Cardiovascular drugs: aldosterone antagonists: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Cardiovascular drugs: aldosterone antagonists

Sample item

A man with heart failure on spironolactone develops painful gynaecomastia and wishes to continue an aldosterone antagonist. Which substitute is less likely to cause this adverse effect?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Eplerenone

Spironolactone also blocks androgen receptors and has progestogenic action, which causes gynaecomastia and menstrual disturbance. Eplerenone is a more selective mineralocorticoid receptor antagonist with little effect on sex steroid receptors, so it avoids these effects while keeping the mortality benefit in heart failure.

Option by option

  • A. Eplerenone (correct)

    Correct. It is a selective aldosterone receptor blocker with minimal sex steroid receptor activity.

  • B. Triamterene

    Triamterene blocks the epithelial sodium channel and lacks proven mortality benefit in heart failure.

  • C. Amiloride

    Amiloride blocks the epithelial sodium channel and is not an aldosterone antagonist.

  • D. Furosemide

    Furosemide is a loop diuretic and does not antagonise aldosterone.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Eplerenone. Spironolactone also blocks androgen receptors and has progestogenic action, which causes gynaecomastia and menstrual disturbance.

Why is "Triamterene" not the answer?

Triamterene blocks the epithelial sodium channel and lacks proven mortality benefit in heart failure.

Why is "Amiloride" not the answer?

Amiloride blocks the epithelial sodium channel and is not an aldosterone antagonist.

Why is "Furosemide" not the answer?

Furosemide is a loop diuretic and does not antagonise aldosterone.

What concept does this question test?

It tests Cardiovascular drugs: aldosterone antagonists in Pharmacology. Eplerenone is a more selective mineralocorticoid receptor antagonist with little effect on sex steroid receptors, so it avoids these effects while keeping the mortality benefit in heart failure.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular drugs: aldosterone antagonists?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.