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At least 1,423 records · Page 79Linked to original sources
PubMed1983

Evaluation of obstructive uropathy with diuretic renography.

Diuretic renography has been recommended as a useful test to distinguish obstructed from dilated, but not obstructed, urinary systems. Twenty-four diuretic renograms were performed in 20 children, and a good correlation was found with other indicators of obstruction. The sensitivity for identifying obstruction was 83%, with a specificity of 94%. Severe hydroureteronephrosis may blunt or even mask the effect of diuresis on causing emptying of the tracer from the renal pelvis. Some kidneys did not drain well with the patient in a supine position but did empty with a change of position; these kidneys should be regarded as nonobstructed.

Adolescent↗
PubMed2002

Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

CONTEXT: Antihypertensive therapy is well established to reduce hypertension-related morbidity and mortality, but the optimal first-step therapy is unknown. OBJECTIVE: To determine whether treatment with a calcium channel blocker or an angiotensin-converting enzyme inhibitor lowers the incidence of coronary heart disease (CHD) or other cardiovascular disease (CVD) events vs treatment with a diuretic. DESIGN: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a randomized, double-blind, active-controlled clinical trial conducted from February 1994 through March 2002. SETTING AND PARTICIPANTS: A total of 33 357 participants aged 55 years or older with hypertension and at least 1 other CHD risk factor from 623 North American centers. INTERVENTIONS: Participants were randomly assigned to receive chlorthalidone, 12.5 to 25 mg/d (n = 15 255); amlodipine, 2.5 to 10 mg/d (n = 9048); or lisinopril, 10 to 40 mg/d (n = 9054) for planned follow-up of approximately 4 to 8 years. MAIN OUTCOME MEASURES: The primary outcome was combined fatal CHD or nonfatal myocardial infarction, analyzed by intent-to-treat. Secondary outcomes were all-cause mortality, stroke, combined CHD (primary outcome, coronary revascularization, or angina with hospitalization), and combined CVD (combined CHD, stroke, treated angina without hospitalization, heart failure [HF], and peripheral arterial disease). RESULTS: Mean follow-up was 4.9 years. The primary outcome occurred in 2956 participants, with no difference between treatments. Compared with chlorthalidone (6-year rate, 11.5%), the relative risks (RRs) were 0.98 (95% CI, 0.90-1.07) for amlodipine (6-year rate, 11.3%) and 0.99 (95% CI, 0.91-1.08) for lisinopril (6-year rate, 11.4%). Likewise, all-cause mortality did not differ between groups. Five-year systolic blood pressures were significantly higher in the amlodipine (0.8 mm Hg, P =.03) and lisinopril (2 mm Hg, P<.001) groups compared with chlorthalidone, and 5-year diastolic blood pressure was significantly lower with amlodipine (0.8 mm Hg, P<.001). For amlodipine vs chlorthalidone, secondary outcomes were similar except for a higher 6-year rate of HF with amlodipine (10.2% vs 7.7%; RR, 1.38; 95% CI, 1.25-1.52). For lisinopril vs chlorthalidone, lisinopril had higher 6-year rates of combined CVD (33.3% vs 30.9%; RR, 1.10; 95% CI, 1.05-1.16); stroke (6.3% vs 5.6%; RR, 1.15; 95% CI, 1.02-1.30); and HF (8.7% vs 7.7%; RR, 1.19; 95% CI, 1.07-1.31). CONCLUSION: Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive. They should be preferred for first-step antihypertensive therapy.

Aged↗
PubMed1998

Synthesis of some novel 2-oxo-pyrano(2,3-b)- and 2-oxo-pyrido(2,3-b)quinoline derivatives as potential antimalarial, diuretic, clastogenic and antimicrobial agents.

The 2-chloro-3-formyl quinoline derivatives (1a-e) on treatment with acetic anhydride and sodium acetate, afforded the corresponding novel 2-oxopyrano(2,3-b) quinoline derivatives (2a-e), and these were subjected to ammonia treatment to yield the corresponding naphthyridine derivatives (3a-e). The prepared compounds (2a-e) were tested for their antimalarial, diuretic, clastogenic and antimicrobial properties. Not all the compounds showed a diuretic effect and the significant increase in the frequency of micronuclei shows that they are non-clastogens, whereas the 7-chloro derivative (2e) was a very effective antimalarial agent against the mosquito species. All the compounds were found to have optimum antimicrobial activity against Staphylococcus aureus, Escherichia coli and Salmonella typhi. Compounds 2d and 2e were found to be most active against the bacteria tested.

