A young hypertensive patient presents with severe hypertension, marked hypokalemia, metabolic alkalosis, and suppressed plasma renin and aldosterone. A diagnosis of pseudohyperaldosteronism (Liddle syndrome) is made. The most appropriate antihypertensive is:
- A Amiloride ✓
- B Spironolactone
- C Hydrochlorothiazide
- D Eplerenone
Correct answer: A. Amiloride
Explanation
Liddle syndrome results from activating mutations of ENaC subunits, causing constitutive sodium channel activity independent of aldosterone. Amiloride blocks ENaC directly and works regardless of aldosterone levels, so it corrects both hypertension and hypokalemia. Spironolactone and eplerenone require an intact aldosterone receptor pathway and are ineffective because aldosterone is already suppressed.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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