Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ETHACRYNIC ACID”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58Linked to original sources
PubMed1980

The role of plasma membrane Ca++-Mg++ activated adenosine triphosphatase of rat mast cells on histamine release.

The role of a Ca++-MG++ activated ATPase, demonstrated on the outer surface of rat peritoneal mast cells, on histamine release induced by antigen (anaphylactic reaction), compound 48/80 and ionophore A23187 has been studied. A high level of the enzyme activity is retained at the optimal pH for histamine release induced by the three releasing agents. The effect of fourteen inhibitors of ATPase has been studied, viz. quinidine, fluoride, platinum salt, suramin, ethacrynic acid, ethyl alcohol, N-ethylmaleimide, Mn++, Ni++, ADP, AMP and the flavones: kaempferol, quercetin, morin. All the inhibitors, which caused varying degrees of inhibition of ATPase, also inhibited histamine release. The inhibition of the enzyme was competitive with ADP, AMP, ethacrynic acid, suramin and morin and non-competitive with the others. The degree of inhibition of ATPase and of histamine release tended to be similar with six inhibitors. With the others the extent of the inhibition of the release and of the enzyme varied. But a marked inhibition of the enzyme was always associated with a pronounced inhibition of histamine release. ATP in lower concentrations (10-20 microM) has been shown to potentiate histamine release induced by all the three releasers, possibly through its utilization by plasma membrane ATPase. The observations agree with the hypothesis that plasma membrane ATPase participates in the histamine release process.

Animals↗
PubMed1987

Design, synthesis, and testing of potential antisickling agents. 6. Rheologic studies with active phenoxy and benzyloxy acids.

In vitro rheologic studies have been performed with homozygous sickle erythrocytes in the presence of phenoxy and benzyloxy antigelling agents. The results correlate with those obtained previously from a standard hemoglobin S solubility assay (C-sat) that monitors the inhibition of hemoglobin S polymerization in solution. The order of activity of compounds in both studies was found to be about the same. The rheologic assay monitors the reduction in pressure (130 mm Hg sickled vs 9 mm Hg nonsickled) needed to push erythrocytes through a 5 micron filter. Among the drugs studied, the antilipidemic drug Clofibrate reduced the filtration pressure by as little as 9%, and a derivative of the diuretic agent ethacrynic acid (Merck-595, 595) reduced it by as much as 94%. Human Serum Albumin (HSA) (0.1% wt/vol) drastically reduced the activity of the noncovalently-acting aromatic acids by requiring at least three times the concentration of drug to obtain similar reductions in pressure. Two covalently-acting compounds, ethacrynic acid and Merck-595, 595, strongly increased the filterability of homozygous S erythrocytes at 1 and 3 mM drug concentrations even in the presence of HSA. No reason is given for the strong inhibitory effect of HSA at such high drug to HSA concentrations.

Anemia, Sickle Cell↗
PubMedDate not supplied

Nitroglycerin metabolism in subcellular fractions of rabbit liver. Dose dependency of glyceryl dinitrate formation and possible involvement of multiple isozymes of glutathione S-transferases.

The hepatic transformation of glyceryl trinitrate (GTN), commonly known as nitroglycerin, was studied in subcellular fractions prepared from rabbit livers. Both the cytosolic and microsomal fractions show activity toward GTN metabolism. Moreover, the formation of glyceryl dinitrates (GDNs) seems to be governed by different enzymatic processes in the two fractions. 1,2-GDN was preferentially formed in cytosolic fractions, whereas in microsomal fractions, 1,3-GDN was the predominant product. In cytosolic fractions, increasing starting concentrations of GTN led to a decrease in both the GTN degradation rate and the GDN ratio (1,2-GDN/1,3-GDN), which was mainly accounted for by saturation of the 1,2-GDN formation pathway. Various glutathione S-transferase (GST) inhibitors affected the rate of GDN formation differentially. In cytosolic fractions, 1-chloro-2,4-dinitrobenzene and iodomethane caused no change in the GDN ratio, while sulfobromophthalein, ethacrynic acid, and p-nitrobenzyl chloride decreased the GDN ratio, suggesting that different GST isozymes are inhibited by these agents. In microsomal fractions, no dose-dependent GTN metabolism and related change in the GDN ratios could be observed. With the exception of ethacrynic acid, addition of GST inhibitors did not decrease GDN metabolite production, and even in this case, no change in the GDN ratio was observed. The results suggest that different GTN metabolic pathways are present in the liver, most likely involving different GST isozymes.

