Dissolution profile of different brands of low solubility drugs available in the Nigerian and Brazilian pharmaceutical markets / Dissolution profile of different brands of low solubility drugs available in the Nigerian and Brazilian pharmaceutical markets

The purpose of this work was to elaborate a diagnosis of the dissolution test in Africa in comparison with Brazil, evaluating the dissolution profile of low solubility drugs such as albendazole, ibuprofen, furosemide, glibenclamide, hydrochlorothiazide and carvedilol to ascertain their quality. The dissolution profiles were evaluated by utilizing the United States Pharmacopeia (USP). The glibenclamide medicine was evaluated according to the Food and Drug Administration (FDA), while a dissolution method was developed for the carvedilol medicine. A filter selection test for all the drugs showed that cannula is suitable for all, except for carvedilol, which is centrifuged. The various brands of Nigerian and Brazilian medicines tested showed some statistical differences. The suitable conditions that allowed the dissolution of carvedilol to be determined were the USP type II apparatus at 75 rpm containing 900 mL of acetate buffer, pH 4.5. The results of the dissolution test showed that out of the 17 different brands of Brazilian medicines and 17 different products from Nigeria, 94.12% and 58.82% passed respectively

O objetivo deste trabalho foi elaborar um diagnóstico do teste de dissolução na África em comparação ao Brasil, avaliando o perfil de dissolução de medicamentos de baixa solubilidade como albendazol, ibuprofeno, furosemida, glibenclamida, hidroclorotiazida e carvedilol para verificar sua qualidade.Os perfis de dissolução foram avaliados utilizando a Farmacopeia dos Estados Unidos (USP). O medicamento glibenclamida foi avaliado de acordo com a Food and Drug Administration (FDA), enquanto um método de dissolução foi desenvolvido para o medicamento carvedilol.Um teste de seleção de filtro para todos os medicamentos mostrou que a cânula é adequada para todos, exceto para o carvedilol, que é centrifugado. As diversas marcas de medicamentos Nigerianos e Brasileiros testadas apresentaram algumas diferenças estatísticas. As condições adequadas que permitiram a determinação da dissolução do carvedilol foram o aparelho USP tipo II a 75 rpm contendo 900 mL de tampão acetato, pH 4,5. Os resultados do teste de dissolução mostraram que das 17 diferentes marcas de medicamentos brasileiros e 17 diferentes produtos da Nigéria, 94,12% e 58,82% foram aprovados, respectivamente

Diuretic effect of alkaloids fraction extracted from Selaginella lepidophylla (Hook. et Grev.) Spring / Efecto diurético de la fracción con contenido de alcaloides extraída deSelaginella lepidophylla (Hook. et Grev.) Spring

The aerial parts of Selaginella lepidophylla (Hook. et Grev.) Spring, are used in Mexican folk medicine to treat renal diseases. The aim of this study was to measure the diuretic response of an aqueous extract (200 mg/kg) and alkaloids fraction at different doses (10, 40 y 100 mg/kg) of this plant and compare it with that induced by furosemide (4 mg/kg). Extract, alkaloids fraction, furosemide and vehicle were administered orally to adult rats and the effects in sodium, potassium and water balance were measured. The extract, the alkaloids fraction and the furosemide produced important and significant increments in urinary excretion of sodium, potassium and water with respect to control group. This increment was dose dependent of the alkaloids fraction, the highest dose produced a major effect. Potassium excretion increased but it was less than the one induced by furosemide. These results suggest that the aqueous extract and rich fraction in alkaloids from S. lepidophylla induce diuretic response.

