Which laboratory value should be closely monitored in a patient being treated with spironolactone for hyperaldosteronism?

Which laboratory value should be closely monitored in a patient being treated with spironolactone for hyperaldosteronism?

• A. Potassium
• B. Sodium
• C. Calcium
• D. Magnesium

Answer: (A)

Spironolactone is a potassium-sparing diuretic that blocks aldosterone. By reducing potassium loss in the distal nephron, it can cause potassium to accumulate in the body. In hyperaldosteronism, aldosterone drives potassium loss, but treating with this drug changes that balance and raises the risk of hyperkalemia. Hyperkalemia can lead to dangerous heart rhythms, so serum potassium levels must be monitored closely, especially when starting therapy or adjusting the dose or in patients with kidney impairment. Sodium, calcium, and magnesium are less directly affected in the acute safety sense, making potassium the key lab to watch.

Spironolactone is a potassium-sparing diuretic that blocks aldosterone. By reducing potassium loss in the distal nephron, it can cause potassium to accumulate in the body. In hyperaldosteronism, aldosterone drives potassium loss, but treating with this drug changes that balance and raises the risk of hyperkalemia. Hyperkalemia can lead to dangerous heart rhythms, so serum potassium levels must be monitored closely, especially when starting therapy or adjusting the dose or in patients with kidney impairment. Sodium, calcium, and magnesium are less directly affected in the acute safety sense, making potassium the key lab to watch.