Animals↗
PubMed1999

Stopped-flow kinetic analysis of the ligand-induced coil-helix transition in glutathione S-transferase A1-1: evidence for a persistent denatured state.

Structural studies have suggested that the glutathione S-transferase (GST) A1-1 isozyme contains a dynamic C-terminus which undergoes a ligand-dependent disorder-order transition and sequesters substrates within the active site. Here, the contribution of the C-terminus to the kinetics and thermodynamics of ligand binding and dissociation has been determined. Steady-state turnover rates of the wild type (WT) and a C-terminal truncated (Delta209-222) rGST A1-1 with ethacrynic acid (EA) were measured in the presence of variable concentrations of viscogen. The results indicate that a physical step involving segmental protein motion is at least partially rate limiting at temperatures between 10 and 40 degrees C for WT. Dissociation rates of the glutathione-ethacrynic acid product conjugate (GS-EA), determined by stopped-flow fluorescence, correspond to the steady-state turnover rates. In contrast, the chemical step governs the turnover reaction by Delta209-222, suggesting that the slow rate of product release for WT is controlled by the dynamics of the C-terminal coil-helix transition. In addition, the association reaction of WT rGST A1-1 with GS-EA established that the binding was biphasic and included ligand docking followed by slow isomerization of the enzyme-ligand complex. In contrast, binding of GS-EA to Delta209-222 was a monophasic, bimolecular reaction. These results indicate that the binding of GS-EA to WT rGST A1-1 proceeds via an induced fit mechanism, with a slow conformational step that corresponds to the coil-helix transition. However, the biphasic dissociation kinetics for the wild type, and the recovered kinetic parameters, suggest that a significant fraction of the [GST.GS-EA] complex ( approximately 15%) retains a persistent disordered state at equilibrium.

Binding Sites↗
PubMed1987

Comparative cardiovascular effects of loop-acting, thiazide-type and potassium-sparing diuretics in spontaneously hypertensive rats.

Studies were carried out in conscious, chronically-cannulated, spontaneously hypertensive (SH) rats to determine the comparative cardiovascular actions of a series of diuretic compounds. The effects of three oral doses of hydrochlorothiazide, trichlormethiazide, chlorthalidone, metolazone, spironolactone, triamterene, amiloride, furosemide, ethacrynic acid, MK-447, hydrochlorothiazide + amiloride, and MK-447 + amiloride on blood pressure and heart rate were monitored continuously for four hr and again 24 hr post-dose. Thiazides, thiazide derivatives and antikaliuretic diuretics exerted little or no antihypertensive effects, while the loop-acting diuretics (except ethacrynic acid) and combinations markedly reduced blood pressure. Antihypertensive responses to furosemide, MK-447 and the diuretic combinations were associated with either stable heart rate or paradoxical bradycardia, but not compensatory tachycardia. Heart rate remained relatively unaltered by individual doses of the remaining compounds.

Animals↗
PubMed2006

Inhibition of human glutathione transferases by multidrug resistance chemomodulators in vitro.

