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Calcitonin was used in conjunction with saline diuresis, furosemide, and prednisone in treatment of a dog that consumed a rodenticide that contained cholecalciferol and has been touted as safe for nontarget species. This report shows that the rodenticide is toxic to dogs and that salmon calcitonin is a useful treatment for the often refractory hypercalcemia induced by vitamin D toxicosis.
We developed a microelectrode technique to characterize the electrophysiological properties in Caco-2 cells, and used it to determine the mechanisms of absorption enhancers. The action of absorption enhancers on the apical membrane of Caco-2 cells was estimated by measuring the apical membrane potential (Vm) with the microelectrode. The Vm value of Caco-2 cells in Hanks' balanced salt solution containing 0.5 mM K+ was 18.9+/-0.8 mV (n=217), and the apical membrane resistance was 49.4+/-1.1 MOhms (n=160). In the electrophysiological study with absorption enhancers, laurylmaltoside (LM) markedly decreased the Vm value, while sodium glycocholate (NaGC) moderately reduced this value, and EDTA did not affect the value. These findings might be associated with their action sites, plasma membrane or tight junction in Caco-2 cell monolayers. In influx and transport studies with these absorption enhancers, LM enhanced the influx of furosemide, which is transported via both the transcellular and paracellular routes into Caco-2 cells, and enhanced its transport to the basolateral side of Caco-2 monolayers more than that of 5(6)-carboxyfluorescein (CF), a paracellular marker. EDTA did not increase the influx of furosemide, and enhanced the transport of furosemide and CF across Caco-2 cell monolayers to the same extent. In contrast, NaGC only slightly increased the influx of furosemide and did not enhance the transport of either furosemide or CF across the Caco-2 monolayers in this study. These findings were well correlated with the effects of these absorption enhancers on the electrophysiological parameters. Therefore, the microelectrode technique might be useful for evaluating the action of absorption enhancers in the plasma membrane at an intact cell level.
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(1) In IVCS loop diuretic efficacy is attenuated by aldosterone activation; (2) complete aldosterone suppression with captopril is difficult to achieve due to dose restriction; (3) spironolactone is favoured for a synergistic response.
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All submersions involved bodies of freshwater. Fourteen animals were submerged in man-made water sources, 13 were submerged in natural water sources, and the body of water was not recorded in 1 case. Twenty (71%) submersions occurred from May through September. Cause was identified in 16 animals and included extraordinary circumstances (n = 6), falling into water (5), breaking through ice (3), and intentional submersion (2). Twelve animals were found submerged in water with unclear surrounding circumstances. Treatment included administration of supplemental oxygen, antimicrobials, furosemide, corticosteroids, and aminophylline and assisted ventilation. Respiratory dysfunction was detected in 21 animals. Neurologic dysfunction was detected in 12 animals, hepatocellular compromise was detected in 6 animals, and cardiovascular dysfunction was detected in 4 animals. Three dogs had hematologic dysfunction, and 2 dogs had acute renal dysfunction. Eighteen (64%) animals survived to hospital discharge, but all of the cats died. In 9 of 10 nonsurvivors, respiratory tract failure was the cause of death or reason for euthanasia.
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Clinical Trial.Gov NCT00982527.
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Therapeutic efficacy of some orally administered molecules is often conditioned by their solubility in physiological fluids as well as their absorption. The last aspect becomes more limitative and conditioning drug plasmatic profiles when the active ingredient is preferentially absorbed in a specific region of the gastrointestinal tract. A case is represented by furosemide (FURO) preferentially absorbed in the stomach, site in which, because of its acidic nature, is poorly soluble. To solve this problem new oral solid formulations have been developed. The inorganic-organic hybrid MgAl-HTlc-FURO has been formulated in tablet in which floating and mucoadhesion properties have been combined. Swellable (Methocel K4, Methocel K15, Methocel K100 M, hydroxypropyl methyl cellulose) or swellable/erodible polymers (Methocel E50 LV, Methocel K100 LV), used to obtain the floating, were combined to Carbopol(®) (971P or 974P) to confer mucoadhesion capacity. Prepared tablets were deeply characterized in terms of hydration capacity, erosion %, buoyancy lag time/floating time and mucoadhesion. The most suitable tablets selected from these preliminary tests, submitted to in vitro release studies, showed a sustained release of FURO. This is useful to maintain the therapeutic concentrations for a long time, in comparison to conventional dosage forms, thanking to the enhancement of formulation residence time in the stomach.
