Furosemide and bumetanide: A study of responses in normal English and German subjects

Abstract

normal English and German sUbjectsA major problem in quantitating dosage equivalence of diuretics is the variation in response between subjects in normal populations as well as in patients with edema. There are also wide variations in response within subjects. Some of this variation can be explained by measurement of factors present prior to drug administration. Known examples are the correlation between the aldosterone secretion rate before treatment and the diuretic response to ethacrynic acid,5 the correlation Supported by Hoechst Phannaceuticals, England.

Bumetanide and frusemide: a comparison of dose‐response curves in healthy men.

“…The significant dissociation of potency estimates for sodium excretion and potassium excretion confirms the suggestion that bumetanide causes less potassium loss than frusemide, for a given natriuresis, in healthy subjects (Branch et al, 1976). Although potassium homeostasis in disease states is influenced greatly by factors other than the diuretic itself, the clinical relevance of this observation is supported by one study (Dunn et al, 1975) and, as pointed out by Branch et al (1976), by data from another (Asbury et al, 1972).…”

“…Although potassium homeostasis in disease states is influenced greatly by factors other than the diuretic itself, the clinical relevance of this observation is supported by one study (Dunn et al, 1975) and, as pointed out by Branch et al (1976), by data from another (Asbury et al, 1972). Bumetanide may have a slight advantage over frusemide for patients in whom potassium loss is particularly undesirable, e.g.…”

“…When bumetanide and frusemide were compared at high dosage in patients with chronic renal failure the results were not consistent with a relative potency of 40:1, and suggested a potency (bumetanide:frusemide) of 20:1 (Allison, Lindsay & Kennedy, 1975;Kampf, 1975;Berg, Tromsdal & Wideroe, 1976). The pharmacological properties of bumetanide and frusemide may differ slightly and in particular there are reports that potassium excretion, for a given natriuresis, was less after bumetanide in healthy subjects (Branch, Read, Levine, Vander Elst, Shelton, Rupp & Ramsay, 1976) and in patients undergoing open heart surgery (Dunn, Kerr, McQueen & Thomson, 1975).…”

“…All urine passed from 09.00-15.00 h was collected. This 6 h period encompasses the full duration of activity of both diuretics (Davies et al, 1974;Branch et al, 1976). Further tapwater (500 ml) was taken at l1.00 h, and lunch (constant within subjects) was eaten at 13.00 h. A second venous blood sample was drawn at 15.00 h, at the end of the urine collection period.…”

The Influence of Sodium and Potassium Supplements on the Diuretic Responses to Frusemide Administration in Normal Subjects

“…Part of the variation in diuretic response to the loop diuretics, frusemide and bumetanide and to the aldosterone antagonists, spironolactone and prorenoate potassium, has been reIated to variations in several pretreatment parameters, namely urinary Na/K ratio, plasma uric acid, plasma prolactin and urinary aldosterone excretion (Ramsay, Auty, Horth, Levine, Shelton & Branch, 1975;Ramsay, Hessian & Tidd, 1975;Levine, Ramsay, Auty, Branch & Tidd, 1976;Branch, Read, Levine, Vander Elst, Shelton, Rupp & Ramsay, 1976). Since both urinary Na/K ratio and urinary aldosterone excretion are influenced by dietary intake of sodium and potassium, diet may modify the apparent diuretic response.…”