Reversal of the drug-resistance phenotype in cancer cells usually involves the use of a chemomodulator that inhibits the function of a resistance-related protein. The aim of this study was to investigate the effects of MDR chemomodulators on human recombinant glutathione S-transferase (GSTs) activity. IC50 values for 15 MDR chemomodulators were determined using 1-chloro-dinitrobenzene (CDNB), cumene hydroproxide (CuOOH) and anticancer drugs as substrates. GSTs A1, P1 and M1 were inhibited by O6-benzylguanine (IC50s around 30 microM), GST P1-1 by sulphinpyrazone (IC50 = 66 microM), GST Al-1 by sulphasalazine, and camptothecin (34 and 74 microM respectively), and GST M1-1 by sulphasalazine, camptothecin and indomethacin (0.3, 29 and 30 microM respectively) using CDNB as a substrate. When ethacrynic acid (for GST P1-1), CuOOH (for A1-1) and 1,3-bis (2-chloroethyl)-1-nitrosourea (for GST M1-1) were used as substrates, these compounds did not significantly inhibit the GST isoforms. However, progesterone was a potent inhibitor of GST P1-1 (IC50 = 1.4 microM) with ethacrynic acid as substrate. These results suggest that the target of chemomodulators in vivo could be a specific resistance-related protein.

Drug Resistance, Multiple↗
PubMed1986

Change in the activity of Cl-,HCO3(-)-ATPase in microsome fraction during early development of the sea urchin, Hemicentrotus pulcherrimus.

In sea urchin embryos, primary mesenchyme cells, descendants from micromeres produced at the 16-cell stage, form spicules or CaCO3 deposits in their skeletal vacuoles, at the post-gastrula stage. Micromeres isolated at the 16-cell stage also differentiate into spicule-forming cells during their culture at the same time schedule as in the embryos. The present study was planned to observe change in the activity of Cl-,HCO3(-)-ATPase, which was expected to contribute to the carbonate supply for CaCO3 deposition, during development. ATP-hydrolysis in the microsome fraction, obtained from embryos of the sea urchin, Hemicentrotus pulcherrimus, and from micromere-derived cells in culture was stimulated by Cl- and HCO3- in the presence of ouabain and EGTA. The ATP-hydrolysis was inhibited by ethacrynic acid, an inhibitor of Cl-,HCO3(-)-ATPase. The activity of Cl-,HCO3(-)-ATPase in embryos and in micromere-derived cells increased during development, keeping pace with the rate of calcium deposition in spicules. Formation of calcified spicules in the cultured micromere-derived cells was inhibited by ethacrynic acid. These results indicate that Cl-,HCO3(-)-ATPase plays an important role in the mechanism of CaCO3 deposition in the primary mesenchyme cells.

Adenosine Triphosphatases↗
PubMed1982

Chronic potassium depletion and sensitivity to tubocurarine.

The effect of low potassium diets with and without deoxycorticosterone (DOCA), furosemide, chlorothiazide, or ethacrynic acid on sensitivity of isolated guinea pig lumbrical nerve-muscle preparations to d-tubocurarine was examined. The ED50 of d-tubocurarine was found to fall as the potassium level was lowered by dietary restriction. Addition of DOCA or furosemide was without effect while chlorothiazide reduced and ethacrynic acid enhanced the effect of diet alone. Acute restoration of potassium levels of 5.9 mM reversed considerably, but not completely, the effect of chronic depletion. Thus, a patient suffering from chronic potassium depletion would be expected to require a decreased dose of d-tubocurarine, and although acute replacement of potassium preoperatively would tend to return the dose requirement toward normal, such reversal might not be complete.

Animals↗
PubMed1983

Urinary calcium excretion in familial hypocalciuric hypercalcemia. Persistence of relative hypocalciuria after induction of hypoparathyroidism.

