Articoli di riviste: "Furosemide – Stability"

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Machado, Ana Isabel, Rita Fragoso, Ana Vitória Martins Neves Barrocas Dordio e Elizabeth Duarte. "Furosemide in water matrix: HPLC-UV method development and degradation studies". Ambiente e Agua - An Interdisciplinary Journal of Applied Science 15, n. 1 (17 febbraio 2020): 1. http://dx.doi.org/10.4136/ambi-agua.2406.

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This study developed a method for furosemide quantification through high performance liquid chromatographic technique. Special attention was given to solute loss and storage stability due to furosemide’s low solubility and photosensitivity, respectively. The performance of Nylon and PVDF filters was tested in a 2 mg.L-1 furosemide solution. PVDF filters showed better recovery capacity and therefore are more suitable for furosemide filtration. Over eight days, three different storage conditions were studied to access furosemide degradation susceptibility: (i) exposure to light at room temperature, (ii) storage at room temperature without exposure to light, and (iii) storage at 4ºC without exposure to light. The study demonstrated that after 48 h under natural light exposure furosemide was completely degraded. Furosemide solution stored in the dark was stable. Storage temperature did not seem to affect furosemide concentration. The study shows that the selection of more suitable filter and storage conditions for furosemide determination is crucial to avoid underestimation errors.

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Elwell, Rowland J., Anne P. Spencer, Julie F. Barnes, James E. Wynn e Curtis E. Jones. "Stability of Furosemide in Human Albumin Solution". Annals of Pharmacotherapy 36, n. 3 (marzo 2002): 423–26. http://dx.doi.org/10.1345/aph.1a232.

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OBJECTIVE: To determine the chemical stability of furosemide in human albumin solution over a 28-day period and to assess admixtures for microbiologic contamination. METHODS: Samples were prepared by mixing furosemide injectable solution and 25% human albumin solution in a 1:1 molar ratio. Six bulk containers were prepared and stored in the dark: 3 under refrigeration (∼4 °C) and 3 at room temperature (∼25 °C). Study samples were withdrawn from each bulk solution immediately after preparation and at predetermined intervals over the subsequent 28 days. Containers were observed for color change and precipitation against a light and dark background at each sampling interval. Total furosemide concentration was determined using HPLC. Additional vials were prepared and assessed for microbiologic growth at time points corresponding with chemical stability results. RESULTS: A mean of 94.5% ± 1.33% of the initial furosemide concentration remained after 48 hours at room temperature. Under refrigeration, 100.6% ± 1.02% of the initial concentration remained at 14 days. Beyond these respective time points, <90% of the initial furosemide concentration remained. No bacterial or fungal growth was observed. CONCLUSIONS: When combined with 25% human albumin solution and stored under darkness, furosemide is chemically stable and free of microbiologic contamination for 48 hours at room temperature and 14 days under refrigeration.

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Hanna, George M., e Cesar A. Lau-Cam. "Stability-Indicating Proton Nuclear Magnetic Resonance Spectroscopic Assay Method for Furosemide in Tablets and Injections". Journal of AOAC INTERNATIONAL 76, n. 3 (1 maggio 1993): 526–30. http://dx.doi.org/10.1093/jaoac/76.3.526.

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Abstract A simple, specific, and accurate proton nuclear magnetic resonance (1H-NMR) spectroscopic method has been developed for the identification and assay of furosemide and its degradation product, 4-chloro-5-sulfamoylanthranilic acid (CSA), in tablets and injections. Dissolution of the sample in D20-NaOD resulted in a solution yielding the required separation among the resonance signals of furosemide, CSA, and ferf-butyl alcohol, the internal standard. The mean ± SD recovery values of furosemide and CSA from 10 synthetic formulations were 99.6 ± 0.8 and 98.9 ± 1.7%, respectively. Commercial tablets (6 lots) and injections (5 lots) of furosemide were assayed by the proposed method and found to contain 53.1-99.8% furosemide and 0.3-45.2% CSA.

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Vlachou, Marilena, Natassa Pippa, Angeliki Siamidi e Aimilia Kyrili. "Thermal analysis studies on the compatibility of furosemide with solid state and liquid crystalline excipients". Chemical Industry 74, n. 1 (2020): 15–23. http://dx.doi.org/10.2298/hemind190910002v.

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In the context of the present study, the thermal behavior of furosemide and the solid state excipients, sodium alginate, poly(ethylene oxide), poly(vinylpyrrolidone), lactose mono-hydrate and magnesium stearate, using Differential Scanning Calorimetry (DSC), was probed. It was found that the thermal behavior of these solid-state pharmaceutical excipients and furosemide correlates nicely with the literature relevant data. Regarding the furosemide-excipients mixtures, the DSC scans appear as a compilation of the thermal curves of each excipient. This suggests that the formulations containing these mixtures, may retain their stability over time. This information, which arises from the cooperativity of materials, their thermal stability and behavioris very helpful for the research and development of safe and effective pharmaceutical formulations. DSC experiments were also carried out with chimeric bilayers (called ?liposomes?), composed of hydrogenated soy phosphatidylcholine (HSPC) and poly(n-butylacrylate)-b-poly(acrylic acid) block copolymer with 70 % content of poly(acrylic acid (PnBA-b-PAA 30/70) with the addition of furosemide at the molar ratio of 9:0.1:1.0 in the system HSPC:PnBA-b-PAA 30/70:furosemide. Chimeric liposomal systems were characterized as ?fluid-like? by their DSC curves, which may be potentially translated as an easy way for release of furosemide from the advanced delivery system.

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Cies, Jeffrey J., Wayne S. Moore, Arun Chopra, Guizhen Lu e Robert W. Mason. "Stability of furosemide and chlorothiazide stored in syringes". American Journal of Health-System Pharmacy 72, n. 24 (15 dicembre 2015): 2182–88. http://dx.doi.org/10.2146/ajhp150023.

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Ram, Rajesh R., Vijay R. Ram e Hitendra S. Joshi. "Analytical Method Validation of Simultaneous Determination of Spironolactone and Furosemide in Tablet Formulation and its Statistical Evaluation". International Letters of Chemistry, Physics and Astronomy 42 (dicembre 2014): 25–35. http://dx.doi.org/10.18052/www.scipress.com/ilcpa.42.25.

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The objective of current study was to Statistical Comparison for Precision and Intermediate Precision study for Analytical Method Validation of Spironolactone and Furosemide in tablet formulation and developed easy, exact and correct isocratic stability indicating reversed phase HPLC assay method and validated for determination of Spironolactone and Furosemide in solid pharmaceutical dosage forms. Isocratic RP-HPLC separation was achieved on an SGE make 150 4.6mm SS Wakosil II 5C18RS 5 μm column (Part Number: 206610 and Serial Number: A01-063) using mobile phase of Acetonitrile- Ammonium acetate buffer (50:50, v/v) at a flow rate of 1.1 ml/min and the detection was carried out at 254 nm using photo-diode array detector. The method was validated for specificity, linearity, precision, accuracy, robustness and solution stability. The method was linear in the drug concentration range of 40-160 µg/ml with a correlation coefficient 0.9977 and 0.9953 for Spironolactone and Furosemide respectively. The precision (RSD) amongst six-sample preparation was 0.87% and 1.1 % for Spironolactone and Furosemide respectively. For repeatability and intermediate precision (RSD) amongst six-sample preparation was 0.46 % and 0.20 % for Spironolactone and Furosemide respectively. As result shown that for furosemide, % RSD was 1.12% and in ANOVA study Significance F value found 0.625502408 and for spironolactone Precision study and Intermediate precision study % RSD was 0.68, in ANOVA study Significance F value found 0.905843808.