Las partes aéreas de Selaginella lepidophylla (Hook. et Grev.) Spring, son usadas en la medicina tradicional mexicana para tratar enfermedades renales. El objetivo del estudio fue medir la respuesta diurética de un extracto acuoso (200 mg/kg) y de diferentes dosis de la fracción de alcaloides (10, 40 y 100 mg/kg) de esta planta y compararla con la inducida por furosemida (4 mg/kg). El extracto, la fracción de alcaloides, la furosemida y el vehículo fueron administrados por vía oral a ratas adultas y se midieron los efectos en el balance de sodio, potasio e hídrico. El extracto, la fracción de alcaloides y la furosemida produjeron importantes y significativos incrementos en la excreción urinaria de sodio, potasio y agua con respecto al grupo testigo. Este incremento fue dependiente de la dosis de la fracción de alcaloides, la dosis más alta produjo el mayor efecto. El incremento en la excreción de potasio fue menor al de furosemida. Los resultados sugieren que el extracto acuoso y la fracción rica en alcaloides de S. lepidophylla inducen una respuesta diurética.

Role of α2-adrenoceptors in the lateral parabrachial nucleus in the control of body fluid homeostasis

Central α2-adrenoceptors and the pontine lateral parabrachial nucleus (LPBN) are involved in the control of sodium and water intake. Bilateral injections of moxonidine (α2-adrenergic/imidazoline receptor agonist) or noradrenaline into the LPBN strongly increases 0.3 M NaCl intake induced by a combined treatment of furosemide plus captopril. Injection of moxonidine into the LPBN also increases hypertonic NaCl and water intake and reduces oxytocin secretion, urinary sodium, and water excreted by cell-dehydrated rats, causing a positive sodium and water balance, which suggests that moxonidine injected into the LPBN deactivates mechanisms that restrain body fluid volume expansion. Pretreatment with specific α2-adrenoceptor antagonists injected into the LPBN abolishes the behavioral and renal effects of moxonidine or noradrenaline injected into the same area, suggesting that these effects depend on activation of LPBN α2-adrenoceptors. In fluid-depleted rats, the palatability of sodium is reduced by ingestion of hypertonic NaCl, limiting intake. However, in rats treated with moxonidine injected into the LPBN, the NaCl palatability remains high, even after ingestion of significant amounts of 0.3 M NaCl. The changes in behavioral and renal responses produced by activation of α2-adrenoceptors in the LPBN are probably a consequence of reduction of oxytocin secretion and blockade of inhibitory signals that affect sodium palatability. In this review, a model is proposed to show how activation of α2-adrenoceptors in the LPBN may affect palatability and, consequently, ingestion of sodium as well as renal sodium excretion.

Efeitos da inalação de beclometasona e furosemida sobre a função pulmonar e índice de oxigenação de recém-nascidos prematuros / Inhalation effects of beclomethasone and furosemide on pulmonary function and oxygenation index of preterm newborns / Efectos de la inhalación de beclometasona y furosemida sobre la función pulmonar e índice de oxigenación de recién nacidos prematuros

O objetivo deste estudo foi avaliar a função pulmonar e o índice de oxigenação de recém-nascidos pré-termo submetidos à inalação endotraqueal de beclometasona e furosemida. Foram avaliados 30 recém-nascidos pré-termo com idade gestacional <36 semanas, sob ventilação mecânica convencional por pelo menos 12 horas. Três inalações sequenciais com as respectivas medicações foram realizadas, com intervalo de três horas entre as mesmas. Foram coletadas amostras de sangue arterial para análise dos gases sanguíneos; após aspiração endotraqueal, a mensuração das variáveis respiratórias foi realizada em dois momentos, antes e após duas horas da última inalação. A complacência dinâmica, assim como o índice de oxigenação, não apresentou diferença estatística significativa entre os momentos antes e após as medicações; no entanto, a resistência de vias aéreas demonstrou redução no grupo beclometasona entre os momentos antes e após a intervenção (p=0,03). Diante desses resultados, não podemos afirmar que a beclometasona e a furosemida inalatória exercem influência significativa na função pulmonar e oxigenação dos recém-nascidos estudados.

