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PubMed1989

Furosemide and dopamine in malarial acute renal failure.

The effects of furosemide and furosemide with dopamine on renal function were studied in 23 patients with acute renal failure due to falciparum malaria whose serum creatinine ranged from 230 to 947 mumol/l. Furosemide given intravenously at the dosage of 200 mg 6 hourly for a period of 4 days did not alter the clinical course of renal failure. Intravenous administration of furosemide (200 mg 6 hourly) with dopamine (1 microgram/kg/min) for 4 days increased creatinine clearance and arrested the progress of renal failure when the serum creatinine was less than 400 mumol/l, but failed to alter the course of renal failure when the serum creatinine exceeded 600 mumol/l.

Acute Kidney Injury↗

PubMed1979

Effect of furosemide on altitude tolerance in experimental animals.

Furosemide which is claimed to prevent acute mountain sickness and pulmonary oedema of high altitude was tried in experimental animals to evaluate its usefulness or otherwise as a measure of prophylaxis. 90 mice, 128 rats and 44 guinea pigs--all males--were used for the studies. Half the number in each species were kept as controls. The remaining half were further divided into two batches. The first batch was given furosemide 10 mg/kg body weight. Two h later they were exposed to simulated altitude of 30,000 ft for 6 h. The second batch was given two injections of furosemide at intervals of 24 h before exposure to simulated altitude. The controls were given distilled water. Our results show that the death rate was more in the furosemide-treated groups, both under mild as well as severe dehydration in all species. The present study does not substantiate the claim than the drug can be used as prophylactic against acute mountain sickness and pulmonary oedema of high altitude.

Acclimatization↗

PubMed1995

Furosemide pharmacokinetics following intratracheal instillation in the guinea pig.

Inhaled furosemide has been shown to attenuate bronchospasm in asthmatics and to increase lung compliance in infants with bronchopulmonary dysplasia (BPD). The reports involving BPD used a dose of 1 mg/kg and some have failed to show an effect with that dose. We determined the pharmacokinetics of furosemide administered directly to the airway in 7 young adult male guinea pigs who received intravenous and intratracheal doses of furosemide. Each animal received a 3 mg/kg i.v. bolus, 1, 3 and 6 mg/kg i.t. in 2 ml/kg normal saline and 3 mg/kg i.t. in 2 ml/kg bovine extract surfactant. Blood was sampled multiple times after each dose. The mean fraction of the intratracheal dose absorbed was 0.50-0.60 for all doses. Surfactant delayed the absorption of furosemide but did not alter the fraction absorbed.

Animals↗

PubMed1985

Treatment of canine permeability pulmonary edema: short-term effects of dobutamine, furosemide, and hydralazine.

The effects of treatment of oleic acid pulmonary edema with dobutamine, furosemide, and hydralazine on cardiopulmonary function in 24 dogs were investigated. Pulmonary capillary wedge pressure (PCWP) was adjusted to approximately 7 mm Hg; 45 min after oleic acid (0.08 ml/kg), dogs were randomly divided into a control group, in which PCWP was maintained at approximately 7 mm Hg, and into treatment groups as described above. Mean time-averaged PCWP was 2.3 mm Hg in dogs treated with dobutamine, 4.1 mm Hg with furosemide, and 4.4 mm Hg with hydralazine. Four hours of treatment with dobutamine and furosemide significantly (p less than .01) reduced accumulation of lung water compared with the control and hydralazine groups. Qs/Qt was lower (p less than .05) with dobutamine and furosemide compared with the other groups. In dogs given hydralazine, cardiac output (CO) and systemic vascular resistance (SVR) remained constant over the 4 hr treatment interval. In contrast, in all other groups, SVR increased and CO decreased (both p less than .05). The short-term pulmonary effects of the above drugs are probably explained by differences in PCWP and/or by regional pulmonary vascular effects.

Analysis of Variance↗

PubMedDate not supplied

Inhibition of furosemide-induced increases in plasma renin activity by amiloride.

