THE PHARMACODYNAMICS OF INTRAVENOUS AND ORAL TORSEMIDE IN PATIENTS WITH CHRONIC RENAL-INSUFFICIENCY

被引:32
作者
RUDY, DW
GEHR, TWB
MATZKE, GR
KRAMER, WG
SICA, DA
BRATER, DC
机构
[1] INDIANA UNIV,SCH MED,DEPT MED,INDIANAPOLIS,IN
[2] VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,RICHMOND,VA 23298
[3] UNIV PITTSBURGH,SCH PHARM & MED,PITTSBURGH,PA
[4] BOEHRINGER MANNHEIM PHARMACEUT INC,DEPT CLIN RES,ROCKVILLE,MD
关键词
D O I
10.1038/clpt.1994.99
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
The pharmacodynamics of intravenous and oral torsemide were determined in two randomized crossover clinical trials in patients with chronic renal insufficiency. There was no significant difference in the rate or magnitude of the diuretic response between oral and intravenous administration. As has been shown with other loop diuretics, patients with chronic renal insufficiency have a reduced diuretic response compared with healthy subjects, This diuretic resistance is primarily related to a diminished delivery of drug to the urinary site of action. The response of torsemide at the tubular level is not different from that seen in subjects with normal renal function. Metabolites of torsemide do not appear to contribute to the diuretic response. A dose of 50 to 100 mg dependent on renal function is required to obtain a maximal response. A ceiling dose of approximately 100 mg in patients with chronic renal insufficiency is therefore recommended.
引用
收藏
页码:39 / 47
页数:9
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