The objective of this study was to evaluate lung function and oxygenation index of preterm infants undergoing endotracheal inhaling of beclomethasone and furosemide. We studied 30 newborn preterms with gestational age <36 weeks, undergoing conventional mechanical ventilation for at least 12 hours. Three sequential inhalations with their medications were executed with an interval of three hours between each. We collected samples of arterial blood for gas analysis, and after endotracheal aspiration, the measurement of respiratory variables was performed in two stages, two hours before and after the last inhalation. Dynamic compliance and the oxygenation index showed no statistically significant difference between before and after the medication, however, the airway resistance group demonstrated a reduction in beclomethasone between the moments before and after the intervention (p=0.03). These results cannot imply that inhaled beclomethasone and furosemide exerted significant influence on lung function and oxygenation in the newborn infants studied.

El objetivo de este estudio fue evaluar la función pulmonar e índice de oxigenación de recién nacidos de pre-término sometidos a la inhalación endotraqueal de beclometasona y furosemida. Fueron evaluados 30 recién nacidos de pre-término con edad gestacional <36 semanas, bajo ventilación mecánica convencional por lo menos 12 horas. Tres inhalaciones secuenciales con las respectivas medicaciones fueron realizadas, con intervalo de tres horas entre las mismas. Fueron tomadas muestras de sangre arterial para el análisis de los gases sanguíneos y después de la aspiración endotraqueal, la medición de las vías respiratorias fue realizada en dos momentos, antes y después de dos horas de la última inhalación. La compliance dinámica así como el índice de oxigenación, no presentaron diferencia estadísticamente significativa entre los momentos antes y después de las mediciones, sin embargo, la resistencia de las vías aéreas demostró reducción en el grupo beclometasona entre los momentos antes y después de la intervención (p=0,03). Mediante estos resultados no podemos afirmar que la beclometasona y la furosemida inhalatoria ejercen influencia significativa en la función pulmonar y oxigenación de los recién nacidos estudiados.

Efecto diurético agudo de los extractos etanólico y acuoso de Ceratopteris pteridoides (Hook) en ratas normales / Acute diuretic effect of ethanolic and aqueous extracts of Ceratopteris pteridoides (Hook) in normal rats

Introducción. Ceratopteris pteridoides es un helecho semiacuático de la familia Parkeriacea, ampliamente utilizado en la medicina popular colombiana como diurético y colelitiásico, sobre el cual no existen reportes científicos que avalen su uso popular como diurético. Objetivo. Evaluar el efecto diurético agudo en dosis única y dosis repetidas a corto plazo, de los extractos etanólico y acuoso de C. pteridoides en un modelo in vivo . Materiales y métodos. El extracto etanólico total fue obtenido por maceración de la planta entera de C. pteridoides con etanol y el extracto acuoso fue obtenido por decocción a 60 °C por 15 minutos. Ambos extractos se sometieron a análisis fitoquímico preliminar y estudio histológico posterior a la administración de los extractos durante ocho días consecutivos (1.000 mg/kg). El efecto diurético se evaluó en ratas Wistar, tratadas con los extractos (500 mg/kg), en forma aguda y en dosis repetidas a corto plazo, cuantificando la eliminación de agua y la excreción renal de sodio y potasio por espectrofotometría de absorción atómica y, de cloruros, por titulación mercurimétrica. Resultados. En el modelo agudo, ambos extractos mostraron un significativo efecto diurético y de excreción renal de sodio y potasio en comparación con el control, mientras que con la administración en dosis repetidas a corto plazo mostraron efecto diurético sin eliminación de electrolitos. El estudio histopatológico no sugirió efectos tóxicos hepáticos o renales. Conclusión. Los resultados demuestran la actividad diurética de C. pteridoides y sustentan el uso popular dado a esta planta como diurético en la costa norte colombiana. Se requieren estudios posteriores que permitan aislar e identificar los compuestos responsables de la actividad y los mecanismos de acción involucrados.