The effect of the potassium-sparing diuretic, amiloride, was studied in conscious rabbits bearing chronic indwelling cannulas to assess whether its reported in vitro kallikrein-inhibiting activity may produce a suppressive effect on furosemide-induced renin secretion similar to that previously demonstrated with another kallikrein inhibitor, aprotinin. Furosemide elicited a rapid and persistent rise in plasma renin activity (PRA), but pretreatment of the same rabbits with a 15-minute intravenous infusion of amiloride, which amounted to 1 mg/kg and commenced at 30 minutes before furosemide, completely prevented this rise. Amiloride also prevented furosemide-induced kaliuresis without an attenuation of the diuretic or natriuretic response and did not alter plasma potassium concentration in the absence of any change in external potassium balance, indicating that suppression of the PRA response is due neither to prevention of extracellular fluid volume contraction nor to the known suppressive effect of hyperkalemia. Mean arterial pressure tended to fall slightly but not significantly with or without amiloride pretreatment. On the basis of these findings and those of our antecedent study with aprotinin, we conclude that the striking similarity between the suppressive effects of two dissimilar inhibitors of kallikrein on pharmacologically evoked renin secretion is consistent with the hypothesis that renal kallikrein participates in the mechanism of renin secretion in vivo.

Amiloride↗

PubMed1992

Acetazolamide and furosemide attenuate asthma induced by hyperventilation of cold, dry air.

We investigated the assumption that the efficacy of inhaled diuretics in asthma is dependent upon inhibition of the Na+/K+/2Cl- cotransporter. We compared the protective effect of acetazolamide, a diuretic without significant effect on the loop cotransporter, with the protection provided by inhaled furosemide in a cold, dry air hyperventilation model of asthma. Seven asthmatic subjects underwent a baseline bronchial challenge and then received a nebulized dose of 80 mg of furosemide or 500 mg of acetazolamide or saline placebo in a randomized, double-blind, placebo-controlled crossover design. Repeat challenges were performed immediately and at 2 and 4 h postnebulization. Acetazolamide caused a 47.2% increase in the amount of cold, dry air required to reduce the FEV1, by 20% (expressed in terms of respiratory heat loss as PD20RHL), from 0.79 multiplied or divided by (x/divided by) 1.13 kcal/min (geometric mean x/divided by geometric SEM) at baseline to 1.17 x/divided by 1.09 kcal/min postnebulization (p < 0.025). Furosemide increased the geometric mean PD20RHL by 53.9%, from 0.86 x/divided by 1.12 kcal/min to 1.33 x/divided by 1.12 kcal/min (p < 0.001). There was no significant change after placebo inhalation (0.81 x/divided by 1.15 kcal/min versus 0.87 x/divided by 1.10 kcal/min, NS). Airway responsiveness had returned to baseline by 2 h postnebulization on all 3 days. Furosemide also caused bronchodilatation, producing a 14.1% rise in the mean FEV1 (p < 0.005 versus prenebulization), whereas neither acetazolamide nor placebo altered airway tone significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetazolamide↗

PubMed1969

An inhibitory effect of furosemide on sodium reabsorption by the proximal tubule of the rat nephron.

The evidence from previous micropuncture studies for an inhibitory effect of furosemide on proximal sodium reabsorption in the rat has been conflicting. Intrinsic reabsorptive capacity, estimated in free flow and shrinking drop experiments, has been reported to be depressed, whereas fractional reabsorption usually remains unchanged. We have recently reported that, during conditions of elevated intraluminal hydrostatic pressure, unless care is taken to prevent retrograde flow of tubule fluid from more distal sites, the concentration of inulin in late proximal fluid is often factitiously elevated. Since furosemide raises intraluminal pressures, often markedly, the failure to detect a depression of fractional reabsorption might be the consequence of retrograde contamination during fluid collection. Experiments were designed to compare the effect of furosemide on fractional sodium reabsorption by the proximal tubule when collections were obtained with distal oil blocks of conventional length as well as with unusually long blocks of oil of low and high viscosities. When reflux is prevented, fractional sodium reabsorption is usually depressed by furosemide, whereas when conventional distal blocks are used, the calculated values for fractional reabsorption either remain unchanged or increase. Simultaneous measurements of nephron glomerular filtration rate indicate that the latter is the consequence of retrograde contamination.

