Pharmacy PEBC Practice Exam

CY is a 58 year old female who has heart failure (NYHA III). Her physician wants CY to start therapy with spironolactone or eplerenone. Which of the following adverse effects is found significantly more often with spironolactone than with eplerenone?

1. Bradycardia

2. Gynecomastia

3. Hyperkalemia

4. Prolonged QT interval

The correct answer is: Gynecomastia

Spironolactone and eplerenone are both types of medications called aldosterone antagonists used to treat heart failure. Both medications work in a similar way by blocking the effects of aldosterone, a hormone that can lead to fluid and salt retention in the body. However, spironolactone is known to cause more adverse effects compared to eplerenone. One of these adverse effects is gynecomastia, the development of breast tissue in males. This is because spironolactone has estrogen-like effects in the body, which can lead to hormonal imbalances and breast tissue growth in males. On the other hand, eplerenone does not have these estrogen-like effects and is therefore less likely to cause gynecomastia. The other options listed, such as bradycardia, hyperkalemia, and prolonged QT interval, are all