Animals↗
PubMed1992

2-Amino-2-oxazolines, V: Synthesis of some 5-dialkylaminomethyl-2-amino-2-oxazolines and evaluation of their diuretic activity.

A series of 5-dialkylaminomethyl-2-amino-2-oxazolines was prepared and screened for diuretic activity. These compounds were previously examined for their lipophilic behaviour using a reversed-phase HPLC technique. The capacity factors, expressed as log k'w, were correlated with the partition coefficient log P. A QSAR analysis of the diuretic activity in relation with the lipophilicity was attempted for these structurally related compounds.

Animals↗
PubMedDate not supplied

Acute tolerance development to the diuretic effect of furosemide in the rat.

Furosemide was given to rats as five different i.v. bolus doses (2.5-100 mg kg-1), or as an i.v. infusion to a steady-state concentration in plasma of 14 micrograms ml-1. The urinary furosemide excretion rate (delta Ae/delta t) and the diuretic effect (volume of urine) were measured. A parallel shift in the excretion-response curve was seen as a fivefold increase in (delta Ae/delta t)50 [delta Ae/delta t) at half-maximal effect) between the i.v. bolus doses from 2.5 to 40 mg kg-1. The slope factor did not change. During infusion, a decrease in efficiency to 20 per cent of the initial value was seen. These results are indicative of an acute tolerance development to the diuretic effect of furosemide. Some intrarenal feedback inhibition mechanism might be involved, as the extracellular fluid volume seems to be of great importance to the effect obtained. The resulting effect can be compared with the influence of a competitive antagonist.

Animals↗
PubMed2002

Enantiomeric separation of diuretics on a novel Pirkle-type chiral stationary phase.

A newly developed Pirkle-type straight chiral stationary phase (CSP), based on the 3,5-dinitrobenzoyl derivative of 1,2 diphenylethylene-diamine and known as ULMO, has been successfully applied to the direct resolution of the enantiomers of several diuretics by liquid chromatography. In this study, the effect of changes in the mobile phase and the intrinsic stereoselective properties of this CSP towards a specific racemate are determined experimentally. A mobile phase consisting of n-hexane and 2-propanol appears most appropriate for the chiral separation of the tested diuretics on the ULMO-column.

Chromatography, Liquid↗
PubMed1976

Bumetanide, a new loop diuretic.

The effect of bumetanide on renal function has been compared with that of furosemide and a placebo in a double-blind study of 9 healthy young men. The sequence for oral administration of the drug was subjected to a random assignation based upon the Latin-square methodology under three different conditions. (1) Normal hydration: The administration of bumetanide (2 mg) produced within the next 4 hr a diuresis comparable to that induced by 80 mg of furosemide. Urinary excretion of sodium, potassium, chloride, calcium, and uric acid also followed comparable patterns. Phosphaturia occurred only under bumetanide. The effect of bumetanide seemed longer lasting. (2) Water loading: The effects of bumetanide and furosemide were comparable with the exception of the phosphaturic effect induced by bumetanide. The action of both diuretics on the diluting segment of the nephron was well demonstrated by the marked depression of CH2O. (3) Water deprivation: The effects of the two diuretics were comparable, including depression tCH20. In none of these conditions did the placebo produce any significant effect.

Adult↗
PubMed1979

Serum potassium and uric acid changes during treatment with timolol alone and in combination with a diuretic.

Timolol, 10 to 40 mg daily, given to 103 patients with uncomplicated arterial hypertension induced significant increments of serum potassium at all dose levels (p less than 0.05). The magnitude of the increments was dependent on daily timolol dosage. When hydrochlorothiazide and amiloride were added, serum potassium decreased (p less than 0.001), but a major determinant of the magnitude of the decrease was the dosage change of the timolol. Serum uric acid was influenced in a paradoxical way during timolol monotherapy; there was a rise in all 3 dosage groups (p less than 0.02) but the lowest group showed the largest increase and vice versa. On addition of hydrochlorothiazide and amiloride, there was a further increase in serum uric acid, the magnitude of which depended on the concomitant reduction in the dose of timolol, with reductions in dose causing a larger rise in serum uric acid and increments, a smaller rise. The increments of serum uric acid were greater in females than in males during both treatment periods. The results indicate that beta blockers induce dose-dependent rises in serum potassium and may counteract undesirable effects of diuretics on serum potassium. Beta blockers seem to have a paradoxical effect on serum uric acid and may aggravate the hyperuricemia induced by diuretics.

