• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.21-24
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• 2014

Clinical presentation of Bartter syndrome is similar to surrepitious vomiting or use of diuretics. Therefore, precise differential diagnosis of Bartter syndrome is crucial. We report a case of medullary nephrocalcinosis (MNC) induced by furosemide mimicking Bartter syndrome. A 55-year-old female patient visited our hospital with renal dysfunction on basis of hypokalemia and metabolic alkalosis. She had no history of hypertension or drug use except allopurinol and atorvastatin. She did not complain of nausea or vomiting on presentation and the serum magnesium level was normal. We performed ultrasonography, that showed MNC. For these reasons, we suspected Bartter syndrome and corrected the electrolyte imbalance. During outpatient follow up, we found that the patient had been taking 400 mg of furosemide daily for 30 years. We could diagnose furosemide induced MNC, and recommended to her to reduce the amount of furosemide.

• Korean Journal of Pharmacognosy
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• v.16 no.3
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• pp.165-170
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• 1985

The water extract of Chenopodium album L. var. centrorubrum had significant diuretic effect when administered orally in rats. The effect of combined administration of the extract with furosemide was slow and prolonged as compared with furosemide.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.110-120
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• 1992

The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate, 30 patients, who belonged to physical status II or III of ASA classification, were selected randomly and divided with two groups as follows : G1(N=15) : Not-administrated furosemide(control group) G2(N=15) : Administrated furosemide(Experimental group). All patients were premedicated with Hydroxyzine(1mg/kg, IM) and were performed continous epidural anesthesia with 2% lidocaine(1-1.5mg/segment). For irrigating solution, 5% D-sorbitol was used and Hartman's solution were given for maintenance fluid and fixed the height of irrigating container to 60 cm from symphysis pubis. With the starting of operation, 20mg furosemide was administrated to experimental group. The blood samples for the values of $Na^+$, $K^+$, Glucose and BUN were performed at the periods of preoperation, 10 min, 20 min, 30 min after the starting of operation and immediate postoperation. Based these data, serum osmolality and effective osmolality were calculated. The results were as follows : 1. The sodium concentration of control group was decreased statistically significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But that of experimental Group was not changed significantly. 2. The serum osmolality and effective osmolality were decreased statistically significantly at 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But those of experimental group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. And so we recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.

• The Korean Journal of Physiology
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• v.9 no.2
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• pp.33-39
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• 1975

Changes of urinary aldosterone excretion, concurrent sodium and potassium excretion following furosemide administration were studied in normotensive young Korean with high sodium intake, moderate sodium restriction and marked sodium depletion. After intravenous injection of furosemd 40mg, plasma and urine samples were collected at every thirty minutes for two hours. Plasma-and urinary aldosterone, electrolyte concentration and urine flow rate were measured by means of radioimmunoassay or flamephotometry. Relations of urinary aldosterone to concurrent sodium or potassium/sodium ratio, and of urinary aldosterone to concurrent plasma aldosterone activity were studied. Following were the results: 1. Furosemide administration resulted in a increased urinary aldosterone concentration and unchanged or somewhat decreased sodium concentration in course of time after the injection. 2. Urinary potassium concentration showed initial decrease and subsequent increase in course of time after furosemide administration and it resulted in a gradual increase in urinary potassium/sodium ratio. 3. Studying the relations between urinary aldosterone excretion and potassium/sodium excretion ratio, or sodium excretion were meaningless because of the urinary flow rate after the injection was decreased with time course. 4. Furosemide administration showed a good relationship of urinary aldosterone concentration to concurrent potassium/sodium ratio rather than concurrent sodium concentration in subjects with sodium restriction, but no meaningful relationship was detected in subjects with high sodium intake because increasing rate of the ratio was not so wide. 5. Furosemide also resulted a reasonable relation of plasma aldosterone concentration to concurrent urinary aldosterone concentration especially during low sodium intake. 6. Above results suggested that relation of urinary aldosterone concentration to K/Na ratio following furosemide administration during sodium restriction is significant and has a benefit to reduce the variation induced by kalemic change showing in the diragram for daily aldosterone to sodium excretion.