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Alfred-Ugbenbo, Deghinmotei, Oleksandr Zdoryk e Viktoria Georgiyants. "Quality assessment and stability study of compounded furosemide syrup". ScienceRise: Pharmaceutical Science, n. 5 (9) (31 ottobre 2017): 28–35. http://dx.doi.org/10.15587/2519-4852.2017.113517.

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Asafu-Adjaye, E. B., A. S. Carlin, E. H. Jefferson, A. R. Bryant, B. Rothman, M. A. Khan e P. J. Faustino. "Comparative stability study of unit-dose repackaged furosemide tablets". Clinical Research and Regulatory Affairs 28, n. 2 (20 aprile 2011): 38–48. http://dx.doi.org/10.3109/10601333.2011.568492.

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Brevedan, Marta I. V., María A. Varillas e Noelia L. Gonzalez Vidal. "Pharmaceutical Equivalence and Stability of Furosemide Tablets in Argentina". Dissolution Technologies 26, n. 4 (novembre 2019): 30–37. http://dx.doi.org/10.14227/dt260419p30.

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Shaik, Javed S., e Nutan N. Rao. "SIMULTANEOUS ESTIMATION AND FORCED DEGRADATION STUDIES OF AMILORIDE HYDROCHLORIDE AND FUROSEMIDE IN A PHARMACEUTICAL DOSAGE FORM USING REVERSE-PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY METHOD". Asian Journal of Pharmaceutical and Clinical Research 11, n. 7 (7 luglio 2018): 215. http://dx.doi.org/10.22159/ajpcr.2018.v11i7.25783.

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Objective: The present study describes the stability indicating reverse-phase high-performance liquid chromatography (RP-HPLC) method for simultaneous estimation of amiloride hydrochloride and furosemide in pharmaceutical dosage forms.Methods: The proposed RP-HPLC method was developed using Shimadzu LC-2030 HPLC system equipped with UV detector, and chromatographic separation was carried on Shim-pack C18 (250 mm×4.6 mm, 5 μ) column at a flow rate of 1 ml/min and the runtime was 4min. The mobile phase consisted of water and acetonitrile in the ratio of 35:65, and elements were scanned using a UV detector at 281 nm.Results: The retention time of amiloride hydrochloride and furosemide was found to be 1.92 min and 3.14min, respectively. Linearity was found to be 12–28 ppm for amiloride hydrochloride and 96–224 ppm for furosemide, respectively. Limit of detection and limit of quantification for amiloride hydrochloride were 0.381 ppm and 1.156 ppm and for furosemide were 2.00 ppm and 6.068 ppm, respectively.Conclusion: The stability indicating method was developed by subjecting the drugs to stress conditions such as acid and base hydrolysis, oxidation, humidity, photolytic, and thermal degradation, and the degraded products formed were resolved successfully from the samples.

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Lima, Ednaldo Q., Miracy M. Albuquerque, Onaldo G. Rodrigues, José R. B. Alencar, Flávia P. M. Medeiros e Pedro J. Rolim Neto. "Technological development of 40mg furosemide tablets: equivalence and bioavaibility study in dogs". Pesquisa Veterinária Brasileira 27, n. 11 (novembre 2007): 462–66. http://dx.doi.org/10.1590/s0100-736x2007001100003.

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Furosemide (40mg) was administered to 20 street dogs, 10 males and 10 females, in two different pharmaceutical forms: (1) compressed furosemide 40mg formulated at the Federal University of Pernambuco (UFPE-tablet), and (2) a commercial formulation with equal bioequivalence produced by the Laboratory for Pharmaceutical Technology of Pernambuco State (LAFEPE), the LAFEPE-furosemide. The study aimed to evaluate the kinetics of dissolution of the UFPE-tablet in order to analyze the behavior of bioavailability of the best formulation for veterinary use. The plasmatic concentrations of furosemide for the determination of parameters of pharmacological kinetics were analyzed by high-performance liquid chromatographic method (HPLC). The in vitro study accomplished through physiochemical analyses demonstrated that the formulas of the furosemide tablets attained the pharmaceutical requirements in agreement with USP 23 and the Brazilian Pharmacopoeia. The evaluation accomplished in dogs with UFPE-tablets given in only dose demonstrated uniformity in blood levels indicating stability in maintenance of the pharmaceutical formulation and efficiency in absorption of the active compound. These values are not significantly different in relation to the 5% confidence limit. Regarding maximum concentration (Tmax) time and global bioavaibility assessed by AUC means, there were no considerable differences as well. UFPE-furosemide displayed 743.492µg/mL.h as AUC average value whereas LAFEPE-furosemide had an average of 537.284µg/mL.h.

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Espinosa Bosch, M., F. Sánchez Rojas e C. Bosch Ojeda. "OHP-048 Compatibility and stability of morphine and furosemide admixtures". European Journal of Hospital Pharmacy 21, Suppl 1 (24 febbraio 2014): A204.3—A205. http://dx.doi.org/10.1136/ejhpharm-2013-000436.500.

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Pathak, Rahul, Ajay Kumar Yadav, Sabin Thapaliya, Brindeshwari Kafle, Anurag Jha e Prem Khadga. "Comparative Study of Slow Infusion versus Bolus Doses of Albumin and Furosemide Infusion to Mobilize Refractory Ascites in Decompensated Chronic Liver Disease". Journal of Nepal Health Research Council 18, n. 2 (7 settembre 2020): 233–37. http://dx.doi.org/10.33314/jnhrc.v18i2.2116.

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Background: Combined use of furosemide with albumin is an approved therapy to overcome diuretic resistance in treatment of ascites in decompensated chronic liver disease. Bolus dosing of diuretics has its own limitations due to pre-existing hypotension, post diuretic sodium retention and braking phenomenon. Slow albumin and furosemide Infusion has been shown to mobilize large ascites with improved diuresis and hemodynamic stability in decompensated chronic liver disease. This study was undertaken to compare efficacy and safety of infusion therapy vs bolus therapy in term the management of refractory ascites.Methods: Decompensated chronic liver disease patients with refractory ascites were randomly assigned into two groups of 15 each - Bolus therapy (intravenous albumin and furosemide as boluses) and Infusion therapy (furosemide infusion at 2mg/hour and albumin at 2g/hour for three days). Diuresis, natriuresis, change in abdominal girth and body weight, and hemodynamic stability (change in SBP) were compared between the two groups.Results: Infusion therapy, as compared to bolus therapy, showed a significantly better diuresis (mean urinary output increment 483ml vs 243ml, p <0.001), natriuresis (mean urinary sodium excretion increment 35.2 mEq/L vs 16.6 mEq/L, p = 0.004),decrease in abdominal circumference (6.1cm vs 3.0cm, p<0.001) and decrease in body weight (5.53 Kg vs 2.86 Kg, p < 0.001). The complications of renal impairment were also lower in the Infusion group. Conclusion: Infusion of furosemide and albumin is a potential safer and effective therapeutic option in the management of refractory ascites with better natriuresis, higher urine output, and higher decrement in abdominal circumference and body weight, and lesser side effects.Keywords: Bolus dose; continuous infusion; decompensated chronic liver disease; refractory ascites.

