Pharmacokinetics of furosemide in neonates

  • P. Vert
  • M. Broquaire
  • M. Legagneur
  • P. L. Morselli
Originals

Summary

The pharmacokinetics of furosemide was evaluated in 12 newborns who received the drug transplacentally, and in 21 neonates who received it directly for therapeutic reasons. In the first group, the apparent plasma half-lives ranged from 96 to 6.8 h with a significant inverse relationship (p<0.01) between the gestational age and the elimination rate. In two cases a clear effect on diuresis was also observed. In the neonates receiving the drug i.v. for therapeutic reasons, the elimination kinetics appeared to follow a two-compartment open model, with a significant difference in the therminal plasma half-life between premature (26.8±12.2 h) and full-term newborns (13.4±8.6 h). In this group no relationship was observed between elimination rate and either gestational or conceptional age. In the case of repeated administration, an increase in plasma clearance and reduction in t1/2 β was noticed.

Key words

furosemide neonates kinetics placental transfer intravenous therapy 

References

  1. 1.
    Adelman RD, Spangler WL, Beasom F, Ishizaki G, Conzelman GM (1979) A comparison of the nephrotoxicity of gentamicin and netilmicin when given with furosemide. Pediat Res 13: 366 (Abstract 241)Google Scholar
  2. 2.
    Aranda JV, Perez J, Sitar DS, Collinge J, Portuguez-Malavasi A, Duffy B, Dupont C (1978) Pharmacokinetic disposition and protein binding of furosemide in newborn infants. J Pediatr 93: 507–511PubMedCrossRefGoogle Scholar
  3. 3.
    Aranda JV, Turmen T, Sasyniuk BI (1980) Pharmacokinetics of diuretics and methylxanthines in the neonate. Eur J Clin Pharmacol 18: 55–63PubMedCrossRefGoogle Scholar
  4. 4.
    Beermann B, Groschinsky-Grind M, Fanraeus L, Lindstrom B (1978) Placental transfer of furosemide. Clin Pharmacol Ther 24: 560–562PubMedGoogle Scholar
  5. 5.
    Broquaire M, Mitchard M (1979) Détermination quantitative rapide du furosemide dans le plasma, le sang ou l'urine par chromatographie liquide à haute performance. Feuill Biol 1: 1–5Google Scholar
  6. 6.
    Carswell W, Semple PF (1974) The effect of furosemide on uric acide levels in maternal blood, fetal blood and amniotic fluid. J Obstet Gynaecol Br Commonw 81: 472–474PubMedGoogle Scholar
  7. 7.
    Engle MA, Lewy JE, Lewy PR, Metcoff J (1978) The use of furosemide in the treatment of oedema in infants and children. Pediatrics 62: 811–818PubMedGoogle Scholar
  8. 8.
    Gomeni C, Gomeni R (1978) IGPHARM: Interactive graphic package for pharmacokinetic analysis. Comp Biomed Res 11: 345–361CrossRefGoogle Scholar
  9. 9.
    Loggie JMH, Kleinman LI, Van Maanen EF (1975) Renal function and diuretic therapy in infants and children. Part II. J Pediatr 86: 657–669Google Scholar
  10. 10.
    Marks KH, Berman W, Friedman Z, Whitman V, Lee C, Maisel MJ (1978) Furosemide in hyaline membrane disease. Pediatrics 62: 785–788PubMedGoogle Scholar
  11. 11.
    Mirkin BL, Green TP, O'Dea F (1980) Disposition and pharmacodynamics of diuretics and antihypertensive agents in renal disease. Eur J Clin Pharmacol 18: 109–116PubMedCrossRefGoogle Scholar
  12. 12.
    Pecorari D, Ragni N, Autera C (1969) Effetti sul neonato della somministrazione di furosemide alla madre durante il travaglio di parto. Acta Biomed 40: 3–11Google Scholar
  13. 13.
    Peterson RG, Simmons MA, Rumack BH, Levine RL, Brooks JG (1980) Pharmacology of furosemide in the premature newborn infant. J Pediatr 97: 139–143PubMedCrossRefGoogle Scholar
  14. 14.
    Ross BS, Pollak AP, Oh W (1978) The pharmacologic effects of furosemide therapy in the low birth weight infant. J Pediatr 92: 149–152PubMedCrossRefGoogle Scholar
  15. 15.
    Sahar A, Tsipstein E (1978) Effects of mannitol and furosemide on the rate of formation of cerebrospinal fluid. Exp Neurol 60: 584–591PubMedCrossRefGoogle Scholar
  16. 16.
    Savage MO, Wilkinson AR, Baum JD, Roberton NRC (1975) Furosemide in respiratory distress syndrome. Arch Dis Child 50: 709–713PubMedCrossRefGoogle Scholar
  17. 17.
    Shankaran S, Poland RL (1977) The displacement of bilirubin from albumin by furosemide. J Pediatr 90: 642–646PubMedCrossRefGoogle Scholar
  18. 18.
    Stein WW, Halberstadt E, Gerner R, Romer E (1977) Beeinflussung der fetalen Nierentätigkeit durch Furosemide. Arch Gynäkol 224: 114–116PubMedCrossRefGoogle Scholar
  19. 19.
    Tilstone WJ, Semple PF, Lawson DH (1977) Effect of furosemide on glomerular filtration rate and clearance of practolol, digoxin, cephaloridine and gentamicin. Clin Pharmacol Ther 22: 389PubMedGoogle Scholar
  20. 20.
    Turmen T, Tom P, Louridas TA, Aranda JV (1980) Protein binding and protein displacement properties of bumetanide and furosemide. Pediatr Res 14: 473 (Abstract 288)Google Scholar
  21. 21.
    Vert P, Legagneur M, Broquaire M, Morselli PL (1980) Pharmacocinétique du furosémide chez le nouveau-né. In: Pharmacologie du Développement, colloque INSERM 89, pp 491–498Google Scholar
  22. 22.
    Votta RA, Parada OH, Winograd RH, Alvarez OH, Tomassinni II, Pastori AA (1975) Furosemide action on the creatinine concentration of amniotic fluid. Am J Obstet Gynecol 123: 621–624PubMedGoogle Scholar
  23. 23.
    Wennberg RP, Rasmussen LF, Ahlfors CE (1977) Displacement of bilirubin from human albumin by three diuretics. J Pediatr 90: 647–650PubMedCrossRefGoogle Scholar
  24. 24.
    Whitington FF, Black DD (1980) Cholelithiasis in premature infants treated with parenteral nutrition and furosemide. J Pediatr 97: 647–649PubMedCrossRefGoogle Scholar
  25. 25.
    Wigand ME, Heidland A (1971) Ototoxic side effects of high doses of furosemide in patients with uremia. Postgrad Med J 47: 54PubMedGoogle Scholar
  26. 26.
    Wladimiroff JW (1975) Effect of furosemide on fetal urine production. Br J Obstet Gynaecol 82: 221–224PubMedGoogle Scholar
  27. 27.
    Woo WR, Dupont C, Collinge J, Aranda JV (1978) Effects of furosemide in the newborn. Clin Pharmacol Ther 23: 266–271PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • P. Vert
    • 1
  • M. Broquaire
    • 1
  • M. Legagneur
    • 1
  • P. L. Morselli
    • 1
  1. 1.Service de Médecine NéonataleMaternité Régionale UniversitaireNancyFrance
  2. 2.Department of Clinical ResearchL.E.R.S., SynthelaboParisFrance

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