Furosemide disposition in cirrhosis

  title={Furosemide disposition in cirrhosis},
  author={Roger K. Verbeeck and Rashmi V. Patwardhan and Jean-Pierre Villeneuve and Grant R. Wilkinson and Robert A. Branch},
  journal={Clinical Pharmacology \& Therapeutics},
Furosemide disposition after rapid intravenous injection (80 mg) was studied in 10 normal healthy subjects and eight patients with cirrhosis and ascites. In the cirrhotic patients the elimination half‐life was modestly longer (81.0 ± 8.0 min and 60.2 ± 5.8 min). This prolongation was not associated with a difference in systemic clearance (156 ± 7 ml/min in normal and 142 ± 16 ml/min in cirrhotic subjects), rather it was a reflection of alterations in furosemide distribution. The steady‐state… 
Furosemide disposition in patients on CAPD
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.
Furosemide kinetics and dynamics in patients with cirrhosis
Furosemide's pharmacokinetics were not, therefore, appreciably altered by cirrhosis, however, Cirrhosis was associated with a reduction in pharmacodynamic response to this diuretic and the rate of urinary furosemides excretion required to achieve 50% of maximal response did not change.
Pharmacokinetic Study of Frusemide in Healthy and Cirrhotic Indian Subjects
Data from current study do not correlate with earlier reports, carried mainly in Western population, due to possibly differences in instrumentation, etc but a possible genetic interplay should not be ruled out.
Pharmacokinetic Changes in Patients With Oedema
Besides affecting absorption and conversion of the prodrug to the active form, probably as a result of the associated disease, oedema has not been proven to cause any clinically relevant changes in pharmacokinetic parameters for individual drugs.
Pole of the Kidneys in the Metabolism of Furosemide: Its Inhibition by Probenecid1
To assess the role of the kidneys in the metabolism of furosemide, its intra-venous kinetics have been studied in control and anephric rabbits, after the ligation of the renal pedicles.
Pharmacokinetic, biliary excretion, and metabolic studies of 14C-furosemide in the rat.
  • J. Prandota, A. Pruitt
  • Biology, Medicine
    Xenobiotica; the fate of foreign compounds in biological systems
  • 1991
The bile of rats contained the parent drug, 4-chloro-5-sulphamoyl-anthranilic acid, and at least two unknown metabolites with the furan ring intact and showed that i.p.v. administration of 50 mg/kg and higher doses of furosemide to rats resulted in saturation of hepatic drug metabolism.
Role of the kidneys in the metabolism of furosemide: its inhibition by probenecid.
It is concluded that the kidneys are responsible for 85% of furosemide total clearance, either via excretion or biotransformation, and that probenecid inhibits both processes.
The clinical pharmacology of loop diuretics in the pediatric patient
A better understanding of the clinical pharmacology of the loop diuretics should aid clinicians in the development of dosing regimens aimed at producing adequate diuresis without promoting excessive diuretic tolerance.
Furosemide dynamics in conscious rabbits: Modulation by angiotensin II
It is concluded that angiotensin II decreases the response to furosemide and the mechanism underlying this effect is related to the pharmacodynamics rather than the kinetics of the diuretic.


Elimination of furosemide in healthy subjects and in those with renal failure
Although the furosemide plasma t½ was essentially normal, the elimination rate of metabolites was decreased and the main route of excretion of label was in the feces, unlike that of healthy subjects.
Disposition of furosemide in functionally hepatectomized dogs.
It is demonstrated that, although nonrenal clearance accounts for about 50% of the elimination of furosemide, the liver does not play a significant role in this process in the dog.
Pharmacokinetics of furosemide in advanced renal failure
Diuretic response was always less after oral than after intravenous furosemide, and the slow, intravenous infusion of this drug is recommended for maximal efficacy in uremic patients.
Biotransformation of furosemide in patients with acute pulmonary edema.
Urinary excretion of furosemide was less in patients with, than in those without, myocardial infarction and the glucuronide metabolite was the major biotransformation product in these patients with acute pulmonary edema.
Renal secretion of [35-S]furosemide and depression by albumin binding.
  • R. H. Bowman
  • Medicine, Biology
    The American journal of physiology
  • 1975
It is concluded that at physiological albumin concentrations, a very small fraction of circulating furosemide will be available for filtration, and tubular-fluid and urinary furoSemide will arise predominantly from secretion.
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  • Biology
    Annals of the New York Academy of Sciences
  • 1971
It has become increasingly evident that most of the oxidative reactions are catalyzed by enzyme systems in liver endoplasmic reticulum, which is disrupted by homogenization to form microsomes, and the diversity of the reactions catalyzing by these enzymes is virtually unique in biochemistry.
A physiological approach to hepatic drug clearance
The proposed classification of drug metabolism based on the hepatic extraction ratio allows prediction and interpretation of the effects of individual variations in drug‐metabolizing activity, route of administration, pharmacokinetic interactions, and disease states on hepatic drug elimination.
Plasma binding and disposition of furosemide in the nephrotic syndrome and in uremia
It is indicated that the disposition of furosemide is not only dependent on renal function but also on the serum albumin concentration.
Plasma and tissue binding of drugs in pharmacokinetics
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