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Keyi, Xu, Nancy Gagnon, Chantal Bisson, Marc Desmarais e Marc LeBel. "Stability of Famotidine in Polyvinyl Chloride Minibags and Polypropylene Syringes and Compatibility of Famotidine with Selected Drugs". Annals of Pharmacotherapy 27, n. 4 (aprile 1993): 422–26. http://dx.doi.org/10.1177/106002809302700404.

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OBJECTIVE: (1) To determine the stability of famotidine 200 μg/mL in admixtures with dextrose 5% injection (D5W) and NaCl 0.9% injection (NS) in polyvinyl chloride (PVC) minibags and polypropylene syringes, at room temperature (22 °C), protected and unprotected from light for 15 days; and (2) to evaluate the visual compatibility of famotidine with 34 selected drugs for four hours at room temperature. DESIGN: Concentration of famotidine samples was determined on day 0 and again on days 3, 6, 9, 12, and 15 by a stability-indicating HPLC. Inspection for visual and pH changes was also performed at these time intervals. RESULTS: More than 95 percent of the day 0 famotidine concentration remained in all samples over the 15-day study period. During this period, all samples remained clear and colorless and no change in absorbance at 450 and 540 nm was observed. The pH of the samples also remained unchanged. Famotidine 2000 μg/mL was found to be compatible with 33 selected drugs; only furosemide was found to be incompatible. A white precipitate was observed when an equal volume of famotidine 2000 μg/mL in NS was mixed with furosemide 3000 μg/mL in D5W. The concentration of famotidine in the supernatant gradually decreased during the 4-hour study period. At 0.5, 1.0, 2.0, and 4.0 hours after mixture of famotidine with furosemide, famotidine concentrations were 97.5, 23.6, 21.7, and 17.2 percent of the initial famotidine concentration, respectively. CONCLUSIONS: Our results show that famotidine 200 μg/mL was stable in admixture with D5W and NS in PVC minibags and polypropylene syringes when these solutions were stored at room temperature, protected and unprotected from light for 15 days. Famotidine 2000 μg/mL in NS was compatible with 33 of the drugs, and was incompatible with furosemide.

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Minkov, Vasily, Alina Beloborodova, Valeri Drebushchak e Elena Boldyreva. "Furosemide solvates: can they serve as precursors to different polymorphs?" Acta Crystallographica Section A Foundations and Advances 70, a1 (5 agosto 2014): C1015. http://dx.doi.org/10.1107/s2053273314089840.

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The importance of polymorphism of molecular crystals is hard to overestimate, especially when dealing with compounds used as materials or drugs. Different polymorphs of a drug substance may have different properties related to their manufacturing, therapeutic usage, or storage (density, hygroscopicity, melting points, thermal stability, solubility, rate of dissolution, surface free energy, toxicity, bioavailability, tabletting, etc.). Different polymorphs, solvates, and co-crystals can be patented, and this opens the way for a competition with brand drugs. Since the energies of different polymorphs are sometimes very close, producing desirable crystalline forms is quite a challenge and can also be complicated by the phenomena of concomitant polymorphism (when several polymorphs crystallize simultaneously from the same batch), or erratic and poorly reproducible (when crystallization gives different polymorphs even at seemingly identical experimental conditions). The aim of the present study was to crystallize various solvates of furosemide, to check whether these solvates can be used as precursors for producing different polymorphs of pure furosemide on their subsequent decomposition upon heating, and to search any correlation between the crystal structures of the solvates and on the furosemide polymorphs produced by desolvation. Four solvates of furosemide with tetrahydrofuran, dioxane, dimethylformamide, and dimethylsulfoxide were crystallized. The detailed structural analysis of furosemide-containing crystal structures showed that the molecule of furosemide has a high conformational lability because of the rotations of the sulfamoyl and furanylmethylamino fragments. Some of the furosemide conformations were shown to be stabilized by the intramolecular N–H···Cl H-bond. Desolvation of the four solvates was studied by TG and X-ray diffraction and was shown to give different products depending on the precursor and particle size.

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Akbuĝa, J., A. Gürsoy e E. Kendi. "The Preparation and Stability of Fast Release Furosemide – PVP Solid Dispersion". Drug Development and Industrial Pharmacy 14, n. 10 (gennaio 1988): 1439–64. http://dx.doi.org/10.3109/03639048809151942.

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Negro, Sofia, Ana Rendon, María Azuara, Yolanda Sánchez, Ana Fernández-Carballido e Emilia Barcia. "Compatibility and Stability of Furosemide and Dexamethasone Combined in Infusion Solutions". Arzneimittelforschung 56, n. 10 (21 dicembre 2011): 714–20. http://dx.doi.org/10.1055/s-0031-1296778.

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Kovács, Andrea, Adrienn Kazsoki, Balázs Démuth, Bernadett Szirányi, János Madarász, Károly Süvegh e Romána Zelkó. "Influence of Aqueous Solubility-Enhancing Excipients on the Microstructural Characteristics of Furosemide-Loaded Electrospun Nanofibers". Pharmaceutics 12, n. 4 (23 aprile 2020): 385. http://dx.doi.org/10.3390/pharmaceutics12040385.

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Electrospun nanofibers were prepared from furosemide-containing hydroxypropyl cellulose and poly(vinylpyrrolidone) aqueous solutions using different solubility enhancers. In one case, a solubilizer, triethanolamine, was applied, while in the other case a pH-modifier, sodium hydroxide, was applied. Scanning electron microscopy (SEM) was carried out for morphological characterization of the fibers. The SEM images indicated similar mean diameter size of the two fibrous formulations. However, in contrast to the NaOH-containing fibers of normal diameter distribution, the triethanolamine-containing fibers showed approximately normal diameter distribution, possibly due to their plasticizing effect and the consequent slightly ribbon-like morphology. Attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), powder X-ray diffraction (XRD) and positron annihilation lifetime spectroscopy (PALS) were applied for microstructural characterization. The FTIR measurements confirmed that furosemide salt was formed in both cases. There was no sign of any crystallinity based on the XRD measurements. However, the PALS highlighted the differences in the average o-Ps lifetime values and distributions of the furosemide-loaded fibrous formulations. The two types of electrospun nanofibrous formulations containing amorphous furosemide salt showed similar macrostructures but different microstructural characteristics depending on the type of solubility enhancers, which lead to altered storage stability.

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Bosch María, Espinosa, Sánchez Rojas Fuensanta e Bosch Ojeda Catalina. "Binary Mixtures of Morphine and Furosemide: Compatibility and Stability at Different Concentrations". Indian Journal of Pharmaceutical Education and Research 49, n. 4s (3 luglio 2015): s75—s81. http://dx.doi.org/10.5530/ijper.49.4s.9.

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Andrew, Wignell, Davies Patrick, Hammond Sophie, Cooling Paul e Barrett David. "P17 Pharmco-stability of plasma-lyte 148 and plasma-lyte 148% glucose 5% with frequently used infused therapeutic agents". Archives of Disease in Childhood 103, n. 2 (19 gennaio 2018): e1.21-e1. http://dx.doi.org/10.1136/archdischild-2017-314584.28.