Animals↗

PubMed1991

Comparison of the effects of hydrochlorothiazide and furosemide on lithium disposition.

OBJECTIVE: This study examined the interaction between lithium and diuretics, comparing both the pharmacokinetic and the pharmacodynamic variable of hydrochlorothiazide, furosemide, and placebo. METHOD: The study, which took place in an outpatient research clinic of a university hospital, used a double-blind, placebo-controlled crossover design. The subjects were normal, healthy male volunteers who responded to recruitment announcements. Thirteen subjects entered and completed the study. All subjects took lithium, 300 mg b.i.d., for 6 weeks. Hydrochlorothiazide, 25 mg b.i.d.; furosemide, 20 mg b.i.d.; and placebo were given during weeks 2, 4, and 6 in a random order of assignment. Serum lithium levels and indices of diuretic activity were measured during each week. RESULTS: The subjects' serum lithium levels after 5 days of taking hydrochlorothiazide were significantly higher than after 5 days of taking furosemide and placebo. At the doses studied, hydrochlorothiazide was also more potent than furosemide in increasing plasma renin activity, increasing sodium excretion, and decreasing lithium excretion. CONCLUSIONS: The observed differences between diuretics in effects on serum lithium may have been due to differences in the potency of the diuretics at the doses studied as well as in the site of action of the diuretic effect. The results must be interpreted cautiously, however, because the effects were small and of questionable clinical significance, and the study used healthy volunteers and low doses of lithium instead of psychiatric patients and the usual therapeutic levels of lithium.

Adult↗

PubMed1975

Dosage titration with furosemide in congestive heart failure patients.

Clinical status and diuretic requirements of a group of congestive heart failure patients were re-evaluated. A group of 115 congestive heart failure patients were hospitalized, given a comprehensive medical examination and treated with placebo for four weeks. Thirteen patients did not exhibit signs and symptoms of congestive heart failure during this phase. The remaining 102 patients were treated with 40 mg furosemide per day for a second 4-week period. Fifty-three required 80-120 mg furosemide per day and 49 were successfully controlled at 40 mg per day. Ten patients dropped out voluntarily and 39 were controlled for an additional four weeks at a dose of 20 mg bid furosemide. In the final phase, dosage was lowered to 20 mg per day and 24 of the 39 patients, (62%), were successfully controlled for four weeks, while 14, (36%), were controlled for eight weeks. Results of this study suggest that a number of congestive heart failure patients can be controlled with relatively low doses of furosemide and that there is a need for periodic re-evaluation of the clinical status and diuretic requirements of patients on maintenance therapy.

Adult↗

PubMed1983

Electrophysiologic properties of furosemide in man.

Furosemide has been extensively used in the treatment of heart failure and its effect on cardiovascular dynamics are well established. Clinical relief of the symptoms of pulmonary congestion frequently precedes any demonstrable diuretic effect, suggesting that extra renal factors may also be involved. More recent studies on the extra-renal action of furosemide showed an increase of venous capacitance as an early hemodynamic effect of the drug. In spite of furosemides wide use in the treatment of heart failure and hypertension, there is no information on the electrophysiologic properties of the drug in man. The present study involving 8 human subjects was undertaken to determine what effect intravenously administered furosemide has on the human conduction system.

Aged↗

PubMed2006

NXY-059 does not significantly interact with furosemide in healthy volunteers.

NXY-059 is a free radical-trapping neuroprotectant that reduces infarct size and preserves brain function in animal models of acute ischemic stroke. Acute ischemic stroke patients receiving NXY-059 may also be exposed to diuretics for treatment of heart failure or hypertension. NXY-059 and furosemide are partly eliminated by active tubular secretion via an organic anion transporter. This double-blind, randomized, crossover, placebo-controlled study investigated whether an infusion of NXY-059 (15 mg/mL) during 12 hours affects the diuretic and saluretic effects of a 30-mg intravenous bolus dose of furosemide (10 mg/mL) administered after 6 hours' infusion, in 13 male and 11 female healthy subjects. The net increase in urine volume and sodium excretion in the interval of 6 to 12 hours was 4.15 L and 178 mmol/L, respectively, during NXY-059 treatment (P = .93) and 4.34 L and 190 mmol/L, respectively, during placebo treatment (P = .54). NXY-059 reduced the renal clearance of furosemide by 19% (P = .019), and furosemide reduced the renal clearance of NXY-059 by 8% (P = .005). NXY-059 was well tolerated.