Introduction. Ceratopteris pteridoides is a semiaquatic fern of the Parkeriacea family, widely used in the Colombian folk medicine as a diuretic and cholelithiasic, of which there are no scientific reports that validate its popular use. Objective. To evaluate the acute and short-term repeated-dose diuretic effect of the ethanolic and aqueous extracts of C. pteridoides in an in vivo model. Materials and methods. The total ethanolic extract was obtained by maceration of the whole plant of C. pteridoides with ethanol and the aqueous extract by decoction at 60°C for 15 minutes. Both extracts were evaluated in preliminary phytochemical analysis and histological studies after the administration of the extracts for 8 consecutive days (1000 mg/Kg). The diuretic effect was evaluated using Wistar rats treated with the extracts (500 mg/Kg), using an acute and a short-term repeated-dose model, and quantifying water elimination, sodium and potassium excretion by atomic absorption spectrophotometry, and chloride excretion by mercurimetric titration. Results. In the acute model both extracts showed significant diuretic, natriuretic, and kaliuretic effect compared to the control group. Whereas, a short-term repeated-dose administration showed a diuretic effect without elimination of electrolytes. The histopathologic study did not suggest a toxic effect in liver or kidney. Conclusion. The results represent evidence of the diuretic activity of C. pteridoides and give support the popular use given to this plant in the north coast of Colombia. Further studies are required to isolate and identify the compounds responsible for the activity and the mechanism of action involved.

Acute toxicity and diuretic studies of the roots of Asparagus racemosus willd in rats / Toxicidad aguda y estudios diuréticos del espárrago racemoso willd en ratas

OBJECTIVE: Asparagusracemosus Willd has been used as diuretic in Ayurveda but has not been validated by a suitable experimental model. Hence the present study was undertaken. MATERIALS AND METHODS: The study was carried out with an aqueous extract of the roots of Asparagus racemosus utilizing three doses viz 800 mg/kg, 1600 mg/kg and 3200 mg/kg for its diuretic activity in comparison with standard drug (furosemide) and control (normal saline) rats after doing acute toxicity study. RESULTS: Acute toxicity study showed no fatality even with the highest dose and the diuretic study revealed significant diuretic activity (p < 0.05) in the dose of 3200 mg/kg. CONCLUSION: Asparagus racemosus showed diuretic activity at a 3200 mg/kg dose without acute toxicity.

OBJETIVO: El espárrago racemoso Willd ha sido usado como diurético en ayurveda pero no ha sido validado mediante un modelo experimental conveniente. De ahí la razón para emprender el presente estudio. MATERIALES Y MÉTODOS: El estudio fue realizado con extracto acuoso de raíces de espárrago racemoso, utilizando tres dosis, a saber, 800 mg/kg, 1600 mg/kg y 3200 mg/kg para analizar su actividad diurética, comparándolo con el medicamento estándar (furosemida), y ratas de control (solución salina normal) después de hacer un estudio de toxicidad aguda. RESULTADOS: El estudio de toxicidad aguda no mostró fatalidad, incluso con la dosis más alta, y el estudio del diurético reveló una actividad diurética significativa (p < 0.05) con la dosis de 3200 mg/kg. CONCLUSIÓN: El espárrago racemoso mostró actividad diurética en una dosis de 3200 mg/kg sin toxicidad aguda.