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AimsPlasma-Lyte148 is a balanced, crystalloid fluid which has been shown to circumvent the hyperchloraemic metabolicacidosis associated with 0.9% Saline. There is limited compatibility data available to support the co-administration of this fluid with commonly infused medications. Such data is essential to support the safe introduction of this fluid, especially in children where intravenous access is often limited. This study aimed to expandon knowledge in this area by assessing the chemical and physical compatibility of Plasma-Lyte with a range of medicines.MethodsAdrenaline, Dobutamine, Dopamine, Furosemide, Midazolam, Milrinone and Morphine were mixed with Plasma-Lyte, Plasma-Lyte with 5% Glucose, and the two control solutions 0.9% Saline and 5% Glucose. Chemical compatibility was assessed by High Performance Liquid Chromatography using the Thermo Scientific UltiMate 3000 system. Physical compatibility was assessed by checking for colour changes and precipitate formation. pH of the admixtures was recorded using a Fisherbrand Hydrus 3000 pH metre. 6 repeats were carried out for HPLC and 2 for physical compatibility checks and pH measurements, with all admixtures assayed at 0, 2 and 24 hours. Chemical stability was defined as <5% change in concentration and pH was considered acceptable for peripheral administration if it was between 5 and 9 at all time points.ResultsAdrenaline, Dobutamine, Dopamine, Morphine and Milrinone were chemically and physically stable when diluted with Plasma-Lyte 148 and Plasma-Lyte 148 with 5% Glucose. Furosemide was compatible with Plasma-Lyte 148, but not Plasma-Lyte 148 with 5% glucose. Midazolam was not compatible with Plasma-Lyte 148 or Plasma-Lyte 148%–5% glucose at the tested concentration of 3 mg/mL. Only Dobutamine, Dopamine, Furosemide and Morphine remained within the pH range 5–9 when mixed with Plasma-Lyte 148 and Plasma-Lyte 148 with glucose.ConclusionAdrenaline, Dobutamine, Dopamine, Morphine and Milrinone can be mixed with Plasma-Lyte 148 and Plasma-Lyte 148 with glucose in clinical practice. Furosemide can beco-administered with Plasma-Lyte 148, but not Plasma-Lyte 148 with 5% glucose. Midazolam should not be mixed with Plasma-Lyte 148 and Plasma-Lyte 148 with glucose at a concentration of 3 mg/mL.

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Vorobets, D. Z. "Effectiveness of different correction methods of pyeloureteral segment according to the data of diuretic ultrasonography". Visnyk of Dnipropetrovsk University. Biology, medicine 6, n. 2 (2 agosto 2015): 151–55. http://dx.doi.org/10.15421/021527.

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Methods of estimation of effectiveness of the open and laparoscopic pyeloplasty, as well as endo-urological palliative methods – laser resection, balloon dilatation and endopyelotomy, which determine the anatomical and functional peculiarities of renal pelvis and pyelo-ureteral junction with the help of ultrasound diagnostics during the forced diuresis, have been proposed. Changes of the area of renal pelvis, the velocity of post-furosemide increase of the scope of renal pelvis, rate of its drainage, changes in the diameter of pyeloureteral junction have been studied. This methodical approach is non-invasive, informative and simple in application. It is shown that dispersions of samples of patients after the open surgery do not differ from the dispersions of samples of the same patients before the operation on such parameters as areas of renal pelvis before the induction of furosemide, areas of renal pelvis after 15 minutes administration of furosemide, the rate of drainage after furosemide, the original diameter of pyeloureteral junction. This may indicate the stability of surgery results. For example, the larger renal pelvis by kidney size before the operation corresponded to the larger designed pelvis after the operation; renal pelvis drained faster before the operation, features faster drainage after the operation as well. Variation in the areas of renal pelvis which decreased in 40 minutes after furosemide, percent rate of longitudinal pelvis area, rate of after-furosemide increase in pelvis area, diameter of pyeloureteral junction in 15 minutes administration of furosemide after the open pyeloplasty was significantly different compared to the variation in the same parameter for the same patients before the operations. More substantial difference was observed in the same patients before and after Anderson-Hynes surgery by parameters of relative rate of after-furosemide drainage of pelvis and increase in diameter of pyeloureteral junction after 15 min administration of furosemide. That is, the same principle of operation provides similar results by anatomical parameters, such as size and diameter of pyeloureteral junction, but quite different results by functional parameters which reflect the possibility of draining of kidney in forced diuresis. Successful open pyeloplasty leads to a significant decrease in the pelvis area at different time intervals after furosemide administration, the relative increase in the pelvis area on the background of the induction of diuresis, rate of pelvis drainage, increase (normalization) in diameter of pyeloureteral junction, including the larger (better) gap of pyeloureteral junction after administration of diuretic. Concerning laparoscopic pyeloplasty, the dispersion of mean values of S, SPR, Vpr, V, VOT, D, DD after the operation was significantly different from those before the operation. This means that as in the case with open surgery, satisfactory clinical results such as reduction in renal pelvis and restoring the passage of urine through sufficient diameter pyeloureteral junction after laparoscopic pyeloplasty lead nevertheless to significant differences in the digital parameters during the objectification of operation effect by means of diuretic ultrasonography using furosemide-induced diuresis. Endoscopic surgery such as laser resection, endopyelotomy and balloon dilatation stably provides similar results (equal variances) by such parameters as pelvis area, which decreases in 40 min after furosemide administration, formation of the wide enough diameter of pyeloureteral junction and its minor fluctuations with the diuretic load. The decrease to normal parameters of all planes of renal pelvis (both before and after loading) and significant improvement of pelvis drainage (parameters responsible for the functional state of kidneys and pyeloureteral junction) indicate the success of palliative surgery in elimination of the narrowing of pyeloureteral junction.

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Adrjanowicz, Karolina, Kamil Kaminski, Katarzyna Grzybowska, Lukasz Hawelek, Marian Paluch, Irena Gruszka, Daniel Zakowiecki et al. "Effect of Cryogrinding on Chemical Stability of the Sparingly Water-Soluble Drug Furosemide". Pharmaceutical Research 28, n. 12 (25 giugno 2011): 3220–36. http://dx.doi.org/10.1007/s11095-011-0496-4.

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Bersot, Carlos Darcy, Rafael Linhares, Carolina Araujo Barbosa e Jose Eduardo Pereira. "Peri-operative fluid management during neurosurgical procedures". Nepal Journal of Neuroscience 18, n. 2 (1 giugno 2021): 9–14. http://dx.doi.org/10.3126/njn.v18i2.33373.

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The management of fluids and electrolytes in neurosurgical patients aims to reduce the risk of cerebral oedema, reduce ICP and at the same time maintain haemodynamic stability and cerebral perfusion. Neurosurgical patients commonly receive diuretics (mannitol and furosemide), developing complications such as bleeding and diabetes insipidus. These patients may require large volumes of intravenous fluids and even blood transfusions for volume resuscitation, treatment of cerebral vasospasm, correction of preoperative dehydration or maintenance of haemodynamic stability. Goal-oriented therapy is recommended in neurological patients, with the aim of maintaining circulating volume and tolerating the changes induced by anaesthesia (vasodilation and myocardial depression).