A new method is described for the determination of the most common diuretic and laxative adulterants found in formulations of anorexics and antidepressants. The method is based on the separation of furosemide, hydrochlorothiazide, chlorthalidone and amiloride (diuretics), phenolphthalein (laxative), amfepramone (anorexic) and fluoxetine and paroxetine (antidepressants) by capillary zone electrophoresis with capacitively coupled contactless conductivity detection. The method showed a precision ranging from 1.9% to 6.9% for a concentration of 25 mg/L, 0.6% to 5.3% for a concentration of 50 mg/L and 1.6% to 6.0% for a concentration of 100 mg/L for all analytes. The accuracy was 99% for amiloride, 102% for chlorthalidone, 101% for hydrochlorothiazide, 101% for furosemide, 94% for phenolphthalein, 105% for fluoxetine, 114% for paroxetine and 117% for amfepramone. The method allowed the drugs to be determined in the formulations at concentrations higher than 5.1 mg/kg for amiloride, 7.7 mg/kg for chlorthalidone, 6.8 mg/kg for hydrochlorothiazide, 10.7 mg/kg for furosemide, 8.4 mg/kg for phenolphthalein, 11.0 mg/kg for fluoxetine, 9.4 mg/kg for paroxetine and 11.0 mg/kg for amfepramone. Three of the 26 analysed herbal formulations were found to be adulterated (not declared on the label) with the diuretic hydrochlorothiazide. Five other samples contained diuretics declared on the label on the formulation. Thus, a total of eight samples, which were marketed as natural products, contained diuretics (declared or not) on the formulation.
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We analyzed the results of 112 consecutive coronary angiography examinations (CAG). All patients received intravenous 500 mL multielectrolyte fluid (PWE) before catheterization. Group I of 55 randomly selected cases in addition were treated with 300 mg of NAC. The other 57 cases (group II) received only hydration. After catheterization, we administered 500 mL 0.9% saline with 20 mg furosemide. A nonionic, low-osmolality contrast agent (OPTIRAY) was used for all catheterizations. All patients underwent measurements of serum creatinine and creatinine clearance levels before and after the procedure (CREA0, CREA1, CC0, and CC1, respectively). We assessed the influence of NAC on CREA1 and the relative change of CREA1/CREA0 and CC1/CC0 ratios.
This experimental model will be useful to screen future aldosterone-synthase inhibitors and study their biological effects in various experimental conditions.
The effect of cis-chlorodiamine platinum (cisplatin) on different tissues of rat was studied. Nephrotoxicity and neurotoxicity were clearly observed both clinically and histologically. The minimising action of penicillamine as a chelating agent and/or lasix as a diuretic on the toxic side-effect of cisplatin was also studied. Both agents succeeded in reducing the toxic side-effect of cisplatin to some extent but failed to reduce mortality among the experimental animals. The study has also manifested liver and heart to be additional organs susceptible to damage, following cisplatin treatment.
This study indicates that the enlargement of the intrastrial space requires not only the blockade of the Na+-K+-2Cl- cotransporter but also normal activity of the Na+-K+-ATPase, and suggests that the bumetanide-induced enlargement of the intrastrial space resulted from the imbalance between the activities of the Na+-K+-2Cl- cotransporter and the Na+-K+-ATPase.
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Inhaled furosemide may be effective, but studies are needed to determine the optimal dosage regimen and long-term risks and benefits of its use in these patients.
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In patients with heart failure, few data describe the neurohormonal response to nesiritide and furosemide either alone or in combination. This study systematically compared the effects of nesiritide, furosemide, and their combination on natriuresis/diuresis and plasma aldosterone in patients with chronic stable heart failure who were relatively diuretic resistant.
TRV120027 is a novel β-arrestin biased ligand of the angiotensin II type 1 receptor; it antagonizes canonical G-protein-mediated coupling while, in contrast to classical angiotensin II type 1 receptor antagonists, it engages β-arrestin-mediated signaling. Consequently, TRV120027 inhibits angiotensin II-mediated vasoconstriction while, via β-arrestin coupling, it increases cardiomyocyte contractility. We hypothesized that TRV120027 would elicit beneficial cardiorenal actions when added to furosemide in experimental heart failure.