• Korean Journal of Clinical Pharmacy
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• v.1 no.1
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• pp.15-21
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• 1991

This study was attempted to investigate the dissolution rate and bioavailability of commercially available furosemide preparations. A. B. and C. The dissolution test was conducted in an artificial gastric juice using the basket method. and furosemide (40 mg) was administered orally to 8 normal volunteers by cross-over design. The results were as follows: the AUC and dissolution rate in 100 min ($D_{100\;min}$) were higher in order of preparations. A > C > B. But the peak concentration. time to reach peak concentration $(T_{max})$, and mean dissolution time (MDT) were in order of preparations. C > A > B. There were significantly linear correlations between the AUC and the $D_{100\;min}$, and between the $T_{max}$ and the MDT. From the results of this experiment. it can be concluded that commercially available preparations bioavailability of furosemide, which may be predicted from the dissolution rate.

• YAKHAK HOEJI
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• v.34 no.6
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• pp.401-406
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• 1990

The Pharmacokinetics of furosemide (5 mg/kg iv) was investigated in rabbits with folate (75 mg/kg, 150 mg/kg 300 mg/ug, iv) induced renal failure. The plasma concentration was increased and urinary excretion was decreased significantly compared with those of normal rabbits. ${\alpha},\;{\beta}\;and\;K_{12},\;K_{21},\;K_{10}$ were decreased, $t_{1/2}$ and AUC were increased significantly. Correlation of serum creatinine concentration and AUC, renal clearance have linear relationship respectively. In short, dosage regimen of furosemide is considered to be adjusted in the dose size and the dosing interval by degree of serum creatinine concentration.

• YAKHAK HOEJI
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• v.31 no.5
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• pp.273-279
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• 1987

The effects of organic acidic drugs on the absorption, excretion and diuretic action of furosemide were studied. Cefalexin, p-aminohippuric acid (PAH), ibuprofen and p-amino salicylic acid (PAS) were selected as organic acidic drugs. The in situ absorption rate and absorption rate constant of furosemide (30$\mu{M}$) were significantly (p<0.05) decreased by 30$\mu{M}$ of cefalexin, PAH, ibuprofen and PAS in rat small intestine. The plasma concentration of furosemide was significantly (p<0.01) increased by cefalexin, PAH and ibuprofen in rabbits. But the urinary excretion rate, renal clearance and diuretic action of furosemide were significantly (p<0.05) decreased by cefalexin, PAH, ibuprofen and PAS in rabbits.

• The Korean Journal of Nuclear Medicine
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• v.12 no.1
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• pp.9-16
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• 1978

It has been suggested that plasma renin activity (PRA) and its response to volume depletion may be abnormal in that it shows little or exaggerated change in patients with chronic renal failure and hypertension. Intravenous furosemide stimulation test was performed in 46 control subjects and 51 patients with chronic renal failure and/or malignant hypertension in order to evaluate PRA response. In contrast to the consistent increase in PRA in control subjects (from $2.5{\pm}1.95\;to\;4.5{\pm}2.51ng/ml/hr$), no consistent increase was observed in patients with chronic renal failure, especially in those who showed favorable response to antihypertensive therapy (from $2.5{\pm}2.21\;to\;2.9{\pm}2.46ng/ml/hr$). But poor responder to antihypertensive treatment showed considerably higher PRA before and after furosemide stimulation (from $4.9{\pm}1.96\;to\;6.4{\pm}1.71ng/ml/hr$) than the responder group did. Moreover, this group seemed to retain the ability to increase PRA in response to intravenous furosemide stimulation. Thus it became apparent that responder group was unable to increase PRA normally in response to furosemide as well as volume depletion, while poor responder seemed to retain that ability. Thus intravenous furosemode may serve as a convenient way to differenfiate those who might be benefited by conservative antihypertensive measures from those who would require more drastic measures such as bilateral nephrectomy for their optimal blood pressure control.