Abdominal Pain↗

PubMed2001

Omapatrilat: neurohormonal and pharmacodynamic profile when administered with furosemide.

Pharmacodynamic effects of combination therapy with omapatrilat and furosemide were evaluated. Two groups of 13 healthy subjects each received furosemide 20 mg dailyfor 15 days coadministered with either placebo on days 6 to 15 or omapatrilat 10 mg on days 6 to 10 and 25 mg on days 11 to 15. In the omapatrilat group, urinary excretion of atrial natriuretic peptide increased, and greater blood pressure reductions were seen compared with placebo. Concomitant omapatrilat treatment did not affect the acute diuresis, natriuresis, and kaliuresis observed with chronic administration of furosemide. Neither effective renal plasma flow nor glomerularfiltration rate changed in either treatment group. No clinically significant safety issues were observed. Daily coadministration of omapatrilat 10 or 25 mg with furosemide 20 mg does not affect the pharmacodynamics offurosemide at steady state.

Adult↗

PubMed1981

Mathematical models of diuresis after oral administration of tizolemide, furosemide and placebo to healthy adults.

Urine volumes and flows as functions of time after oral administration of placebo, furosemide 80 mg and tizolemide 100 mg to sixteen healthy male adults at 08.00 a.m. are described through mathematical models. Accumulated urine volumes after dosing, V, as functions of time, t, are accounted for by sigmoid functions and urine flows are described as dV/dt. No significant differences were found between the 24-hour urine volume mean values after furosemide (2457 ml) and tizolemide (2283 ml) and both were significantly higher than the corresponding mean value after placebo (1369 ml) ( p less than 0.001). Peak diuresis after dosing occurs about 1.5 hours for furosemide, 4 hours for tizolemide and 6 hours for placebo. Fourteen hours after dosing, urine volume amounts to 90% of the 24-hour urine volume after furosemide and to 76% after tizolemide, so that both substances may be regarded as diurnal diuretics.

Administration, Oral↗

PubMed1988

The effects of piretanide in patients with congestive heart failure and diabetes mellitus: a double-blind comparison with furosemide.

A double-blind parallel group study was carried out to compare the effects of piretanide on daily glucose profiles, symptoms of congestive heart failure and serum electrolytes with those of furosemide in 24 diabetic in-patients suffering from congestive heart failure. After a 3-day run-in period on placebo, patients were allocated at random to receive 10-days' treatment with either 6 mg piretanide or 40 mg furosemide once daily. The results showed that there were no differences between the glucose profiles between the first and the last day of treatment, nor were there any differences between the two treatments. Piretanide and furosemide both produced a significant reduction in the number of symptoms of congestive heart failure. There were no significant changes in biochemical variables within the groups, nor were there any differences between the groups, except for an increase in uric acid and decrease in total protein values after furosemide. Mean triglyceride values decreased significantly after piretanide treatment, and SGOT values decreased after both treatments, the latter change being of no clinical relevance. Side-effects were generally mild in both groups and did not require any counter-measures.

Adult↗

PubMed1986

Effects of acute water load, hypertonic saline infusion, and furosemide administration on atrial natriuretic peptide and vasopressin release in humans.

