Which effect does Spironolactone have that Triamterene does NOT have?

Which effect does Spironolactone have that Triamterene does NOT have?

• A. Hyperkalemia
• B. Anti-androgen effects
• C. Gynecomastia
• D. Increased urinary potassium excretion

Answer: (B)

Spironolactone has antiandrogen effects because it is a steroidal aldosterone antagonist that also blocks androgen receptors and can inhibit androgen synthesis. This antiandrogen activity can lead to clinical signs like gynecomastia in men. Triamterene, a non-steroidal potassium-sparing diuretic that blocks ENaC channels, does not have antiandrogen effects, so gynecomastia and other antiandrogen-related effects do not occur with it. While both drugs can cause hyperkalemia due to reduced potassium excretion, that shared effect doesn’t distinguish spironolactone from triamterene. The option describing increased urinary potassium excretion isn’t a effect of spironolactone (it actually reduces potassium excretion), making it an incorrect distinguishing choice.

Spironolactone has antiandrogen effects because it is a steroidal aldosterone antagonist that also blocks androgen receptors and can inhibit androgen synthesis. This antiandrogen activity can lead to clinical signs like gynecomastia in men. Triamterene, a non-steroidal potassium-sparing diuretic that blocks ENaC channels, does not have antiandrogen effects, so gynecomastia and other antiandrogen-related effects do not occur with it. While both drugs can cause hyperkalemia due to reduced potassium excretion, that shared effect doesn’t distinguish spironolactone from triamterene. The option describing increased urinary potassium excretion isn’t a effect of spironolactone (it actually reduces potassium excretion), making it an incorrect distinguishing choice.