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Zahálka, Lukáš, Sylva Klovrzová, Ludmila Matysová, Zdenka Šklubalová e Petr Solich. "Furosemide ethanol-free oral solutions for paediatric use: formulation, HPLC method and stability study". European Journal of Hospital Pharmacy 25, n. 3 (2 agosto 2017): 144–49. http://dx.doi.org/10.1136/ejhpharm-2017-001264.

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Otsuka, Makoto, Mika Onoe e Yoshihisa Matsuda. "Hygroscopic stability and dissolution properties of spray-dried solid dispersions of furosemide with eudragit". Journal of Pharmaceutical Sciences 82, n. 1 (gennaio 1993): 32–38. http://dx.doi.org/10.1002/jps.2600820108.

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Gumieniczek, Anna, Hanna Trębacz, Łukasz Komsta, Agnieszka Atras, Beata Jopa, Michał Szumiło e Łukasz Popiołek. "DSC, FT-IR, NIR, NIR-PCA and NIR-ANOVA for determination of chemical stability of diuretic drugs: impact of excipients". Open Chemistry 16, n. 1 (2 marzo 2018): 116–32. http://dx.doi.org/10.1515/chem-2018-0014.

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Abstract (sommario):

AbstractIt is well known that drugs can directly react with excipients. In addition, excipients can be a source of impurities that either directly react with drugs or catalyze their degradation. Thus, binary mixtures of three diuretics, torasemide, furosemide and amiloride with different excipients,i.e. citric acid anhydrous, povidone K25 (PVP), magnesium stearate (Mg stearate), lactose, D-mannitol, glycine, calcium hydrogen phosphate anhydrous (CaHPO4) and starch, were examined to detect interactions. High temperature and humidity or UV/VIS irradiation were applied as stressing conditions. Differential scanning calorimetry (DSC), FT-IR and NIR were used to adequately collect information. In addition, chemometric assessments of NIR signals with principal component analysis (PCA) and ANOVA were applied.Between the excipients examined, lactose and starch did not show any interactions while citric acid, PVP, Mg stearate and glycine were peculiarly operative. Some of these interactions were shown without any stress, while others were caused or accelerated by high temperature and humidity, and less by UV/VIS light. Based on these results, potential mechanisms for the observed interactions were proposed Finally, we conclude that selection of appropriate excipients for torasemide, furosemide and amiloride is an important question to minimize their degradation processes, especially when new types of formulations are being manufactured.

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Zong, Shanghong, Bochen Pan, Leping Dang e Hongyuan Wei. "Stability, solubility and thermodynamic properties of dimorphs of furosemide-4,4′-bipyridine cocrystals in organic solvents". Journal of Molecular Liquids 289 (settembre 2019): 111017. http://dx.doi.org/10.1016/j.molliq.2019.111017.

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Carda-Broch, S., J. Esteve-Romero e M. C. Garcı́a-Alvarez-Coque. "Furosemide assay in pharmaceuticals by Micellar liquid chromatography: study of the stability of the drug". Journal of Pharmaceutical and Biomedical Analysis 23, n. 5 (ottobre 2000): 803–17. http://dx.doi.org/10.1016/s0731-7085(00)00378-2.

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Garnero, Claudia, Ana Karina Chattah e Marcela Longhi. "Stability of furosemide polymorphs and the effects of complex formation with β-cyclodextrin and maltodextrin". Carbohydrate Polymers 152 (novembre 2016): 598–604. http://dx.doi.org/10.1016/j.carbpol.2016.07.006.

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30

Servais, Hélène, e Paul M. Tulkens. "Stability and Compatibility of Ceftazidime Administered by Continuous Infusion to Intensive Care Patients". Antimicrobial Agents and Chemotherapy 45, n. 9 (1 settembre 2001): 2643–47. http://dx.doi.org/10.1128/aac.45.9.2643-2647.2001.

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ABSTRACT The stability and compatibility of ceftazidime have been examined in the context of its potential use in concentrated solutions for continuous infusion in patients suffering from severe nosocomial pneumonia and receiving other intravenous medications by the same route. Ceftazidime stability in 4 to 12% solutions was found satisfactory (<10% degradation) for 24 h if kept at a temperature of 25°C (77°F) maximum. Studies mimicking the simultaneous administration of ceftazidime and other drugs as done in clinics showed physical incompatibilities with vancomycin, nicardipine, midazolam, and propofol and a chemical incompatibility withN-acetylcystein. Concentrated solutions (50 mg/ml) of erythromycin or clarithromycin caused the appearance of a precipitate, whereas gentamicin, tobramycin, amikacin, isepamicin, fluconazole, ketamine, sufentanil, valproic acid, furosemide, uradipil, and a standard amino acid solution were physically and chemically compatible.

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Lalwani, Anita, D. Bhalodiya, C. Patel, L. Panchal e P. Shelat. "Optimization and Evaluation of Solubility-Modulated Gastroretentive Floating Matrix Tablet of Furosemide". International Journal of Pharmaceutical Sciences and Nanotechnology 7, n. 3 (31 agosto 2014): 2581–89. http://dx.doi.org/10.37285/ijpsn.2014.7.3.11.

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The objective of the present study was to prepare delivery system for furosemide which has poor solubility and has specific absorption in stomach. Solid dispersion of furosemide (SD) was prepared in polyethylene glycol 6000 and characterized using differential scanning calorimetry. Floating gastroretentive tablets of the prepared solid dispersion were then prepared by wet granulation technique, using polymer Methocel K100M CR (HPMC) and sodium bicarbonate. A 32 factorial design was applied systematically to study the effect of the amount of HPMC (X1) and sodium bicarbonate (X2) on the floating lag time (YFLT) and amount of drug release at the end of 1st hr (Y60), 6th hr (Y360) and 12th hr (Y720). The solubility of SD was higher than that of drug alone and the physical mixture. The results of multiple regression analysis, when applied to responses obtained for experimental design batches, indicated that low level of HPMC and high level of sodium bicarbonate decreased the floating lag time, while the amount of drug released at all time points decreased with increase in level of HPMC. Swelling behavior of experimental design batches was studied and its relationship with mechanism of drug release was interpreted. Batch D3 came close to satisfying the drug release and floating criteria. Drug compatibility with the excipients used was ascertained using FTIR. Stability studies were carried out at recommended storage conditions and the tablets were found to be stable. Delivery system could be developed for furosemide which addressed the solubility and site specificity issues of drug.

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Wignell, Andrew. "3 Pharmaco-stability of plasma-lyte 148 and plasma-lyte 148+5% glucose with commonly used therapeutic agents". Archives of Disease in Childhood 103, n. 2 (19 gennaio 2018): e2.23-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.3.

