呋嘛滴鼻液的质量控制

目的测定呋嘛滴鼻液中呋喃西林和盐酸麻黄碱的含量进行质量控制。方法采用HPLC,Agilent Eclipse×OB-C18色谱柱,乙腈：0．05mol／L磷酸二氢钾溶液（22：78）为流动相,检测波长为255nm。结果呋喃西林在8～32μg／ml浓度范围内,盐酸麻黄碱在400~1600μg／ml浓度范围内,峰面积与浓度呈良好的线性关系,其相关系数分别为r=0．9998和r=0．9999,呋喃西林的平均回收率为99．66％,盐酸麻黄碱的平均回收率为99．90％。结论本法测定呋嘛滴鼻液的含量,简便、快速、结果准确,可用于其质量控制。     

地塞米松和速尿超声雾化吸入治疗小儿支气管哮喘的临床研究

目的 :观察地塞米松和速尿超声雾化吸入治疗小儿支气管哮喘的疗效。方法 :在吸氧、补液、抗感染、纠正酸碱平衡紊乱等治疗的基础上 ,采用地塞米松和速尿超声雾化吸入。结果 :地塞米松和速尿超声雾化吸入治疗组的总有效率为 93.33% ,明显高于对照组。结论 :地塞米松和速尿超声雾化吸入治疗小儿支气管哮喘 ,安全方便 ,有效率高 ,具有较高的实用价值 ,值得推广应用     

吸入速尿对致敏原乙酰胆碱和组胺混合液诱发哮喘的保护效应

本研究采用整体实验方法 ,观察了速尿对致敏原、药物诱发哮喘的保护效应。结果表明 :吸入速尿能明显延长鸡卵蛋白、乙酰胆碱和组胺混合液所诱发哮喘的潜伏期 ,与给药前或对照组比较差异非常显著。认为本药具有良好的平喘作用。这不仅为哮喘的治疗又开新途径 ,而且有助于进一步阐明哮喘的发病机理     

Management of salt poisoning in an extremely low birth weight infant

We present the first reported case of severe salt poisoning in an extremely low birth weight neonate. The salt poisoning was managed with the careful use of intravenous fluids, insulin to manage the severe hyperglycemia, and furosemide to induce a saline diuresis. The hypertonicity was normalized slowly over 3 days by following the corrected serum sodium (Na) (serum Na+2.7 mEq for every 100 mg/dl of glucose over 100). No neurological damage was seen in our patient during the development of the hypertonicity or its correction. This suggests that the premature brain can develop osmoprotective molecules if hypertonicity develops slowly over 2–3 days. Slow correction is therefore recommended to avoid the development of water intoxication during correction. Despite the development of mild reversible renal failure, a large saline diuresis was induced with furosemide, thereby avoiding the need for dialysis in our patient. The only complication was the development of necrotizing enterocolitis, which has not been previously reported in association with salt poisoning.The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.     

Furosemide disposition in patients on CAPD

Single doses of oral and intravenous furosemide were given to 8 healthy male volunteers (40 mg) and 11 patients with renal failure maintained on continuous ambulatory peritoneal dialysis (CAPD) (80 mg). In the volunteers, absorption was variable. Only one half of the intravenous dose and one third of the oral dose was available for renal pharmacological action as judged by the urinary recovery. In the patients, absorption was also variable and was markedly delayed (t _max 128 vs 90 min) but more complete (bioavailability 70.1 vs 53.6%). The differences between the two groups were not significant, however (95% C.I.: -90 to 30 and -40.4 to 7.5 respectively). The mean elimination half-life was significantly longer in the patients following both the oral (228 vs 65.1 min) and intravenous dose (195 vs 60.3 min). The total body clearance of furosemide in the volunteers was 138 ml·min^–1 and this was much lower in the CAPD patients (61.9 ml·min^–1) in whom the renal clearance was minimal. The peritoneal clearance of furosemide was negligible. Although there were trends indicating differences in absorption between the two groups, the significant differences in furosemide disposition observed in CAPD patients were due to renal failure.     

