Med. praxi. 2014;11(3):127-130

Drugs affecting renin-angiotensin-aldosterone system, diuretics and kalemia: are we vigilant enough?

MUDr.Michal Prokeš, PharmDr.Josef Suchopár

INFOPHARM, Praha

The therapy of cardiovascular diseases has significantly improved following addition of drugs affecting renin-angiotensin-aldosterone

system (RAAS) to clinical practice, but the risk of hyperkalemia must also be considered, especially when other drugs with the same adverse

effect are prescribed. In this review article, we offer information from clinical trials and also from clinical praxis, where co-prescription

of drugs affecting RAAS and mineralocorticoid receptor antagonists (MRA, e.g. spironolacton and eplerenon) is used. There seems to

be more patients affected by serious hyperkalemia in clinical praxis than clinical studies revealed. This difference is probably caused by

lower age of patients engaged in clinical studies as well as more precise monitoring of patients, better patient education and appropriate

dose selection. When used appropriately, the combination of drugs affecting RAAS and MRA can significantly improve health care

outcomes across the spectrum of patients with heart failure with reduced ejection fraction.

patient monitoring.

Keywords: mineralocorticoid receptor antagonists, spironolactone, eplerenone, renin-angiotensin-aldosterone system, hyperkalemia,

Published: May 15, 2014  Show citation