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AimsPlasma-Lyte 148 is a balanced, crystalloid intravenous fluid which is both calcium-free and isotonic. It has been demonstrated to reduce the risk of hyperchloraemic metabolic acidosis and iatrogenic hyponatraemia seen with use of normal saline and hypotonic solutions respectively. Investigating the compatibility of Plasma-Lyte 148 and Plasma-Lyte 148+5% gucose with morphine, midazolam, fentanyl, ketamine, clonidine, aminophylline, salbutamol and furosemide will provide vital data to facilitate the introduction of these fluids into routine paediatric practice.MethodChemical stability was assessed by high performance liquid chromatography (HPLC) using the ‘Hewlett Packard (Agilent) 1100’ HPLC system. A gradient method with 20 mM ammonium carbonate (A) and acetonitrile (B) mobile phases and an ‘ACE Excel 3 SuperC18’ column was used. The flow rate was set to 0.03 ml/min, temperature to 40°C and injection volume for all drug admixtures to 5 µL apart from ketamine (4 µL) and furosemide (1 µL). Physical stability was assessed by observation of precipitate formation or colour change. Six repeats of each IV fluid and drug mix were assayed at three time points: 0, 2 and 24 hours. pH changes were measured using Fisherbrand Hydrus 300. Normal saline and 5% glucose were used as controls for all experiments.ResultsNo precipitate formed in any of the samples. Chemical stability was defined as <5% concentration change. All examined therapeutic agents were stable at 2 and 24 hours relative to control solutions. Relative to starting concentration, all drugs except midazolam were stable to ±3%. Midazolam showed similar variation in concentration with all four fluids. All combinations remained in a safe peripheral administration pH range of 5–9. Plasma-Lyte 148 admixtures were found have a pH closest to that of the blood.ConclusionCompared to standard diluents, the tested therapeutic agents are chemically and physically stable for 24 hours at the concentrations measured, and are all stable at commonly encountered Y site concentrations, when diluted with Plasma-Lyte 148 or Plasma-Lyte 148+5% glucose. All are pH stable and all are suitable for peripheral administration.

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Jim, Lucia K. "Physical and Chemical Compatibility of Intravenous Ciprofloxacin with other Drugs". Annals of Pharmacotherapy 27, n. 6 (giugno 1993): 704–7. http://dx.doi.org/10.1177/106002809302700604.

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OBJECTIVE: To determine the physical and chemical compatibilities of ciprofloxacin lactate infusion with other commonly used intravenously administered drugs. DESIGN: Ciprofloxacin lactate injection in a commercially available concentration of 2 mg/mL was mixed with 15 intravenous drugs during simulated Y-site injection. Ciprofloxacin was mixed with usually employed concentrations of other drugs in a 1:1 ratio and examined physically by visual inspection and chemically by HPLC analysis. Adsorption of ciprofloxacin to intravenous administration sets with or without inline filters was also studied. SETTING: The study was carried out at ambient temperature (25 °C) under fluorescent lighting except for vitamin B complex, which was protected from light. All samples were prepared in a laminar airflow hood. MAIN OUTCOME MEASURES: Physical incompatibility was determined by visual inspection against a black-and-white background, and chemical incompatibility was measured by a stability-indicating HPLC assay for ciprofloxacin. Concentrations determined at time zero (before mixing) were defined as 100 percent. Values estimated for each sample at subsequent time points were calculated as percentages of the initial concentration. Recovery below 90 percent of the initial concentration is defined as significant loss. RESULTS: Of the 15 drugs studied, only heparin, furosemide, and teicoplanin were found to be incompatible with ciprofloxacin. Adsorption of ciprofloxacin to administration sets with and without inline filters was minimal. Metronidazole was also found to decrease to 90 percent of its initial concentration immediately upon mixing. CONCLUSIONS: Ciprofloxacin ready-to-infuse solution is compatible with most of the drugs studied except heparin, furosemide, teicoplanin, and, perhaps, metronidazole. Because only the stability and potency of ciprofloxacin were studied, further testing is needed to confirm if any chemical deterioration of the other drugs occurred when combined with ciprofloxacin.

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Ruponen, Marika, Konsta Kettunen, Monica Santiago Pires e Riikka Laitinen. "Co-Amorphous Formulations of Furosemide with Arginine and P-Glycoprotein Inhibitor Drugs". Pharmaceutics 13, n. 2 (27 gennaio 2021): 171. http://dx.doi.org/10.3390/pharmaceutics13020171.

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In this study, the amino acid arginine (ARG) and P-glycoprotein (P-gp) inhibitors verapamil hydrochloride (VER), piperine (PIP) and quercetin (QRT) were used as co-formers for co-amorphous mixtures of a Biopharmaceutics classification system (BCS) class IV drug, furosemide (FUR). FUR mixtures with VER, PIP and QRT were prepared by solvent evaporation, and mixtures with ARG were prepared by spray drying in 1:1 and 1:2 molar ratios. The solid-state properties of the mixtures were characterized with X-ray powder diffraction (XRPD), Fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) in stability studies under different storage conditions. Simultaneous dissolution/permeation studies were conducted in side-by-side diffusion cells with a PAMPA (parallel artificial membrane permeability assay) membrane as a permeation barrier. It was observed with XRPD that ARG, VER and PIP formed co-amorphous mixtures with FUR at both molar ratios. DSC and FTIR revealed single glass transition values for the mixtures (except for FUR:VER 1:2), with the formation of intermolecular interactions between the components, especially salt formation between FUR and ARG. The co-amorphous mixtures were found to be stable for at least two months under an elevated temperature/humidity, except FUR:ARG 1:2, which was sensitive to humidity. The dissolution/permeation studies showed that only the co-amorphous FUR:ARG mixtures were able to enhance both the dissolution and permeation of FUR. Thus, it is concluded that formulating co-amorphous salts with ARG may be a promising option for poorly soluble/permeable FUR.

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Bosch-Ojeda, C., M. Espinosa-Bosch e F. Sánchez-Rojas. "PP-002 Compatibility and stability of hyoscine N-butyl bromide and furosemide admixtures for use in palliative care". European Journal of Hospital Pharmacy 22, Suppl 1 (marzo 2015): A117.2—A117. http://dx.doi.org/10.1136/ejhpharm-2015-000639.282.

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Li, Maolin, Mengwei Wang, Yumin Liu, Ruiling Ouyang, Mingdi Liu, Dandan Han e Junbo Gong. "Co-amorphization Story of Furosemide-Amino Acid Systems: Protonation and Aromatic Stacking Insights for Promoting Compatibility and Stability". Crystal Growth & Design 21, n. 6 (11 maggio 2021): 3280–89. http://dx.doi.org/10.1021/acs.cgd.1c00015.

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Riley, Christopher M. "Stability of Milrinone and Digoxin, Furosemide, Procainamide Hydrochloride, Propranolol Hydrochloride, Quinidine Gluconate, or Verapamil Hydrochloride in 5% Dextrose Injection". American Journal of Health-System Pharmacy 45, n. 10 (1 ottobre 1988): 2079–91. http://dx.doi.org/10.1093/ajhp/45.10.2079.

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38

Silva, Wallace Andrino, Aline Macêdo Pinheiro, Cipriano Correia Junior, Paulo Henrique Lima, Kellen Micheline Alves Henrique Costa, José Hipólito Dantas Júnior e Paulo José Medeiros. "ANESTHESIA FOR RENAL TRANSPLANT SURGERY IN ADULTS". JOURNAL OF SURGICAL AND CLINICAL RESEARCH 11, n. 2 (18 dicembre 2020): 128–34. http://dx.doi.org/10.20398/jscr.v11i2.21090.

