Cardiovascular drugs: finerenone: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular drugs: finerenone

Sample item

A man with type 2 diabetes and albuminuric chronic kidney disease remains albuminuric on a maximally tolerated ACE inhibitor, with serum potassium 4.4 mmol/L. A mineralocorticoid receptor antagonist without a steroid nucleus, with little gynaecomastia, is added. Which drug is it?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Finerenone

Finerenone is a non-steroidal, selective mineralocorticoid receptor antagonist that reduces progression of diabetic kidney disease and cardiovascular events. Because it is non-steroidal it causes little gynaecomastia or sexual dysfunction, though hyperkalaemia needs monitoring. Spironolactone and eplerenone are steroidal.

Option by option

  • A. Amiloride

    Amiloride blocks the epithelial sodium channel and is not an aldosterone receptor antagonist.

  • B. Spironolactone

    Spironolactone is steroidal and commonly causes gynaecomastia.

  • C. Finerenone (correct)

    Correct. Finerenone is the non-steroidal mineralocorticoid receptor antagonist.

  • D. Eplerenone

    Eplerenone is a steroidal MR antagonist with little anti-androgen effect, but it has a steroid nucleus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Finerenone. Finerenone is a non-steroidal, selective mineralocorticoid receptor antagonist that reduces progression of diabetic kidney disease and cardiovascular events.

Why is "Amiloride" not the answer?

Amiloride blocks the epithelial sodium channel and is not an aldosterone receptor antagonist.

Why is "Spironolactone" not the answer?

Spironolactone is steroidal and commonly causes gynaecomastia.

Why is "Eplerenone" not the answer?

Eplerenone is a steroidal MR antagonist with little anti-androgen effect, but it has a steroid nucleus.

What concept does this question test?

It tests Cardiovascular drugs: finerenone in Pharmacology. Because it is non-steroidal it causes little gynaecomastia or sexual dysfunction, though hyperkalaemia needs monitoring. Spironolactone and eplerenone are steroidal.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular drugs: finerenone?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.