaction Chromosome Amiloride Approved AGT 183 increased Amiloride results in increased expression of AGT protein modified form 1q42.2 Spironolactone Approved AGT 183 increased Spironolactone results in increased expression of AGT protein modified form 1q42.2 Spironolactone Approved AGT 183 increased Spironolactone results in increased expression of AGT protein modified form 1q42.2