Changes in sodium appetite evoked by lesions of the commissural nucleus of the tractus solitarius

Ablation of the area postrema/caudal nucleus of the tractus solitarius (NTS) complex increases sodium intake, but the effect of selective lesions of the caudal NTS is not known. We measured depletion-induced sodium intake in rats with electrolytic lesions of the commissural NTS that spared the area postrema. One day after the lesion, rats were depleted of sodium with furosemide (10 mg/kg body weight, sc) and then had access to water and a sodium-deficient diet for 24 h when 1.8 percent NaCl was offered. Water and saline intakes were measured for 2 h. Saline intake was higher in lesioned than in sham-lesioned rats (mean ± SEM: 20 ± 2 vs 11 ± 3 mL/2 h, P < 0.05, N = 6-7). Saline intake remained elevated in lesioned rats when the tests were repeated 6 and 14 days after the lesion, and water intake in these two tests was increased as well. Water intake seemed to be secondary to saline intake both in lesioned and in sham-lesioned rats. A second group of rats was offered 10 percent sucrose for 2 h/day before and 2, 7, and 15 days after lesion. Sucrose intake in lesioned rats was higher than in sham-lesioned rats only 7 days after lesioning. A possible explanation for the increased saline intake in rats with commissural NTS lesions could be a reduced gastrointestinal feedback inhibition. The commissural NTS is probably part of a pathway for inhibitory control of sodium intake that also involves the area postrema and the parabrachial nucleus.

Matching salt intake to physiological need in rats using foraging protocols

Several studies of the quantitative relationship between sodium need and sodium intake in rats are reviewed. Using acute diuretic treatment 24 h beforehand, intake matches need fairly accurately when intake is spread out in time by using a hypotonic solution of NaCl. In contrast, using a hypertonic solution, intake is typically double the need. Using the same diuretic treatment, although the natriuresis occurs within ~1 h, the appetite appears only slowly over 24 h. Increased plasma levels of aldosterone parallel the increased intake; however, treatment with metyrapone blocks the rise in aldosterone but has no effect on appetite. Satiation of sodium appetite was studied in rats using sodium loss induced by chronic diuretic treatment and daily salt consumption sessions. When a simulated foraging cost was imposed on NaCl access in the form of a progressive ratio lever press task, rats showed satiation for NaCl (break point) after consuming an amount close to their estimated deficit. The chronic diuretic regimen produced hypovolemia and large increases in plasma aldosterone concentration and renin activity. These parameters were reversed to or toward non-depleted control values at the time of behavioral satiation in the progressive ratio protocol. Satiation mechanisms for sodium appetite thus do appear to exist. However, they do not operate quantitatively when concentrated salt is available at no effort, but instead allow overconsumption. There are reasons to believe that such a bias toward overconsumption may have been beneficial over evolutionary time, but such biasing for salt and other commodities is maladaptive in a resource-rich environment.

Comparison of the diuretic effects of frusemide and the Karavi Panchaka Ayurveda decoction.

OBJECTIVE: To investigate the diuretic, natriuretic and kaliuretic effects of the antihypertensive Ayurveda drug Karavi Panchaka decoction and compare it with the diuretic frusemide. DESIGN: An animal study using Sprague-Dawley rats. The volume of urine and the total sodium and potassium excreted in the urine by rats in response to orally fed Karavi Panchaka decoction were compared with rats fed with frusemide. Control experiments were done with rats receiving similar volumes of distilled water orally. The Ayurveda drug was prepared in accordance with the traditional method in the laboratory using medicinal plant specimens individually collected and identified. MEASUREMENTS: The volume of urine excreted during a 24-hour period following administration of the Ayurveda drug, frusemide or water was measured.The total sodium and potassium ion concentrations in the urine samples were determined using flame photometry. RESULTS: The Karavi Panchaka decoction clearly showed a statistically significant increase in urine excretion when compared with the control group that received only distilled water. The potassium ion excretion was significantly increased in the Karavi Panchaka decoction treated group when compared to the control group. This increase was statistically similar to that caused by frusemide. Neither drug had a significant effect on sodium ion excretion at the dosages used. CONCLUSION: Our results show that the Karavi Panchaka decoction significantly increases urine and potassium ion excretion in rats, but has no effect on sodium ion excretion at the dosage used. The effect of the Ayurveda drug on urine output as well as the sodium and potassium ion excretion is similar to that of frusemide administered at the dose used in our study.

