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MIDAMORamilorideis a potassium-conservingantikaliureticdrug that possesses weakcompared with thiazide diureticsnatriureticdiureticand antihypertensive activityThese effects have been partially additive to the effects of thiazide diuretics in some clinical studiesWhen administered with a thiazide or loop diureticMIDAMORamiloridehas been shown to decrease the enhanced urinary excretion of magnesium which occurs when a thiazide or loop diuretic is used aloneMIDAMORamiloridehas potassium-conserving activity in patients receiving kaliuretic-diuretic agents.
Antikaliuretic therapy should be instituted only with caution in severely ill patients in whom respiratory or metabolic acidosis may occursuch as patients with cardiopulmonary disease or poorly controlled diabetesIf MIDAMORamilorideis given to these patientsfrequent monitoring of acid-base balance is necessaryShifts in acid-base balance alter the ratio of extracellular/intracellular potassiumand the development of acidosis may be associated with rapid increases in serum potassium levels.
MIDAMORamilorideexerts its potassium sparing effect through the inhibition of sodium reabsorption at the distal convoluted tubulecortical collecting tubule and collecting ductthis decreases the net negative potential of the tubular lumen and reduces both potassium and hydrogen secretion and their subsequent excretionThis mechanism accounts in large proof for the potassium sparing action of amiloride.
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