A 46-year-old man with heart failure (EF 25%) presents with tender bilateral gynecomastia after 6 months of therapy. His vital signs show BP 118/76 mmHg, HR 58 bpm, RR 16, and temperature 37°C. Recent labs reveal potassium 5.2 mEq/L and creatinine 1.1 mg/dL. He denies testicular pain or masses. He currently takes lisinopril and the aldosterone antagonist initiated at his last visit. Which medication most likely caused his gynecomastia?
- A)Hydrochlorothiazide
- B)Acetazolamide
- C)Furosemide
- D)Amiloride
- E)SpironolactoneGABARITO
Explicação
Spironolactone is an aldosterone receptor antagonist that is potassium sparing and beneficial in heart failure. Because it also antagonizes androgen receptors and can increase estrogenic effects, gynecomastia is a classic adverse effect. Ver explicação completa e trilha adaptativa →