• The Korean Journal of Physiology
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• v.21 no.1
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• pp.13-22
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• 1987

Effects of synthetic atrial natriuretic peptide and furosemide on the cardiovascular and renal functions were examined in the freshwater turtle, Amyda japonica. Both atria and ventricle of turtle contained an immunoreactive atrial natriuretic peptide. Synthetic rat atrial natriuretic peptide (atriopeptin III) and turtle atrial extract caused a decrease in mean arterial blood pressure and the vasodepressor effect was dose-dependent. In hydrated turtles received either atriopeptin III or turtle atrial extract, no significant change in renal function was observed until 100 min except a slight natriuresis at 60 or 100 min after injection of 30 ug/kg atriopeptin III or atrial extract, respectively. However, furosemide, 2 mg/kg, caused marked diuresis, natriuresis and kaliuresis. In non-hydrated turtles, no significant change in renal function was observed until 6 hrs following injection of 30 ug/kg atriopeptin III. Plasma aldosterone decreased at 2 hr and increased at 24 hr after injection of atriopeptin III although plasma renin concentration did not change. But, furosemide caused persistent diuresis, natriuresis and kaliuresis. Additionally, plasma aldosterone and renin concentrations were significantly increased at 24 hrs after injection of furosemide. In conclusion, we suggest that the freshwater turtle may have an atrial natriuretic peptide in heart and vascular receptors for atrial natriuretic peptide, and that atrial natriuretic peptide is more important in the regulation of blood pressure rather than that of renal function in freshwater turtles. We also suggest that an increased plasma renin concentration caused by furosemide may not be due to the sodium concentration delivered to macula densa, but due to the dehydration caused by persistent diuresis and natriuresis.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1188-1198
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• 1998

Background : The purpose of the present study was to determine the protective effect of antiasthmatic activity of inhaled heparin, cromolyn sodium, budesonide, furosemide in exercise-induced asthma(EIA). The other important considerable point of this study was the mechanism of bronchoconstriction on EIA. Methods : Eight subjects with a history of EIA were studied on 5 different experiment days. After obtaining baseline $FEV_1$ and FVC, subjects performed a standardized exercise challenge. EIA was assessed by measurement of $FEV_1$ before and after exercise. On experiment day 4, the exercise challenge was performed after the subjects inhaled either heparin (1,000 units/kg/day for 5 days), furosemide (1mg/kg for 5 days), cromolyn (4mg/day for 5 days), or budesonide ($400{\mu}g/day$ for 5 days). On experiment day 5, the methacholine bronchial provocation test was performed. On experiment day 3, activated partial thromboplastine time(aPTI) was checked. Results : Maximum decrements of $FEV_1$ (mean${\pm}$SE) among 0 to 120 minutes after exercise were as follows : heparin was $83.1{\pm}4.81%$ (p=0.010), furosemide was $80.5{\pm}6.87%$ (p=0.071), cromolyn was $86.8{\pm}6.53%$ (p=0.340), and budesonide was $79.4{\pm}7.31%$ (p=0.095). Above medications were compared to the control value ($72.5{\pm}18.2%$) by paired t-test. No medications had effect on $PD_{20}$ of methacholine bronchial provocation test The results were control $1.58{\pm}0.49{\mu}mol$), heparin ($4.17{\pm}1.96{\mu}mol$), furosemide ($1.85{\pm}0.86{\mu}mol$), cromolyn ($2.19{\pm}0.89{\mu}mol$), and budesonide ($3.38{\pm}1.77{\mu}mol$), respectively(p>0.05). The inhaled heparin had no effect of anticoagulation. Conclusion : These data demonstrate that inhaled heparin has a protective effect on EIA. The effect of inhaled cromolyn was statistically absent with manufacture's recommended dosage on EIA. So, the dosage of cromolyn should be carefully evaluated in future. Although inhalation of budesonide and furosemide have no statistical significance compared to control, these drugs also have some protective effects on EIA.