eplerenone的适应症

Binds to mineralocorticoid receptors, thereby blocking the binding of aldosterone, a component of the renin-angiotensin-aldosterone system (RAAS). Aldosterone synthesis occurs primarily in the adrenal gland and is regulated by multiple factors, including angiotensin II and non-RAAS mediators such as adrenocorticotropic hormone (ACTH) and potassium. Aldosterone binds to mineralocorticoid receptors in epithelial tissues (such as the kidneys) and non-epithelial tissues (such as the heart, blood vessels, and brain) and increases blood pressure by inducing sodium reabsorption and possibly other mechanisms.

Indications of eplerenone: 1. Congestive heart failure after acute myocardial infarction: eplerenone can improve the quality of life of patients with left ventricular dysfunction (ejection fraction ≤ 40%). Clinical trials have proven that eplerenone can also be used for congestive heart failure after acute myocardial infarction; 2. Anti-hypertension: eplerenone can be used alone or in combination with other antihypertensive drugs for the treatment of hypertension.

The main adverse reactions of eplerenone are: cough, diarrhea, abdominal pain, angina, myocardial infarction, proteinuria, headache, dizziness, fatigue, flu-like symptoms, etc. Other adverse reactions include: gynecomastia, abnormal vaginal bleeding; increases (serum potassium, triglycerides, cholesterol, alanine aminotransferase, γ-glutamyl transferase, creatinine, uric acid levels), and decreases in serum sodium levels.

Precautions for eplerenone: (1) eplerenone cannot be combined with potassium supplements, potassium-containing salts or contraindicated drugs (potassium-sparing diuretics, strong inhibitors of CYP450 liver enzymes). (2) Non-steroidal anti-inflammatory drugs and lithium can affect the plasma concentration of eplerenone and affect the efficacy. (3) Patients with high serum potassium, type 2 diabetes patients with microalbuminuria, patients with high serum creatinine levels, and patients with muscle intoxication clearance <50 mL/min should not take it. (4) Pregnant women, children, and those with hepatic and renal insufficiency should use with caution.