A new specific RIA for alpha-human atrial natriuretic hormone (alpha hANP) was used to determine whether changes in plasma volume elicited by acute water loading, hypertonic saline infusion, and furosemide administration caused changes in ANP release and resultant changes in renal and cardiovascular function in normal subjects. In addition, changes in plasma arginine vasopressin (AVP), PRA, and aldosterone concentrations were studied simultaneously. Mean plasma alpha hANP and AVP levels were 51.3 +/- 16.0 (+/- SE) and 3.1 +/- 0.6 pg/ml, respectively, in the basal state. Plasma alpha hANP rose to 77.8 +/- 27.6 in response to a 4.5% increase in plasma volume induced by water loading, increased further to 134.1 +/- 28.9 in response to a 23% volume increase induced by hypertonic saline, and fell to 70.2 +/- 15.8 pg/ml in response to a decrease in plasma volume after furosemide treatment (P less than 0.01-0.05). On the other hand, plasma AVP fell to 1.8 +/- 0.1 pg/ml after the water load, rose to 4.1 +/- 0.6 after hypertonic saline, and rose further to 5.8 +/- 0.8 pg/ml after furosemide (P less than 0.01-0.05). Water and hypertonic saline loading decreased PRA, but plasma aldosterone concentrations did not change; subsequent furosemide administration increased both (P less than 0.01-0.05). Arterial pressure and heart rate did not change significantly. Increases in urinary Na excretion and osmolar clearances were associated with a rise in plasma alpha hANP after water loading and hypertonic saline infusion (P less than 0.01-0.05), but changes in urine flow were mainly associated with alterations in AVP release. associated with alterations in AVP release.

Adult↗

PubMed1983

Quantitative CT assessment of furosemide- and mannitol-induced changes in brain water content.

We studied the effects of two commonly employed antiedema agents, mannitol and furosemide, on CT brain density in eight patients with primary and metastatic brain tumors. Noncontrast CTs were performed before and after IV furosemide or IV mannitol, and serial blood samples were analyzed for osmolality. Computer-generated frequency histograms of CT numbers from "before-and-after" brain slices were using quantile-quantile (QQ) plots and the Kruskal-Wallis statistic. After IV mannitol, there was a progressive increase in CT brain density, which corresponded to an upward shift in the QQ plot over the range 0 to 70 Hounsfield units. The differences between baseline and posttreatment histograms for mannitol patients were significantly different from controls, and maximum differences coincided with peak serum osmolality. No statistically significant effects were observed in the furosemide group despite maximal diuresis. The relative magnitude of the quantitative changes observed after mannitol and furosemide administration are consistent with anticipated changes in brain water content.

Brain Edema↗

PubMed1993

[Effects of KW-3635 on the diuretic action of furosemide in rats].

The effects of KW-3635 (sodium (E)-11-[2-(5,6-dimethyl-1-benzimidazolyl) ethylidene]-6,11-dihydrodibenz-[b,e]oxepine-2-carboxylate monohydrate, CAS 127166-41-0), a novel thromboxane A2 (TxA2) receptor antagonist, on furosemide diuresis were examined in rats. After an overnight fast, the rats received either saline or drugs, and 6-hr urine samples were collected. Urine volume, urinary excretion of electrolytes and urine TxB2 were measured. The administration of KW-3635 (10, 30 mg/kg, p.o.) or BM-13505 (10, 30 mg/kg) significantly increased the diuretic effect of furosemide (10 mg/kg, p.o.). Neither drug had any effect on urinary excretion of TxB2. These results demonstrated that the diuretic effect of furosemide was potentiated by TxA2 receptor blockade with KW-3635 or BM-13505. It is suggested that the diuretic effect of furosemide might be modulated by renal production of TxA2 elicited by this drug.

Administration, Oral↗

PubMed1991

Influence of chronic lithium treatment on urinary amount of furosemide in rats.

The present study was undertaken to examine whether the urinary amount of furosemide is influenced by chronic lithium treatment. LiCl at 2 mEq/kg/day in 1 ml vehicle (5% glucose solution) or 1 ml of vehicle alone was injected intraperitoneally for 8 days into Wistar rats. On day 8, 30 mg/kg of furosemide in 3% body weight of 1% NaCl was given orally, and urine was collected for 6 hr after dosage. The urinary amount of furosemide in the Li-treated rats was significantly lower than that in the control animals [Li group (n = 12): 514 +/- 75 (mean +/- S.E.) vs. control group (n = 12): 916 +/- 85 micrograms/kg/6 hr, P less than 0.01]. This finding indicates that pharmacokinetic alterations of furosemide might occur during chronic treatment with lithium.

Administration, Oral↗