Familial hypocalciuric hypercalcemia (FHH) is an autosomal dominant trait comprising hypercalcemia, hypophosphatemia, parathyroid hyperplasia, and unusually low renal clearance of calcium. We evaluated the role of parathyroid hormone in the relative hypocalciuria of FHH and characterized the renal transport of calcium in this disorder using three previously hypercalcemic FHH patients with surgical hypoparathyroidism and three controls with surgical hypoparathyroidism. Intravenous infusion of calcium chloride in two patients with FHH and in three controls increased serum calcium from a mean basal of 5.0 to a mean peak of 6.8 meq/liter in two FHH patients and from 4.2 to 5.7 in three control subjects. Urinary calcium in a third FHH patient was studied without calcium infusion during recovery from hypercalcemia of vitamin D intoxication. At all serum concentrations of calcium, calcium clearance was lower in FHH than in controls; at base-line serum calcium, the ratio of calcium clearance to inulin clearance (C(Ca)/C(IN)) in FHH subjects was 32% of that in controls and decreased to 19% during hypercalcemia. Calcium infusion increased the ratio of sodium clearance to inulin clearance in controls from a base line of 0.020 to 0.053 at peak concentrations of calcium in serum, but did not affect this parameter in FHH (0.017 at base-line serum calcium vs. 0.019 at peak). When calcium infusion studies were performed (in two patients with FHH and one control) during administration of acetazolamide, a drug whose principal renal action causes inhibition of proximal transport of solute, C(Ca)/C(IN) in the patients with FHH was 29 and 7% of that of the control at base-line and peak serum calcium, respectively. In contrast, ethacrynic acid, a diuretic that acts in the ascending limb of the loop of Henle, increased C(Ca)/C(IN) more in the FHH patients than in the control subject; C(Ca)/C(IN) was 65% at base-line and 47% at peak serum calcium, compared with that of the control subject. The greater calciuric response to ethacrynic acid than to acetazolamide or calcium infusion alone in FHH indicates that a major renal locus of abnormal calcium transport in this disorder may be the ascending limb of the loop of Henle.Decreased clearance of calcium in patients with FHH and hypoparathyroidism when compared with hypoparathyroid controls indicates that relative hypocalciuria in FHH is not dependent on hyperparathyroidism. Since the parathyroid glands in FHH are not appropriately suppressed by calcium, this implies that FHH represents a disorder of abnormal transport of, and/or response to, extracellular calcium in at least two organs, parathyroid gland and kidney.

Adolescent↗
PubMed2000

Effects of trivalent antimony on human erythrocyte glutathione-S-transferases.

Trivalent antimony (SB3+) in the form of potassium antimony tartrate was found to be an inhibitor of glutathione-S-transferases (GST) from human erythrocytes with a 50% inhibition concentration (IC50) of 0.05 mM. The inhibition was, however, incomplete with 15-20% of the GST activity remaining unaffected. In comparison, ethacrynic acid, a known inhibitor of GST, was tenfold more potent and affected close to 100% inhibition. Pentavalent antimony (SB5+) in the form of sodium stibogluconate had no effect on GST. Group V metalloids such as arsenite was slightly inhibitory, and arsenate was noninhibitory. When compared with five heavy metals, the inhibitory potency followed the order of SB3+ > Hg2+, Cu2+ > Cd 2+ > Cr3+ > Fe2+ x SB3+ inhibition of GST was competitive against the substrate 1-chloro-2,4-dinitrobenzene (CDNB) with an apparent Ki of 0.018 mM. Increasing the glutathione (GSH) concentration, however, produced a biphasic response: at concentrations below 1 mM, GSH was noncompetitive against SB3+, but at 1 mM and higher it was apparently competitive. A concurrent study of interactions between GSH, CDNB, and SB3+ showed that there was a significant nonenzymatic conjugation of CDNB at high GSH concentrations, which was suppressed by SB3+. The presence of albumin (500 mg/dL), or up to 5 mM N-acetylcysteine, cysteine, or ethylenediamine tetraacetic acid (EDTA) did not protect GST from the inhibitory effect of SB3+. The ability of erythrocyte GST to conjugate CDNB, which was measured directly by the formation of dinitrophenyl-glutathione (DNP-glutathione), was reduced by approximately 20 and 33%, respectively, in the presence of 2 and 10 mM SB3+, and nearly abolished with the addition of 0.2 mM ethacrynic acid. Based on these inhibition characteristics and the preferential accumulation of SB3+ in mammalian erythrocytes, it may be deduced that in the case of high antimonial intake, for example, during therapeutic treatment of Leishmaniasis, SB3+ levels in erythrocytes may be high enough to depress GST activity, which might compromise the ability of erythrocytes to detoxify electrophilic xenotbiotics.