Amiloride↗
PubMed2003

The eating disorders medicine cabinet revisited: a clinician's guide to appetite suppressants and diuretics.

OBJECTIVE: This article explores the frequencies of use of alternative medications, available products, and their potential toxicities. METHOD: Survey data were gathered from 39 consecutive patients diagnosed with bulimia nervosa who were seeking treatment. A survey of area outlets (health food stores, pharmacies, grocery stores) was conducted to establish a database of available agents. Putative active ingredients were identified. MEDLINE literature searches, as well as reviews of specialized texts, were performed to identify the potential toxicities of the ingredients. RESULTS: Diet pill use was found in 64% of patients; 18 % reported use in the past month. The survey identified 167 products. Diuretic use was found in 31% of patients; 21% reported use in the past month. Twenty-five diuretic products were identified. DISCUSSION: Alternative medicines are frequently used in the population of patients seeking treatment for bulimia nervosa. An abundance of products are available with potentially significant toxicities.

Anorexia Nervosa↗
PubMedDate not supplied

Evaluation of a new diuretic, diapamide, in congestive heart failure.

The diuretic response of patients with congestive heart failure to establish doses of diapamide (750 mg) and furosemide (80 mg) was compared in an open, crossover study. Peak urine output occurred in the first 6 hours after administration of furosemide but somewhat later (12 to 18 hours) with diapamide. Both agents produced active diuresis and natriuresis in most patients. Comparisons of drug effect during the first days of each treatment period and analysis of the entire first treatment period indicated that urine output with furosemide was significantly greater than with diapamide. Urinary sodium excretion on the first day of treatment was not significantly greater with furosemide than with diapamide, nor were the differences significant on subsequent days. The observed differences between drugs on urinary potassium and chloride excretion were not statistically significant. The most frequently occurring adverse reaction was mild to moderate nausea, which was reported by five patients receiving diapamide and two patients receiving furosemide. Diarrhea and vomiting were also more frequent with diapamide. Diapamide would appear to serve a role between the milder thiazide diuretics and the more effective furosemide.

Adult↗
PubMedDate not supplied

Toxicologic evaluation of bumetanide, potent diuretic agent.

The studies reported represent the preclinical toxicologic evaluation of bumetanide. Toxicity testing in rats, rabbits, dogs, and baboons indicate that bumetanide is well tolerated in various species. The toxicity that was observed is, for the most part, the direct consequence of its potent diuretic activity and is similar to that produced by other "loop" diuretics. Bumetanide was fetotoxic at maternal toxic doses in the rabbit, but no evidence of teratogenic effects was observed in rabbits, rats, mice, or hamsters. The compound was devoid of mutagenic activity by the Ames test and was found to be noncarcinogenic in long-term rat studies.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

The effect of loop diuretics on the excretion of Na+, Ca2+, Mg2+, and Cl-.

Bumetanide, ethacrynic acid, and furosemide were administered in two equipotent doses to the same five dogs in three separate studies. Intravascular volume was maintained by the replacement of urinary losses. Fractional chloride excretion was used as a marker of diuretic effect. Comparison of absolute and fractional excretion of Na+, Cl-, Ca2+, and Mg2+ did not demonstrate a significant difference among the three diuretics.

Animals↗
PubMed1995

Thiazide diuretics and fractures: can meta-analysis help?