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Renal transplant surgery may be associated with important perioperative complications. In this scenario, the anesthetic technique should provide optimal conditions for the surgical team, guarantee hemodynamic stability and kidney perfusion, and adequate analgesia. Preoperative evaluation should always be performed. In the intraoperative period, standard monitoring is sufficient in most cases. General balanced anesthesia, alone or in combination with spinal anesthesia or peripheral block, is the technique of choice. Management of blood pressure during the surgery is crucial. Before reperfusion, a mean arterial blood pressure of 65 mmHg is recommended, increasing to 80–90 mmHg when reperfusion is imminent until the end of surgery. Vasopressors, such as ephedrine, may be necessary to achieve blood pressure targets. Mannitol and furosemide are commonly used to increase urine output. In the postoperative period, analgesia should be ensured.

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Kurmi, Moolchand, Sanjay Kumar, Bhupinder Singh e Saranjit Singh. "Implementation of design of experiments for optimization of forced degradation conditions and development of a stability-indicating method for furosemide". Journal of Pharmaceutical and Biomedical Analysis 96 (agosto 2014): 135–43. http://dx.doi.org/10.1016/j.jpba.2014.03.035.

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40

Ram, V. R., P. N. Dave e H. S. Joshi. "Development and Validation of a Stability-Indicating HPLC Assay Method for Simultaneous Determination of Spironolactone and Furosemide in Tablet Formulation". Journal of Chromatographic Science 50, n. 8 (28 maggio 2012): 721–26. http://dx.doi.org/10.1093/chromsci/bms062.

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Mate, Karen E., Michelle Barnett, Karen P. Kerr, C. Dimity Pond e Parker J. Magin. "Stability of anticholinergic load in Australian community-dwelling older people: a longitudinal analysis". Family Practice 37, n. 3 (30 novembre 2019): 314–20. http://dx.doi.org/10.1093/fampra/cmz076.

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Abstract Background It is recommended that anticholinergic medication is avoided in older people, especially those with cognitive impairment. Objective To investigate anticholinergic load (ACL) over time in older primary care patients with and without cognitive impairment. Methods Community-dwelling general practice patients at baseline (n = 1768), at year one (n = 1373) and a restricted cohort (with possible or definite cognitive impairment) at year two (n = 370) had medication regimens documented by a research nurse during a home visit. Anticholinergic medicines were categorized as levels 1–3 (low-high potency) and summed for each participant as a measure of their ACL. Results Most participants had no change in ACL over time, but there was some turnover in the anticholinergic medications used. The mean change in ACL was 0.012 ± 0.99 from baseline to 12 months and −0.04 ± 1.3 from baseline to 24 months. Cardiovascular drugs were the most commonly used level 1 anticholinergics, followed by antidepressants and opioids. Antidepressants and urologicals were the most commonly used level 3 anticholinergics. The rate of anticholinergic deprescribing was equivalent to the rate of anticholinergic initiation, and commonly involved the level 1 drugs warfarin, furosemide and temazepam, and the level 3 drugs amitriptyline and oxybutynin. People with dementia had a higher ACL at baseline and year one compared with other participants. Conclusion ACL of community-dwelling older people was very stable over time. This may represent lost opportunities for deprescribing as well as potentially inappropriate prescribing, particularly in those with cognitive impairment.

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Al-Shdefat, Ramadan I. "Enhanced diuretic action of furosemide by complexation with β-cyclodextrin in the presence of sodium lauryl sulfate". Green Processing and Synthesis 9, n. 1 (15 dicembre 2020): 744–50. http://dx.doi.org/10.1515/gps-2020-0069.

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AbstractPreparation of inclusion complex using cyclodextrins is a well-known formulation strategy to elevate the solubility of drugs. However, often cyclodextrins alone may not bring a considerable improvement in the solubility of low solubility drugs. In this study, the inclusion complexation of furosemide (FSM) was tried with β-cyclodextrin (β-CD) either with the use or without the use of sodium lauryl sulfate (SLS), which is a surfactant. By using the kneading method, the binary complex of FSM/β-CD in the equal molar ratio was used. FSM and β-CD were kneaded continuously until a thick past was achieved, which was evaporated for a period of about 24 h. The solid complexed product was then crushed and stored in airtight container until use. Phase solubility studies confirmed a stoichiometric ratio of 1:1 (FSM/β-CD and FSM/β-CD with SLS). The apparent stability constant and complexation efficiencies of significantly enhanced in the presence of SLS. The prepared complexes were evaluated for DSC, PXRD, 1H NMR, and in vitro release studies. The results exhibited a significant enhancement in diuresis in rats. It is evident that the addition of SLS with β-CD significantly enhances the solubilizing efficiencies and hence bioavailability of FSM.

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Chen, Fuchao, Baoxia Fang e Sicen Wang. "A Fast and Validated HPLC Method for Simultaneous Determination of Dopamine, Dobutamine, Phentolamine, Furosemide, and Aminophylline in Infusion Samples and Injection Formulations". Journal of Analytical Methods in Chemistry 2021 (27 febbraio 2021): 1–9. http://dx.doi.org/10.1155/2021/8821126.

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A simple, fast, and validated HPLC method was developed for the simultaneous quantization of five cardiovascular agents: dopamine (DPM), dobutamine (DBM), phentolamine (PTM), furosemide (FSM), and aminophylline (APL) either in infusion samples or in an injection dosage form. The proposed method was achieved with a 150 mm × 4.6 mm, 5.0 μm C18 column, by using a simple linear gradient. Mobile phase A was buffer (50 mM KH2PO4) and mobile Phase B was acetonitrile at a flow rate of 1.0 mL/min. The column temperature was kept at 30°C, and the injection volume was 20 μL. All analytes were separated simultaneously at a retention time (tr) of 3.93, 5.84, 7.06, 8.76, and 9.67 min for DPM, DBM, PTM, FSM, and APL, respectively, with a total run time of less than 15.0 min. The proposed method was validated according to ICH guidelines with respect to accuracy, precision, linearity, limit of detection, limit of quantitation, and robustness. Linearity was obtained over a concentration range of 12.0–240.0, 12.0–240.0, 20.0–200.0, 6.0–240.0, and 10.0–200.0 μg/mL DPM, DBM, PTM, FSM, and APL, respectively. Interday and intraday accuracy and precision data were recorded in the acceptable limits. The new method has successfully been applied for quantification of all five drugs in their injection dosage form, infusion samples, and for evaluation of the stability of investigated drugs in mixtures for endovenous use. The results of the stability study showed that mixtures of DPM, DBM, PTM, FSM, and APL in 5% glucose or 0.9% sodium chloride injection were stable for 48 hours when stored in polypropylene syringes at 25°C.

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Ntchapda, Fidèle, Djedouboum Abakar, Blaise Kom, Paulin Nana, Christian Bonabe, Maguirgue Kakesse, Emmanuel Talla e Théophile Dimo. "Diuretic Activity of the Aqueous Extract Leaves ofFicus glumosaDel. (Moraceae) in Rats". Scientific World Journal 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/693803.

