T HIS study was undertaken to ascertain whether the addition of spironolactone (Aldaetone") to the therapeutic regimen will serve to clear edema in patients with advanced congestive heart failure in whom highly effective regimens,' including abundant intramuscular meralluride or oral thiazides, have proved unsuccessful.It was expected also to throw light on the following matters: the time to the appearance of effect after an oral dose of spironolactone; the persistence of the effect; evidence of cumulation; the range of effective dosage and levels of dosage that are free of toxicity; the diuretic efficacy of spironolactone used alone compared with meralluride and the thiazides; the incidence of undesirable effects of spironolactone in regimens for clearing edema; and the most effective plan for management of pseudointractable congestive heart failure by the concurrent use of spironolactone and meralluride or the thiazidcs.
This communication describes an exercise in quantitative human pharmacology having characteristics uncommon in clinical trials: measurement of those effects for which the drug is intended;
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