Eplerenone, sold under the brand name Inspra, is an aldosterone antagonist type of potassium-sparing diuretic that is used to treat chronic heart failure and high blood pressure, particularly for patients with resistant hypertension due to elevated aldosterone. It is a steroidal antimineralocorticoid of the spirolactone group and a selective aldosterone receptor antagonist (SARA). Eplerenone is more selective than spironolactone at the mineralocorticoid receptor relative to binding at androgen, progestogen, glucocorticoid, or estrogen receptors. Medical uses
Heart failure
Eplerenone reduces risk of death in patients with heart failure, particularly in patients with recent myocardial infarction (heart attack). Hypertension
Eplerenone lowers blood pressure in patients with primary hypertension. Eplerenone also reduces arterial stiffness and vascular endothelial dysfunction.For persons with resistant hypertension, eplerenone is safe and effective for reducing blood pressure, particularly in persons with resistant hypertension due to hyperaldosteronism. Central serous chorioretinopathy
Eplerenone is often prescribed for people with central serous chorioretinopathy (CSC). However, the most recent and largest randomized controlled trial showed that eplerenone has no significant effect on chronic CSC. Adverse effects
Common adverse drug reactions (ADRs) associated with the use of eplerenone include: hyperkalaemia, hypotension, dizziness, and reduced renal clearance. Eplerenone may have a lower incidence than spironolactone of sexual side effects such as feminization, gynecomastia, impotence, low sex drive and reduction of size of male genitalia. This is because other antimineralocorticoids have structural elements of the progesterone molecule, causing progestogenic and antiandrogenic outcomes.
The remainder is attributed to secondary causes: vascular problems, infections and various other conditions. History
The importance of severe headaches in the diagnosis of subarachnoid hemorrhage has been known since the 1920s, when London neurologist Charles Symonds described the clinical syndrome. The term "thunderclap headache" was introduced in 1986 in a report by John Day and Neil Raskin, neurologists at the University of California, San Francisco, in a report of a 42-year-old woman who had experienced several sudden headaches and was found to have an aneurysm that had not ruptured. References
Further reading
Dodick, DW (1 January 2002). "Thunderclap headache". Journal of Neurology, Neurosurgery & Psychiatry. 72 (1): 6–11. doi:10.1136/jnnp.72.1.6. PMC 1737692. PMID 11784817. Ju, Yo-El; Schwedt, Todd (29 March 2010). "Abrupt-Onset Severe Headaches". Seminars in Neurology. 30 (2): 192–200. doi:10.1055/s-0030-1249229. PMC 3558726. PMID 20352589. Ducros, A; Bousser, MG (9 January 2013). "Thunderclap headache". BMJ. 346 (jan08 15): e8557. doi:10.1136/bmj.e8557. PMID 23303883. S2CID 2537784. == External links ==