A 56-year-old man with resistant hypertension (BP 168/104 mmHg) and primary hyperaldosteronism (plasma aldosterone 24 ng/dL, renin suppressed) started spironolactone 25 mg daily two months ago. He now presents with bilateral breast tenderness and mild gynecomastia. Vital signs show HR 78/min, RR 14/min, temperature 37°C. Serum potassium is 5.2 mEq/L. He denies testicular pain or libido changes. Which mechanism best explains this adverse effect?
- A)Spironolactone irreversibly inhibits carbonic anhydrase
- B)Spironolactone activates epithelial sodium channels
- C)Spironolactone blocks vasopressin V2 receptors
- D)Spironolactone also antagonizes androgen receptorsGABARITO
- E)Spironolactone inhibits the Na K 2Cl cotransporter
Explicação
Spironolactone is an aldosterone receptor antagonist that also has antiandrogen effects, which can produce gynecomastia and breast tenderness in men. This adverse effect is less prominent with eplerenone because it is more selective. Ver explicação completa e trilha adaptativa →