Antimony↗
PubMed1985

Inhibitory effect of acetazolamide on renal tubular reabsorption of NaHCO3 and NaCl in dogs varies inversely with plasma pH.

To examine the effect of carbonic anhydrase inhibition on proximal tubular electrolyte reabsorption, plasma pH was altered before and after acetazolamide administration in six volume-expanded dogs during continuous infusion of ethacrynic acid to inhibit transcellular NaCl reabsorption. Plasma pH was altered by changing PCO2, keeping plasma bicarbonate concentration and glomerular filtration rate constant. Linear inverse relationships were obtained between electrolyte reabsorption and plasma pH. Before acetazolamide administration, a change in plasma pH of 0.1 unit from pH 7.4 altered bicarbonate reabsorption by about 10% and sodium and chloride reabsorption remaining during ethacrynic acid infusion by about 6.5%. Administration of acetazolamide (30 mg/kg b.wt.) caused a reduction in electrolyte reabsorption at all plasma pH levels examined. A further reduction occurred after increasing the dose to 100 mg/kg b.wt. The absolute inhibitory effects were almost twice as large during hypercapnia as during hypocapnia whereas the reduction in fractional reabsorption was the same at all plasma pH levels. Both variations in plasma pH and administration of acetazolamide altered the reabsorption of bicarbonate, chloride and sodium in molar ratios of about 1:2:3. Hence, acetazolamide inhibits a constant fraction of the NaHCO3 reabsorption and the associated NaCl reabsorption in the proximal tubules independent of changes in plasma pH.

Absorption↗
PubMed1983

Insights into intrarenal sites and mechanisms of action of diuretic agents.

Effective diuresis requires both sufficient glomerular filtrate and adequate delivery of the diuretic drug to the lumen of the renal tubule. Diuretics will not "force open" the kidney. Diuretics that work primarily in the proximal tubule include osmotic diuretics (e.g., mannitol), diuretics that interfere with the adenyl cyclase system (e.g., xanthines), and those which inhibit carbonic anhydrase (e.g., acetazolamide). Some thiazide and thiazide-like diuretics have a secondary site of action in the proximal tubule based on either carbonic anhydrase inhibition or other mechanisms, such as inhibition of sodium phosphate reabsorption. The diuretics that work primarily in the medullary diluting segment of the loop of Henle, furosemide and ethacrynic acid, block the active reabsorption of chloride and interfere with the tubular reabsorption of free water. The exact mechanism remains unknown. These diuretics tend to have a "high ceiling," to be potent and rapidly acting, and to have a short duration of effect. They are excellent for the treatment of severe fluid overload or pulmonary edema but are not ideal for the treatment of uncomplicated hypertension. Furosemide is a sulfonamide derivative; ethacrynic acid can be used in patients who are allergic to sulfa drugs. Diuretics that work primarily in the cortical diluting segment include the thiazides and thiazide-like drugs. They inhibit sodium transport by an undetermined mechanism. Most of them seem to reach a dose-response plateau beyond which little additional effect is gained by increasing the dose. Most of them appear to lose efficacy as the glomerular filtration rate decreases, except for metolazone and indapamide. The thiazides are most commonly used to treat hypertension. Diuretics that work primarily in the distal tubule and collecting tubule include the aldosterone inhibitor spironolactone and two drugs that impair tubular reabsorption of sodium by direct action, triamterene and amiloride. These drugs are primarily used for their potassium-sparing effect.

