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The potassium-sparing agents spironolactone, triamterene, and amiloride are often useful in combination with the loop diuretics and thiazides. Triamterene and amiloride act on the distal tubule to reduce potassium secretion. Their diuretic potency is only mild and not adequate for most patients with heart failure, but they may minimize the hypokalemia induced by more potent agents.
Side effects: Hyperkalemia, gastrointestinal symptoms, renal dysfunction and gynecomastia.
Reversible airways obstructive disease, advanced heart block, or episodic decompensation. Vasodilators Agents that dilate arteriolar smooth muscle and lower peripheral vascu
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