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Determinants of the diuretic response to furosemide in infants with congestive heart failure

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Summary

A wide interindividual variation in the degree of diuresis produced following treatment with furosemide has been observed in infants with congestive heart failure. A method of pharmacokinetic analysis that separates drug disposition from renal response to furosemide was used to compare the effect of this agent in infants with congestive heart failure with the effect seen in infants with fluid retention secondary to noncardiac factors. No differences in the drug elimination rate, urinary drug excretion, or renal diuretic response between the 2 groups were seen. Infants in both groups exhibited a wide range in all variables examined. The marked interindividual variation in response originates from decreased delivery of furosemide to its site of action in some patients and a decreased responsiveness to the drug in others.

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References

  1. Andreasen F, Mikkelsen E: Distribution, elimination and effect of furosemide in normal subjects and in patients with heart failure.Eur J Clin Pharmacol 12:15–22, 1977

    Google Scholar 

  2. Aranda JV, Perez J, Sitar DS, Collinge J, Portuguez-Malavasi A, Duffy B, DuPont C: Pharmacokinetic disposition and protein binding of furosemide in newborn infants.J Pediatr 93:507–511, 1978

    Google Scholar 

  3. Beerman B, Dalen E, Lundstrom B: Elimination of furosemide in health subjects and in those with renal failure.Clin Pharmacol Ther 27:70–78, 1977

    Google Scholar 

  4. Beerman B, Dalen E, Lundstrom B, Rosen A: On the fate of furosemide in man.Eur J Clin Pharmacol 9:57–61, 1975

    Google Scholar 

  5. Bennett WM, Bagby GC, Antonovic JN, Porter GA: Influence of volume expansion on proximal tubular sodium reabsorption in congestive heart failure.Am Heart J 85:55–64, 1973

    Google Scholar 

  6. Branch RA, Roberts CJC, Homeida M, Levine D: Determinants of response to furosemide in normal subjects.Br J Clin Pharmacol 4:121–127, 1977

    Google Scholar 

  7. Burg M, Stoner L, Cardinal J, Green N: Furosemide effect on isolated perfused tubules.Am J Physiol 225:119–124, 1973

    Google Scholar 

  8. Chernavasin P, Seiwell R, Brater DC, Liang WMM: Pharmacodynamic analysis of the furosemide-probenecid interaction in man.Kidney Int 16:187–195, 1979

    Google Scholar 

  9. DeWardener HE: The control of sodium excretion.Am J Physiol 235:F163–173, 1978

    Google Scholar 

  10. Engle MA, Lewy JE, Lewy PR, Metcoff J: The use of furosemide in the treatment of edema in infants and children.Pediatrics 62:811–818, 1978

    Google Scholar 

  11. Green TP, Mirkin BL: Resistance of proteinuric rats to furosemide: Urinary drug protein binding as a determinant of drug effect.Life Sci 26:623–630, 1980

    Google Scholar 

  12. Greither A, Goldman S, Edelen JS, Benet LZ, Cohn K: Pharmacokinetics of furosemide in patients with congestive heart failure.Pharmacology 19:121–131, 1979

    Google Scholar 

  13. Haussler VA, Hajdu P: Untersuchungen mit dem salidureticum 4-chlor-N-(furylmethyl)-5-sulfamyl-anthranilsaure.Arzneim-Forsch 14:710–714, 1964

    Google Scholar 

  14. Homeida M, Roberts C, Branch RA: Influence of probenecid and spironolactone on furosemide kinetics and dynamics in man.Clin Pharmacol Ther 22:402–409, 1977

    Google Scholar 

  15. Krongrad E, Joos HA: Furosemide in treatment of edema of infants and children.NY St J Med 71:2521–2525, 1971

    Google Scholar 

  16. Loggie JMH, Kleinman LI, Van Maaner EF: Renal function and diuretic therapy in infants and children.J Pediatr 86:485–496, 657–669, 825–832, 1975

    Google Scholar 

  17. Martin BK: Treatment of data from drug urinary excretion.Nature 214:247–249, 1967

    Google Scholar 

  18. Peterson RG, Simmons MA, Rumack BH, Levine RL, Brooks JG: The pharmacology of furosemide in the premature newborn infant.J Pediatr 97:139–143, 1980

    Google Scholar 

  19. Quinn MD, Marsh DJ: Peritubular capillary control of proximal tubule reabsorption in the rat.Am J Physiol 236:F478–487, 1979

    Google Scholar 

  20. Rose HJ, Pruitt AW, Dayton PG, McNay JL: Relationship of urinary furosemide excretion rate to naturetic effect in experimental azotenia.J Pharmacol Exp Ther 199:490–497, 1976

    Google Scholar 

  21. Ross, BS, Pollak A, Oh W: The pharmacologic effects of furosemide therapy in the low birth weight infant.J Pediatr 92:149–152, 1978

    Google Scholar 

  22. Savage MO, Wilkinson AR, Baum JD, Robertson NRC: Furosemide in respiratory distress syndrome.Arch Dis Child 50:709–713, 1975

    Google Scholar 

  23. Tilstone WJ, Fine A: Furosemide kinetics in renal failure.Clin Pharmacol Ther 23:644–650, 1978

    Google Scholar 

  24. Weiner MW, Weinman EJ, Kashgarian M, Hayslett JP: Accelerated reabsorption in the proximal tubule produced by volume depletion.J Clin Invest 50:1379–1385, 1971

    Google Scholar 

  25. Woo WCR, Dupont C, Colinge J, Aranda JV: Effects of furosemide in the newborn.Clin Pharmacol Ther 23:266–271, 1978

    Google Scholar 

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Authors and Affiliations

  1. Division of Clinical Pharmacology, Departments of Pediatrics and Pharmacology, University of Minnesota Medical School, 3-260 Millard Hall, 55455, MN, Minneapolis

    Thomas P. Green M.D. & Bernard L. Mirkin

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  1. Thomas P. Green M.D.
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  2. Bernard L. Mirkin
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Additional information

Supported in part by grants from the Pharmaceutical Manufacturer's Association Foundation, USPHS (GM 07566), the University of Minnesota Graduate School and the Minnesota Medical Foundation. This paper was part of the Ray C. Anderson Symposium.

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Green, T.P., Mirkin, B.L. Determinants of the diuretic response to furosemide in infants with congestive heart failure. Pediatr Cardiol 3, 47–51 (1982). https://doi.org/10.1007/BF02082332

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  • DOI: https://doi.org/10.1007/BF02082332

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