COMPARATIV EEFFECTS OF SPIRONOLACTONE AND COMBINATION WITH FUROSEMIDE OF ASCITES FLUID AND BLOOD ELECTROLYTE IN CIRRHOSIS

  • Zamharira Muslim Faculty of Pharmacy, Andalas University
  • Helmi Arifin Faculty of Pharmacy, Andalas University
  • Nasrul Zubir Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Andalas University/DR. M. Djamil General National Hospital, Padang

Abstract

Objective: This study was to compare the effects of spironolactone and combination with furosemide on blood electrolyte levels and ascites fluid in patients with cirrhosis. [G1] 

Methods: This research was undertaken with prospectively experimental analysis on a limited population in DR. M Djamil General National Hospital, Padang. We include 11 patients with spironolactone used and 13 patients with combination spironolactone-furosemide utilized.

Results: The percentage of patients who experienced blood electrolyte disturbances with the use of spironolactone was hyponatremia 72.72%, hypernatremia 0%, hypokalemia 45.45%, hyperkalemia 9.09%, hypocalcemia 9.09%, hypercalcemia 18.18%. The percentage of blood electrolyte disturbances on the use of a combination of spironolactone-furosemide hyponatremia was 100%, hypernatremia 0%, hypokalemia 23.07%, hyperkalemia 7.69%, hypocalcemia 15.38%, hypercalcemia 0%. A reduction in body weight and abdominal circumference patients before and after use of spironolactone-furosemide combination is significant (p=0.000). [G2] [G3] 

Conclusion: The effects of spironolactone and combination with furosemide to the blood electrolyte levels in this study showed that the highest percentage of impaired blood electrolyte is hyponatremia and hypocalcemia. Spironolactone-furosemide combination therapy for weight-loss and abdominal circumference better than the single use of spironolactone.

 

Keywords: Cirrhosis, Spironolactone, Furosemide, Ascites, Blood Electrolyte

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References

1. Minino AM, Heron MP, Smith BL. Deaths: preliminary data for 2004. Natl Vital Statistics Reports 2006;54:1-49.
2. Sudoyo AW, Bambang S, Idrus A, Marcellus SK, Siti S. Buku Ajar Ilmu Penyakit Dalam. 4th ed. Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam. Fakultas Kedokteran Universitas Indonesia; 2007.
3. Friedman SL. Liver fibrosis from bench to bed‐side. J Hepatol 2003;38(Suppl):S38-S53.
4. Dipiro JT. Pharmacotherapy: A Pathophysiologic Approach. 6th ed. US: McGraw-Hill Companies; 2005.
5. Suzuki H, Stanley AJ. Current management and novel therapeutic strategies for refractory ascites and hepatorenal syndrome. QJM 2001;94:293-300.
6. Moore KP, Wong F, Ginès P. The management of ascites in cirrhosis: report on the consensus conference of the international ascites club. Hepatology 2003;38:258-66.
7. Runyon BA. Practice guidelines committee: american association for the study of liver diseases (AASLD). Management of adult patients with ascites due to cirrhosis. Hepatology 2004;39:841-56.
8. Angeli P, Wong F, Watson H, Gin`es P. The CAPPS Investigators. Hyponatremia in cirrhosis: results of a patient population survey. Hepatology 2006;44(6):1535-42
9. Sweetman. Martindale: The complete drug reference. London: Chicago Pharmaceutical Press; 2009.
10. Klutts JS, Scott MG. Physiology and disorders of Water, Electrolyte, and Acid-Base Metabolism In: Tietz Text Book of Clinical Chemistry and Molecular Diagnostics 4th ed. Vol. 1. Philadelphia: Elsevier Saunders Inc; 2006. p. 1747-75.
11. Sutadi SM. Sirosis Hepatitis, Internal Medicine of Medical Faculty Sumatera Utara University; 2003.
12. Katzung BG. Farmakologi dasar dan klinik. 8th ed. Jakarta: Salemba Medika; 2004.
13. Runyon BA. AASLD Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: an update. Hepatology 2009;49:2087-107.
14. Sood, Rita. Ascites: Diagnosis and Management. J Indian Acad Clin Med 2004;5(1):81-8.
15. Moore KP, Aithal GP. Guidelines on the management of ascites in cirrhosis. Gut 2006;55(Suppl VI): vi1–vi12.
16. James SD, Anna SF, Lok AK, Burroughs E, Jenny H. Sherlock’s Diseases of the Liver and Biliary System. 12th ed. Edited by Blackwell Publishing Ltd; 2011.
17. Santos J, Planas R, Pardo A. Spironolactone alone or in combination with furosemide in the treatment of moderate ascites in nonazotemic cirrhosis. A randomized comparative study of efficacy and safety. J Hepatol 2003;39:187–92.
18. Angeli P, Fasolato S, Mazza E. Combined versus sequential diuretic treatment of ascites in nonazotemic patients with cirrhosis: results of an open randomized clinical trial. Gut 2010;59:98–104.
19. Vlachogiannakos J, Tang AKW, Patch D. Angiotensin converting enzyme inhibitors and angiotensin II antagonists as therapy in chronic liver disease. Gut 2001;49:303–8.
20. Planas R, Montoliu S, Balleste B. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol 2006;4:1385–94.
21. Gentilini P. Update on ascites and hepatorenal syndrome. Dig Liver Dis 2002;34:592-605.
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How to Cite
Muslim, Z., H. Arifin, and N. Zubir. “COMPARATIV EEFFECTS OF SPIRONOLACTONE AND COMBINATION WITH FUROSEMIDE OF ASCITES FLUID AND BLOOD ELECTROLYTE IN CIRRHOSIS”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 8, no. 8, June 2015, pp. 176-9, https://innovareacademics.in/journals/index.php/ijpps/article/view/4756.
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