Which progestin component of a combined oral contraceptive is a spironolactone analogue possessing anti-mineralocorticoid and anti-androgenic activity, warranting caution in women prone to hyperkalaemia?
- A Drospirenone ✓
- B Desogestrel
- C Levonorgestrel
- D Norethisterone
Correct answer: A. Drospirenone
Explanation
Drospirenone is structurally derived from spironolactone and retains its anti-mineralocorticoid (potassium sparing) and anti-androgenic actions, so it can cause hyperkalaemia and is avoided in renal or adrenal insufficiency. It also improves acne and premenstrual symptoms, which drives its popularity. Levonorgestrel and norethisterone are androgenic second-generation progestins, and desogestrel is a selective third-generation progestin without mineralocorticoid antagonism. The spironolactone link is the classic examination hook.
Reference: KD Tripathi Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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