In which conditions is spironolactone typically indicated?

Spironolactone is typically indicated in heart failure and hypertension due to its mechanisms as a potassium-sparing diuretic and an aldosterone antagonist. It works by inhibiting the actions of aldosterone, which helps in reducing fluid overload and hypertension. In cases of heart failure, it aids in preventing the progression of the disease and can improve morbidity and mortality. By promoting sodium excretion while retaining potassium, it provides a beneficial effect on the cardiovascular system, making it especially useful in patients with both hypertension and heart failure.

The other options are less relevant for spironolactone’s primary uses. Diabetes and metabolic syndrome do not align directly with its therapeutic action, while asthma and COPD generally require bronchodilators or corticosteroids for management. Chronic pain and inflammation typically utilize other classes of medications, such as NSAIDs or opioids, rather than a diuretic like spironolactone.