Chronic excitotoxic lesion of the dorsal raphe nucleus induces sodium appetite

We determined if the dorsal raphe nucleus (DRN) exerts tonic control of basal and stimulated sodium and water intake. Male Wistar rats weighing 300-350 g were microinjected with phosphate buffer (PB-DRN, N = 11) or 1 æg/0.2 æl, in a single dose, ibotenic acid (IBO-DRN, N = 9 to 10) through a guide cannula into the DRN and were observed for 21 days in order to measure basal sodium appetite and water intake and in the following situations: furosemide-induced sodium depletion (20 mg/kg, sc, 24 h before the experiment) and a low dose of dietary captopril (1 mg/g chow). From the 6th day after ibotenic acid injection IBO-DRN rats showed an increase in sodium appetite (12.0 ± 2.3 to 22.3 ± 4.6 ml 0.3 M NaCl intake) whereas PB-DRN did not exceed 2 ml (P < 0.001). Water intake was comparable in both groups. In addition to a higher dipsogenic response, sodium-depleted IBO-DRN animals displayed an increase of 0.3 M NaCl intake compared to PB-DRN (37.4 ± 3.8 vs 21.6 ± 3.9 ml 300 min after fluid offer, P < 0.001). Captopril added to chow caused an increase of 0.3 M NaCl intake during the first 2 days (IBO-DRN, 33.8 ± 4.3 and 32.5 ± 3.4 ml on day 1 and day 2, respectively, vs 20.2 ± 2.8 ml on day 0, P < 0.001). These data support the view that DRN, probably via ascending serotonergic system, tonically modulates sodium appetite under basal and sodium depletion conditions and/or after an increase in peripheral or brain angiotensin II.

Transcranial Doppler ultrasound analysis of resistive index in rostral and caudal cerebral arteries in dogs

Transcranial Doppler (TCD) was carried out to determine the resistive index (RI) values of normal canine cerebral arteries and its reproducibility and to evaluate the change of cerebral vascular resistance following diuretics administration. RI values of rostral cerebral artery (RCA) were compared between fontanelle window and temporal window. Normal ranges and reproducibility of the RI values were examined in the rostal cerebral artery (RCA) and caudal cerebral artery (CCA). And after administration of diuretics, TCD-derived RI values were measured at RCA and CCA. Cerebral vascular RI values of RCA and CCA were 0.55 +/- 0.05 and 0.55 +/- 0.03 in the normal dogs, respectively. There was no significant difference of RI between male and female; between fontanelle window and temporal window. Reproducibility of RI measurements between intraobserver and interobserver were relatively high. The RI of RCA and CCA were significantly increased 15 minutes after mannitol administration (p<0.01) and returned to baseline values by 30 minutes, but it did not significantly change after furosemide and saline administration. The results suggest that TCD is a useful test which can obtain reproducible results from any window and has the advantage of detecting subtle changes in cerebral vascular resistance.

Does Albumin Preinfusion Potentiate Diuretic Action of Furosemide in Patients with Nephrotic Syndrome?

The aim of this cross-over study was to investigate whether albumin infusion before furosemide administration could potentiate the diuretic action of furosemide. Seven patients with nephrotic syndrome were given the following infusions in random order on two separate days: 1) a sham solution followed by 160 mg of furosemide, 2) 100 ml of 20% human albumin followed by 160 mg of furosemide. Urine and serum furosemide concentrations were measured by high-performance liquid chromatography. The increment of urine volume was greater in albumin preinfusion than in furosemide alone. However, the increments of sodium and chloride excretions between furosemide alone and albumin preinfusion were not different. No significant differences in the pharmacokinetic parameters between the two treatments were observed: area under the concentration-time curve (AUC: 12.7+/-2.2 vs 15.1+/-4.4 g/ml hr), total plasma clearance (253+/-41 vs 256+/-54 ml/min), volume of distribution (341+/-34 vs 494+/-153 ml/kg), elimination half life (4.0+/-1.1 vs 4.6+/-0.8 hr), and urine furosemide excretion of the administered amount (16.5+/-7.3 vs 7.5+/-1.6%). In conclusion, these data show that albumin preinfusion potentiated diuresis, but not natriuresis, of furosemide without any change in the pharmacokinetics of the agent in patients with nephrotic syndrome.