呋喃苯胺酸对蟾蜍心肌电与机械活动的影响

使用浮置式细胞内微电极方法,结合肌力换能器,观察了呋喃苯胺酸(Furosemide,Fur6×10~(-4)mol/L)对蟾蜍离体心肌电及机械活动的影响。结果显示:Fur作用20min时使右心房收缩力(FC)增加到147.50%;动作电位幅值(APA)、O相上升最大速率(V_(max))及动作电位时程(APD_(50))分别增加到108.69%、106.58%及103.45%。对APD_(25)、APD_(90)及窦性周长(SCL)无明显影响,Fur的正性肌力作用能被维拉帕米(Verapamil,Ver2.2×10~(-7)mol/L)所取消。实验结果提示Fur具有促进Ca~(2+)内向电流的作用。     

速尿654－2治疗急性腹泻50例

速尿、６５４－２联用治疗急性腹泻５０例。经临床观察，可明显级解急性期的症状，减少并发症的发生。显效率达６４％，总有效率达１００％。     

Chronic diuretic therapy attenuates renal BOLD magnetic resonance response to an acute furosemide stimulus

Background

Blood Oxygen Level Dependent (BOLD) magnetic resonance (MR) is a novel imaging tool that detects changes in tissue oxygenation. Increases in renal oxygenation in response to a standard 20 mg intravenous furosemide stimulus have been evaluated to assess kidney viability in patients with renal artery stenosis (RAS). The effect of prior exposure to furosemide on the ability of BOLD MR techniques to evaluate renal function is unknown.This study tested the hypothesis that chronic loop diuretic therapy is associated with attenuated responses in renal tissue oxygenation as measured by BOLD MR with an acute 20 mg intravenous furosemide stimulus in participants undergoing evaluation for RAS.

Methods

Thirty-eight participants referred for evaluation of RAS were recruited for this study. We examined renal cortical and medullary BOLD signal (T2*) intensities before and after a 20 mg intravenous furosemide stimulus. Additionally, we measured changes in renal artery blood flow using phase contrast techniques.

Results

After controlling for covariates age, race, gender, diabetes, glomerular filtration rate, body mass index, and stenosis severity, daily oral furosemide dose was an independent, negative predictor of renal medullary T2* response (p = 0.01) to a standard 20 mg intravenous furosemide stimulus. Stenosis severity and ethnicity were also significant independent predictors of changes in T2* signal intensity in response to an acute furosemide challenge. Changes in renal blood flow in response to acute furosemide administration were correlated with changes in T2* in the renal cortex (r = 0.29, p = 0.03) but not the medulla suggesting changes in renal medullary oxygenation were not due to reduced renal medullary blood flow.

Conclusions

Chronic furosemide therapy attenuates BOLD MR responses to an acute furosemide stimulus in patients with RAS being evaluated for renal artery revascularization procedures. Thus, patients who are chronically administered loop diuretics may need a different dosing strategy to accurately detect changes in renal oxygenation with BOLD MR in response to a furosemide stimulus.     

急性失代偿性心力衰竭患者连续与间歇注射呋塞米的对比研究

目的：比较连续（cIV）或间歇（iIV）静注给予呋塞米对急性失代偿性心力衰竭（ADHF）患者的疗效和安全性的差异。方法纳入2011年6月~2012年11月江苏省南通市海安县南莫中心卫生院ADHF患者56例,其中26例采用cIV方式给药的患者纳入cIV组,30例采用iIV方式给药的患者纳入iIV组,主要终点为每日净尿量（nUOP）,次要终点包括：nUOP/呋塞米、每日总尿量（tUOP）、tUOP/呋塞米、研究过程中的失重、需要的额外急性代偿性心力衰竭治疗、给药的持续时间和住院天数及安全性评估（包括损失的电解质和低血压的发生率）。结果 cIV组患者nUOP和tUOP均高于iIV组[nUOP：（2098±1132）ml vs.（1575±1100）ml,P=0.086;tUOP：（3726±1121）ml vs.（2955±1267）ml,P=0.019],同时tUOP/呋塞米比值也更高[（38.6±31.0）ml/mg vs.（22.2±12.5）ml/mg,P=0.021];其他指标,包括nUOP/呋塞米、研究过程中的失重、需要的额外急性代偿性心力衰竭治疗、给药的持续时间及安全性无差异。cIV组的住院时间比iIV组更短[（6.9±3.7）d vs.（10.9±8.3）d,P=0.006）]。结论cIV方式较iIV方式更有利减轻ADHF患者水钠潴留情况,且患者耐受性良好。     

Changes in Pharmacokinetics and in Effect of Furosemide in the Elderly

In this paper the general changes in the pharmacokinetics of drugs in the elderly are summarized. The suggestion is proposed, that in the case of diuretics - which act after renal excretion -the results of these changes are totally different: contrary to other drugs the standard dose of a diuretic must have less sali-uretic effect instead of more effect.

This thesis is supported by the results of experiments with furo-semide in old patients: the kinetics are changed as expected, leading to higher plasma levels and increased Area Under the (plasma level versus time) Curve (AUC), but the effects are -dependent on renal function - decreased. To a certain degree kinetics and dynamics of furosemide can be explained and predicted on the basis of simple patient parameters. If diuretics are used in old people to treat congestive heart failure, the normal adult dose has to be used, and occasionally a larger dose has to be given.