MRAs—spironolactone, eplerenone, and finerenone—do far more than nudge blood pressure. They improve outcomes in heart failure, offer targeted benefits in CKD with T2D, and play a unique role in cirrhosis-related ascites. In this focused review, Dr. Busti walks through the why behind the what: aldosterone receptor blockade, tissue selectivity (kidney vs heart), and how those differences drive real-world choices, dosing, and safety.
We compare agents head-to-head, unpack RAAS physiology, and translate it into exam-ready pearls and bedside judgment—covering hyperkalemia risk, gynecomastia, CYP3A4 interactions, ACEi/ARB combinations, and how to counsel on potassium-containing salt substitutes.
Episode highlights
Access bonus materials and downloads from the episode at https://www.thisiswhy.health/topics/pharmacology-review-loop-diuretics
Disclaimer: This content is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard in this content.