Diuretic therapy and ascitic fluid pattern in heart failure

It is claimed that diuretics can change the pattern of ascitic fluid analysis in heart failure, but, it has remained a controversial issue. To test the hypothesis that in heart failure diuretics change the transudative pattern of ascites to exudative. In a prospective study, 50 patients [32 male, 18 female] with a mean age of 49 years [range, 26-67 years], and ascites secondary to heart failure were randomly allocated to two therapeutic groups. Group I: 30 patients received furosemide and group II: 20 patients received triamtrene H for two weeks. Abdominal paracentesis was performed before, and one and two weeks after diuretic therapy. The difference in ascitic fluid total protein [AFTP] and cell count was not significant at baseline between the two groups. In patients on furosemide, the change in AFTP compared to the baseline was significant [p<0.001 and p<0.001, respectively] one and two weeks after therapy. In patients on triamtrene H, the change in AFTP one and two weeks after therapy compared to the baseline was significant [p<0.01 and p<0.001, respectively]; ascitic fluid met exudative criteria in three patients [15%]. In group I patients, the difference in ascitic fluid cell count, one and two weeks after therapy was statistically significant [p<0.001 and p<0.001 respectively] compared to the baseline. In group II, the difference in ascitic fluid cell count one and two weeks after therapy compared to the baseline was not significant. In group I: 23 patients [76.6%] showed a significant change in their ascitic fluid pattern while in group II: 3 patients [15%] showed ascitic fluid changes toward the exudative pattern [p<0.05]. In patients with heart failure, furosemide changes transudative ascitic to exudative; the change is more significant in the amount of protein than in the cell count, and occurs at the end of the first week of therapy and continues thereafter

Uso de furosemida inhalado en pacientes con crisis asmática / Inhaled furosemide in patients with asthmatic crisis

Estudio prospectivo de 53 pacientes de ambos sexos, en edades entre 6 y 17 años con crisis asmática leve o moderada, durante los meses de junio de 1993 a febrero de 1994. Se separaron en grupo, A de 33 pacientes que recibió furosemida inhalado y el grupo B, control, con 20 pacientes que recibió salbutamol inhalado. Todos los pacientes fueron sometidos a valoración clínica y pruebas de función respiratoria pre y posterior a la inhalación de uno u otro medicamento. En el grupo A, cuatro pacientes incrementaron el 20 por ciento o más posterior a la inhalación en el FVC, siete en el FEVI, 21 en el VEF 25-75 por ciento y ocho en PEF. En el grupo B, dos pacientes incrementaron el 20 por ciento o más, posterior a la inhalación en el FVC, cuatro en el FEVI, 17 en el VEF 25-75 por ciento y seis en el PEF. En VEF 25-75 por ciento es el indicador que con mayor frecuencia se incrementó en los dos grupos. De acuerdo a las PFR, el furosemida tiene efectos similares al salbutamol

Antiallergic potential of furosemide.

Recent reports have indicated the effectiveness of furosemide in inhibiting responses to inhaled allergen and in treating allergic conjunctivitis. In the present study furosemide was tested for its antiallergic potential using compound 48/80 induced paw edema and in vitro mast cell degranulation. Furosemide was found to significantly inhibit compound 48/80 paw edema and compound 48/80 induced histamine release. Furosemide was also found to inhibit histamine release during passive peritoneal anaphylaxis in rats. The results suggest that furosemide may be inhibiting the release of mediators of anaphylaxis from the mast cells.