Animals↗
PubMed1991

Relationship between thinning of eggshells and reduction in number of eggs produced after administration of some saluretic drugs in domestic fowls.

1. The effect of some diuretic drugs (acetazolamide, hydrochlorothiazide, chlorthalidone, furosemide, ethacrynic acid and amiloride) on eggshell formation and egg production in domestic fowls were investigated. All of the tested compounds significantly inhibited eggshell formation, furosemide being the most potent drug. 2. The number of laid eggs was also reduced by several of the diuretics. There was a correlation between reduction of shell thickness and number of eggs (r = 0.77; P less than 0.01). 3. If the tested diuretics were subdivided into two groups according to their different modes of action, where furosemide, ethacrynic acid and amiloride represent sodium transport inhibitors, and acetazolamide, hydrochlorothiazide and chlorthalidone (contributory action of the two latter) are inhibitors of carbanhydrase, the highest correlation coefficient (r = 0.96) between reduction of shell thickness and egg production was found for sodium transport inhibitors. The corresponding correlation coefficient for carbanhydrase inhibitors (r = 0.44) was not significant. 4. The probable mechanisms of action of the diuretics on eggshell formation and ovulation are discussed.

Animals↗
PubMed1984

Stereo-specificity of diuretic receptors in the nephron: a study of the enantiomers of indacrinone (MK-196) in man.

Urinary clearance techniques have been employed to compare the renal sites of action of three phenoxyacetic acid diuretics in man: ethacrynic (etacrynic) acid and the two enantiomers of indacrinone (MK-196). The effects of these compounds on fractional free-water clearance and reabsorption during maximal hydration and hydropenia, respectively, indicate that whilst ethacrynic acid and (-)-indacrinone have their natriuretic site of action in the medullary portion of the thick ascending limb of Henle's Loop, the (+)-enantiomer of indacrinone acts in the 'cortical diluting segment' or early distal tubule. The natriuretic potencies of all three agents are different as is their effect on the renal handling of uric acid. Ethacrynic acid produces minor urate retention whilst both enantiomers of indacrinone produce uricosuria and hypouricaemia. The apparent difference in the renal sites of action of the enantiomers of indacrinone is discussed in relation to our current knowledge of stereo-selectivity in other pharmacological systems.

Absorption↗
PubMed1983

Effect of transport inhibitors on secretion by perfused rat submandibular gland.

Ouabain (10(-3) M) caused a 95.8% reduction in the volume of saliva secreted during a 60-min period by the isolated, perfused submandibular gland of the rat exposed to acetylcholine (10(-6) M) and modified salivary cation (Na and K) concentrations but not salivary Cl concentrations. Furosemide (10(-3) M) caused a 74.9% reduction in saliva volume and significantly reduced salivary Cl concentrations but did not modify salivary Na or K. Ethacrynic acid (10(-4) M) resulted in a 58.6% reduction in saliva volume, increased salivary Na and Cl concentrations, and reduced salivary K+ concentrations at low rates of flow. The results suggest that an ouabain-sensitive Na+-K+-ATPase and a furosemide-sensitive NaCl cotransport system contribute to acetylcholine-induced fluid secretion in the rat submandibular gland. The Na+-K+-ATPase probably provides the energy or driving force for the NaCl cotransport system by maintaining a Na+ gradient in the salivary cells. The lesser effect of ethacrynic acid on saliva volumes may result from a quantitatively smaller action on the same NaCl cotransport affected by furosemide. An ouabain-sensitive pump present in salivary ducts regulates transductal transport of Na and K.

Acetylcholine↗
PubMed1982

Ultrastructural and electrophysiological studies of acute ototoxic effects of furosemide.

