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Epithelial Sodium Channel Aquaporin-2 Aquaporin-3 Potassium channel subfamily K member 1 Epithelial Sodium Channel Sodium/potassium- transporting ATPase subunit gamma Sodium/potassium- transporting ATPase subunit gamma Mineralocorticoid receptor Mineralocorticoid receptor Mineralocorticoid receptor Epithelial Sodium Channel Epithelial Sodium Channel Sodium/potassium- transporting ATPase subunit alpha-4 Epithelial Sodium Channel Sodium/potassium- transporting ATPase subunit alpha-3 Sodium/potassium- transporting ATPase subunit beta-1 Na+ Na+ H2O H2O H2O Na+ K+ K+ K+ K+ Spironolactone Spironolactone Aldosterone Spironolactone Aldosterone Sodium/potassium- transporting ATPase subunit alpha-2 Sodium/potassium- transporting ATPase subunit alpha-1 Sodium/potassium- transporting ATPase subunit beta-2 Sodium/potassium- transporting ATPase subunit beta-3 ATPase, (Na+)/K+ transporting, beta 4 polypeptide Epithelial sodium channel Sodium/potassium ATPase Distal Tubule Lumen Interstitium Principal Cell Binding of spironolactone blocks aldosterone from binding to the receptor. Spironolactone competitively inhibits mineralocorticoid receptors. Less aldosterone- mineralocorticoid complexes are available in the nucleus for transcription to occur. Protein synthesis is decreased and therefore, less sodium channels and Na+/K+ ATPase are available on the membrane. Less Na+ reabsorption occurs due to the few Na+ channels present. Increased K+ retention since less K+ is transported into the lumen for excretion in urine. More water is excreted in urine due to the high Na+ concentration in the lumen. Cytosol Nucleus Spironolactone is administered as an oral tablet
Nucleus SCNN1G AQP2 AQP3 KCNK1 SCNN1G FXYD2 FXYD2 NR3C2 NR3C2 NR3C2 SCNN1A SCNN1B ATP1A4 SCNN1D ATP1A3 ATP1B1 Sodium Sodium Water Water Water Sodium Potassium Potassium Potassium Potassium Spironolactone Spironolactone Aldosterone Spironolactone Aldosterone ATP1A2 ATP1A1 ATP1B2 ATP1B3 Unknown Epithelial sodium channel Sodium/potassium ATPase
SCNN1G AQP2 AQP3 KCNK1 SCNN1G FXYD2 FXYD2 NR3C2 NR3C2 NR3C2 SCNN1A SCNN1B ATP1A4 SCNN1D ATP1A3 ATP1B1 Na+ Na+ H2O H2O H2O Na+ K+ K+ K+ K+ Sptone Sptone Aldostr Sptone Aldostr ATP1A2 ATP1A1 ATP1B2 ATP1B3 E s c Sod ATP Distal Tubule Lumen Interstitium Principal Cell Binding of spironolactone blocks aldosterone from binding to the receptor. Spironolactone competitively inhibits mineralocorticoid receptors. Less aldosterone- mineralocorticoid complexes are available in the nucleus for transcription to occur. Protein synthesis is decreased and therefore, less sodium channels and Na+/K+ ATPase are available on the membrane. Less Na+ reabsorption occurs due to the few Na+ channels present. Increased K+ retention since less K+ is transported into the lumen for excretion in urine. More water is excreted in urine due to the high Na+ concentration in the lumen. Cytosol Nucleus Spironolactone is administered as an oral tablet
Nucleus SCNN1G AQP2 AQP3 KCNK1 SCNN1G FXYD2 FXYD2 NR3C2 NR3C2 NR3C2 SCNN1A SCNN1B ATP1A4 SCNN1D ATP1A3 ATP1B1 Na+ Na+ H2O H2O H2O Na+ K+ K+ K+ K+ Sptone Sptone Aldostr Sptone Aldostr ATP1A2 ATP1A1 ATP1B2 ATP1B3 E s c Sod ATP