Tratamiento del asma bronquial en crisis moderada con fenoterol y furosemida nebulizados, en niños de 5 a 14 años que acuden al Servicio de Emergencia del Hospital Central de Aeronáutica en Lima, durante julio y agosto de 1995

Estudios experimentales han demostrado que la furosemida, administrada inhalatoriamente en pacientes asmáticos antes de la exposición intencionada a una variedad de estimulantes bronquiales, previene de los efectos broncoconstrictores; motivando estudios clínicos en el asma aguda y crónica como medicamento antiasmático inhalatorio. Para investigar el efecto de la administración inhalatoria de la furosemida más fenoterol en la reversibilidad de la crisis asmática y sus efectos colaterales; se realizó un estudio experimental, prospectivo y comparativo en 44 niños asmáticos(5-14 años). El grupo experimental GA(n=22), fue nebulizado con furesemida(1mg/Kg), máximo 30 mg.) más fenoterol(0.1mg/Kg., máximo 3mg). Los pacientes antes de ser nebulizados presentaron parámetros clínico-flujométricos comparable(con la prueba t de student, p<0.05). A los 35 minutos el PEF incrementó en los dos grupos, siendo significativo en el GA(por la prueba t de student, p<0.05), y ocasionando un mayor número de altas(GA=14,GB=5). A los 80 minutos el PEF incrementó en los dos grupos, no existiendo diferencia significativa(por la prueba t de student,p<0.05), y persistiendo mayor número de altas en el grupo experimental(GA=21,GB=18). La frecuencia respiratoria disminuyó y la frecuencia cardíaca aumentó en todos los casos(taquicardia sólo en GB), presentando además tremor y nerviosismo, así como naúseas(4 pacientes del GB) vómitos(1 paciente del GB) e irritación nasal(1 paciente del GA). Sólo un paciente de cada grupo no respondió al tratamiento, no hubo complicaciones. Se demostró que la nebulización de furosemida más fenoterol es más eficaz en revertir la crisis asmática aguda moderada en niños, en comparación del fenoterol; evidenciando el efecto broncodilatador de la furosemida y sin efectos colaterales ajenos al fenoterol

Furosemida vs terbutalina en la crisis asmática

En los últimos 7 años algunos estudios han establecido que la Furosemida nebulizada inhibe la broncoconstricción inducida por metabisulfito, ejercicio, aguda destilada y alergenos. Hay poca información sobre la utilidad clínica de la Furosemida y no hay experiencia en Crisis Asmática (CA). Para resolver tales interrogantes se realizó el presente estudio. Los pacientes con CA que consultaron al servicio de urgencia del Hospital Universitario de Cartagena desde noviembre de 1993 hasta mayo de 1994 ingresaron en el presente estudio, previo consentimiento informado. A todos los pacientes se les realizó historia clínica y cada hora se monitorizaron: signos vitales, pulso paradójico, cianosis, estado de conciencia, sibilancias, tirajes y Flujo Espiratorio Pico (FEP). Los pacientes con CA severa o Asma Potencialmente Fatal fueron excluidos. Al ingreso, al azar y doble ciego, los pacientes pasaron a un grupo terapéutico de Terbutalina ( 2 gotas por cada 10 Kg de peso Solución nebulizadora de 1cc=10mg) o de Furosemida (40 mg nebulizados). En ambos grupos la nebulización se realizó cada 20 minutos por 3 ocasiones, la primera hora, y luego cada 4 horas durante un máximo de 24 horas. En CA moderada se asoció aminofilina IV en ambos grupos. Cada hora se analizaron los parámetros anotados y según ellos se decidió hospitalizar, continuar manejo en el servicio de urgencia o dar de alta. Para el análisis estadístico se registraron los datos en una tabla maestra, se tomaron medidas de tendencia central (media), porcentajes, desviación estándar. Los parámetros clínicos y funcionales evaluados fueron analizados mediante prueba T de student (p menor 0.05).