Previous studies of the effects of ethacrynic acid on the inner ear following intraperitoneal injection of the diuretic have shown a progression of reversible changes occurring in the stria vascularis. The time course of these changes approximately parallels alterations in endolymphatic potential (EP). In this report, some preliminary findings concerning the effects of furosemide after intraperitoneal injection of 80 mg/kg are described. EP declined over a longer time course than that recorded with intravenous injection. Cochlear microphonic (CM) and compound action potential (CAP) also declined but to differing degrees. In the stria vascularis a progression of changes was apparent. In general, the changes were similar to those observed following ethacrynic acid intoxication and affected marginal cells, intermediate cells and strial capillaries. The upper basal turn of the cochlea was affected first and the damage spread apically. In the organ of Corti, stereocilia on the outermost row of outer hair cells were disorganized. This was apparent in approximately the same region as initial strial effects and was only observed when strial derangement was quite marked.

Animals↗
PubMed2005

Augmentation of cisplatin sensitivity in cisplatin-resistant human bladder cancer cells by modulating glutathione concentrations and glutathione-related enzyme activities.

OBJECTIVES: To investigate the roles of glutathione and glutathione-S-transferase (GST) in cisplatin-resistance mechanisms in human bladder cancer, by using glutathione-depleting or GST-blocking agents. MATERIALS AND METHODS: Cisplatin-resistant human bladder cancer cell lines were established by continuous exposure of T24 cells to increasing concentrations of cisplatin. Buthionine sulphoximine (BSO), ethacrynic acid and indomethacin were used to deplete glutathione or block GST. Intracellular glutathione content, GST activity and cisplatin cytotoxicity were determined after exposing parental and drug-resistant cell lines to these agents. RESULTS: Intracellular glutathione content and GST activity were significantly decreased, and cisplatin cytotoxicity significantly enhanced, in both parental and resistant cell lines by glutathione-depleting or GST-blocking agents. However, the resistance of cisplatin-resistant cell lines did not fully recover to that of the parental cells with combined BSO and indomethacin. CONCLUSIONS: Both increased glutathione content and GST activity are significant in the cisplatin resistance of human bladder tumour cells. Because BSO, ethacrynic acid and indomethacin caused a partial recovery of resistance in the cisplatin-resistant cell line, further studies are needed to investigate their efficacy for treating patients with metastatic bladder carcinoma resistant to cisplatin.

Antineoplastic Agents↗
PubMed1968

Respiratory adjustment to chronic metabolic alkalosis in man.

This study examined the ventilatory adjustment to chronic metabolic alkalosis induced under controlled conditions in normal human volunteers. Metabolic alkalosis induced by buffers (sodium bicarbonate, trishydroxymethylamine methane) or ethacrynic acid was associated with alveolar hypoventilation, as evidenced by a rise in arterial Pco(2), a fall in arterial Po(2), a reduced resting tidal volume, and a diminished ventilatory response to CO(2) inhalation. Alveolar hypoventilation did not occur when metabolic alkalosis was induced in the same subjects by thiazide diuretics or aldosterone despite comparable elevations of the arterial blood pH and bicarbonate concentration.The different ventilatory responses of the two groups could not be ascribed to differences among individuals comprising each group, pharmacological effects of the alkalinizing agents, differences in the composition of the lumber spinal fluid, changes in extracellular fluid volume, or sodium and chloride balance.The differences in ventilatory adjustments were associated with differences in the patterns of hydrogen and potassium ion balance during the induction of alkalosis. Alveolar hypoventilation occurred when hydrogen ions were buffered (sodium bicarbonate, trishydroxymethylamine methane) or when renal hydrogen ion excretion was increased (ethacrynic acid). Alveolar hypoventilation did not occur when induction of similar degrees of extracellular alkalosis was accompanied by marked potassium loss and no demonstrable increase in external hydrogen loss (thiazides and aldosterone).These observations suggest that respiratory depression does not necessarily accompany extracellular alkalosis but depends on the effect of the mode of induction of the alkalosis on the tissues involved in the control of ventilation.

Journal Article↗