Question
Spironolactone/ Amiloride in lithium induced nephrogenic diabetes insipidus
Name the following (Two examples for each): (5x1=5)
Q15 0.3 marks Short Answers ★ ✓
Answer
Amiloride is the appropriate choice — it blocks lithium entry into collecting-duct principal cells through the epithelial sodium channel (ENaC), the same channel lithium uses to enter and interfere with ADH-mediated water reabsorption, directly correcting the nephrogenic diabetes insipidus. Spironolactone, a mineralocorticoid receptor antagonist, does not block this lithium-entry pathway and additionally risks raising serum lithium levels and causing antiandrogenic adverse effects (gynecomastia), making it unsuitable here.
1 Renal Pharmacology
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