A 40 years old female currently on a drug for psychiatric illness and hypeension presents with NYHA class III hea failure with dyspnea, pedal edema and K+ levels of 5.5 mEq/L and creatinine 2.5 mg%. Which of the following drug is best avoided?
(A) Carvedilol (B) Enalapril (C) Spironolactone (D) Digoxin
(C) Answer- C. Spironolactone In this case patient is having heafailure with hyperkalemia and renal dysfunction with psychiatric illness. Spironolactone and enalapril, both causes hyperkalemia hut spironolactone csuses CNS depression also. Digoxin causes hypokalemia In this patient, spironolactone should be avoided.Mechanism of ActionPharmacologic antagonist of aldosterone in collecting tubulesWeak antagonism of androgen receptorsWeak inhibitor of testosterone synthesis