Published observational estimates of the effect of thiazide diuretics on osteoporotic fracture risk vary from a 70% reduction to a 60% increase but there have been no randomized controlled trials. The aims of this study were to use the technique of meta-analysis to attempt to resolve this conflict and to explore whether duration and/or dose of therapy has an effect on osteoporotic fracture risk. The data sources utilized were Medline and Excerpta Medica databases supplemented by reviews and back references. A total of 18 observational studies that looked at the relationship between diuretics and fracture were located, of which 13, involving 29,600 subjects, had extractable data on thiazides and fracture occurrence. Current thiazide users were protected against hip fracture (OR 0.82, 95% CI 0.73-0.91). Thiazide use of long duration may be protective (OR 0.82, 95% CI 0.62-1.08) but not short duration (OR 1.23, 95% CI 0.99-1.54). The size of this effect, which compares favorably to other interventions, indicates that a randomized controlled trial to resolve the problem of potential confounders and safety profile would require a minimum of 7000 person-years of observation in those at highest risk of fracture (women aged 80 or over) which is unlikely to be pursued at the present time. The results of this meta-analysis indicate that current thiazide users have a 20% reduction in fracture risk and that long-term use may reduce fractures by a similar amount.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Liquid membrane phenomenon in diuretics.

Surface activity and critical micelle concentrations are reported for two diuretic drugs, furosemide and triamterene. The drugs generate a liquid membrane on a supporting membrane. Transport of chloride, sodium, and potassium ions through the liquid membranes generated by the drugs was studied. The data suggest that the phenomenon of liquid membrane formation may contribute to the diuretic action.

Diuretics↗
PubMed2002

Diuretic activity of Fabiana patagonica in rats.

A pharmacological evaluation of the diuretic activity of Fabiana patagonica Speg. (Solanaceae) was carried out in isotonic saline loaded rats. The data reported in the present work indicate that the acetone extract and infusion of the aerial part of Fabiana patagonica showed a moderate diuretic activity. This activity could be due, in part, to the presence of oleanolic acid isolated as the major metabolite of F. patagonica.

Animals↗
PubMed1992

Negative-ion mass spectra of methylated diuretics.

The negative-ion mass spectra of 19 methylated diuretics are presented and correlations between these spectra and the chemical structures of the compounds are indicated. The spectra are of interest as the basis of an analytical method for the identification of small quantities of diuretics in the urine of hypokalemic patients.

Diuretics↗
PubMed1995

Stereoselective renal effects of the loop diuretic ozolinone in the anesthetized dog.

The renal effects of i.v. injections of (+/-)-ozolinone, its enantiomers (-)-ozolinone and (+)-ozolinone and its prodrug (+/-)-etozoline, were compared with those of furosemide, in pentobarbital anesthetized dogs. Renal blood flow (electromagnetic flow-meter) and glomerular filtration rate (polyfructosan clearance) were assessed on the left denervated kidney together with renin secretion and urinary electrolyte excretion. (-)-Ozolinone (15.5 mg/kg i.v.) behaves as a stereoselective loop diuretic equipotent to 20 mg/kg of furosemide and 45 mg/kg of (+/-)-ozolinone; (+)-ozolinone induced only minor salidiuretic effects. Both ozolinone enantiomers markedly increased the renal blood flow and decreased the filtration fraction, suggesting that the vosodilating effect predominates on the efferent glomerular arterioles. (-)-Ozolinone also induced an acute rise in renin secretion. The inhibition of prostaglandin synthesis (indomethacin or meclofenamate) prevented renin hypersecretion in response to (-)-ozolinone and modified its salidiuretic effects but had no effect on the vascular response. The inhibition of the kallikrein-kinin system by aprotinin had no effect on the overall renal response to (-)-ozolinone. The inhibition of the renin-angiotensin system by captopril decreased blood pressure, prolonged the (-)-ozolinone-induced decrease in renal vascular resistance and increased renin secretion. Our results demonstrate that the loop diuretic, ozolinone, induces stereoselective and prostaglandin-dependent renin secretion, which is involved in the regulation of intra-renal hemodynamics.

Analysis of Variance↗
PubMed1990

The difference in endocochlear and endolymphatic sac d.c. potentials in response to furosemide and canrenoate as diuretics.

We investigated the effects of furosemide, a loop diuretic, and canrenoate, an aldosterone antagonist, on the endocochlear potential (EP) and the endolymphatic sac potential (ESP) in the guinea pig. Furosemide produced no significant change in the ESP at a dose of 100 mg/kg after an intravenous infusion for 20 min. However, this dose decreased the EP to a negative level. Canrenoate produced no significant change in the EP at an intravenous dose of 300 mg/kg for 20 min, but it did decrease the ESP. The differences in the EP and ESP in the response to the diuretics indicate a dissimilarity of the origin of both d.c. potentials in the endolymphatic space.

Animals↗