A 55-year-old man with hypertension has been on hydrochlorothiazide monotherapy for 2 years. He presents with blood pressure 148/92 mmHg, heart rate 78/min, and denies dyspnea. Laboratory studies reveal serum potassium 3.2 mEq/L (normal 3.5–5.0), serum glucose 145 mg/dL, and serum uric acid 7.8 mg/dL. Urinalysis shows no proteinuria. Which drug would most appropriately address his hypokalemia, hyperglycemia, and hyperuricemia?
- A)Chlorthalidone
- B)Hydralazine
- C)Metoprolol
- D)Amlodipine
- E)SpironolactoneGABARITO
Explicação
Spironolactone, a potassium-sparing aldosterone antagonist, would correct hypokalemia caused by thiazide-induced urinary potassium wasting. It also has metabolic benefits for glucose and uric acid compared to continuing thiazide monotherapy. Ver explicação completa e trilha adaptativa →