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Experiments were carried out to validate the use ofF. glumosaextract as a diuretic in the treatment of hypertension as claimed by traditional healers. The experiments were performed under the same conditions with two synthetic pharmacological diuretics considered as check (Furosemide and Amiloride hydrochlorothiazide). The aqueous extract leaves ofF. glumosaaccelerated the elimination of overloaded fluid. At the maximum of diuretic response, urinary osmolarity decreased significantly when compared with controls. The single dose treatment of the aqueous extract leaves ofF. glumosahas significantly increased urine volume 24 h after administration of the extract. The stability of aldosterone level, the absence of correlation with the plasma levels of sodium, and the increased clearance of free water in the animals receiving the extract show that increased diuresis and natriuresis moderate elevation are tubular in origin. The increase in Na+, K+, and Cl−induced by the extract caused alkalinization of the urine and showed a strong inhibitory effect of carbonic anhydrase and saluretic. These effects were mainly observed at the dose of 375 mg/kg. These observations confirm the traditional use in the treatment of hypertension and support the importance of the conservation of local knowledge as well as the conservation of Cameroonian biodiversity.

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Battal, Muharrem, Bünyamin Gürbulak, Ozgür Bostanci, Müveddet Banu Yılmaz, Yasar Ozdenkaya e Oguzhan Karatepe. "Cholangiocarcinoma Presenting with Hypercalcemia and Thrombocytopenia". Case Reports in Medicine 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/246817.

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Malignant hypercalcemia and thrombocytopenia may result from bone metastasis of cholangiocarcinoma (CC). Our case was 53-year-old man admitted to emergency department with symptoms of anorexia, weight loss, nausea, vomiting, and general fatigue in February 2012. His laboratory findings showed hypercalcemia and thrombocytopenia. CT showed a large multinodular mass in the right lobe and, extending through left lobe of the liver. We considered the diagnosis of hypercalcemia of malignancy with elevated calcium levels and suppressed PTH level with the existence of skeletal bone metastasis and the absence of parathyroid gland pathology. Treatment of hypercalcemia with IV saline, furosemide, and calcitonin improved the patient symptoms. After the 8th day of admission, calcium level, thrombocytopenia, and other symptoms were normalized. Patient was sustained surgically inoperable and transferred to medical oncology department for the purpose of palliative chemotherapy and intended radiotherapy for bone metastasis. Hypercalcemia relapsed 4 weeks after discharge and patient died at the 5th month after admission due to disseminated metastasis. We should be aware of CC with symptomatic hypercalcemia and rarely low platelet count. The correction of hypercalcemia provides symptomatic relief and stability of patients.

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Simic, Dusica, Irina Milojevic, Ivana Budic e Veljko Strajina. "Myocarditis exacerbation in a child undergoing inguinal hernioplasty after viral infection". Srpski arhiv za celokupno lekarstvo 137, n. 9-10 (2009): 537–39. http://dx.doi.org/10.2298/sarh0910537s.

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Introduction Immunosuppressive effects of general anesthesia and surgery could have unexpected consequences in a child with recent infection. The incidence of myocarditis in childhood is unknown. Case outline During general anesthesia for inguinal hernia repair, a seven-year-old boy suddenly developed heart failure. Clinical presentation included hypotension, pulmonary edema, drop in hemoglobin oxygen saturation, ST segment elevation and premature ventricular contractions. Homodynamic stability and adequate oxygenation were achieved with dopamine and furosemide. Preoperative history, physical examination and complete blood count were unremarkable. Moderate cardiomegaly and pulmonary edema were present on chest radiography. Diminished left ventricular contractility found on echocardiography increased troponin I and CK-MB levels suggested myocardial injury. Increased C-reactive protein with lymphocytosis suggested inflammation as its cause. Parents failed to report rubella 10 days before the operation. A clinical diagnosis of myocarditis as a complication of rubella was based on increased titer of IgM to rubella. With intravenous immunoglobulin, corticosteroids and symptomatic treatment for heart failure, his condition improved and ejection fraction reached 68 % one month after operation. Conclusion In future, we need protocols with instructions for pediatric patients undergoing elective surgery and anesthesia after viral infections.

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Wronski, T., E. Seeliger, P. B. Persson, C. Forner, C. Fichtner, J. Scheller e B. Flemming. "The step response: a method to characterize mechanisms of renal blood flow autoregulation". American Journal of Physiology-Renal Physiology 285, n. 4 (ottobre 2003): F758—F764. http://dx.doi.org/10.1152/ajprenal.00420.2002.

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Response of renal vasculature to changes in renal perfusion pressure (RPP) involves mechanisms with different frequency characteristics. Autoregulation of renal blood flow (RBF) is mediated by the rapid myogenic response, by the slower tubuloglomerular feedback (TGF) mechanism, and, possibly, by an even slower third mechanism. To evaluate the individual contribution of these mechanisms to RBF autoregulation, we analyzed the response of RBF to a step increase in RPP. In anesthetized rats, the suprarenal aorta was occluded for 30 s, and then the occlusion was released to induce a step increase in RPP. Three dampened oscillations were observed; their oscillation periods ranged from 9.5 to 13 s, from 34.2 to 38.6 s, and from 100.5 to 132.2 s, respectively. The two faster oscillations correspond with previously reported data on the myogenic mechanism and the TGF. In accordance, after furosemide, the amplitude of the intermediate oscillation was significantly reduced. Inhibition of nitric oxide synthesis by Nω-nitro-l-arginine methyl ester significantly increased the amplitude of the 10-s oscillation. It is concluded that the parameters of the dampened oscillations induced by the step increase in RPP reflect properties of autoregulatory mechanisms. The oscillation period characterizes the individual mechanism, the dampening is a measure for the stability of the regulation, and the square of the amplitudes characterizes the power of the respective mechanism. In addition to the myogenic response and the TGF, a third rather slow mechanism of RBF autoregulation exists.

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Uemura, Kazunori, Atsunori Kamiya, Ichiro Hidaka, Toru Kawada, Shuji Shimizu, Toshiaki Shishido, Makoto Yoshizawa, Masaru Sugimachi e Kenji Sunagawa. "Automated drug delivery system to control systemic arterial pressure, cardiac output, and left heart filling pressure in acute decompensated heart failure". Journal of Applied Physiology 100, n. 4 (aprile 2006): 1278–86. http://dx.doi.org/10.1152/japplphysiol.01206.2005.

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Pharmacological support with inotropes and vasodilators to control decompensated hemodynamics requires strict monitoring of patient condition and frequent adjustments of drug infusion rates, which is difficult and time-consuming, especially in hemodynamically unstable patients. To overcome this difficulty, we have developed a novel automated drug delivery system for simultaneous control of systemic arterial pressure (AP), cardiac output (CO), and left atrial pressure (Pla). Previous systems attempted to directly control AP and CO by estimating their responses to drug infusions. This approach is inapplicable because of the difficulties to estimate simultaneous AP, CO, and Pla responses to the infusion of multiple drugs. The circulatory equilibrium framework developed previously (Uemura K, Sugimachi M, Kawada T, Kamiya A, Jin Y, Kashihara K, and Sunagawa K. Am J Physiol Heart Circ Physiol 286: H2376–H2385, 2004) indicates that AP, CO, and Pla are determined by an equilibrium of the pumping ability of the left heart (SL), stressed blood volume (V), and systemic arterial resistance (R). Our system directly controls SL with dobutamine, V with dextran/furosemide, and R with nitroprusside, thereby controlling the three variables. We evaluated the efficacy of our system in 12 anesthetized dogs with acute decompensated heart failure. Once activated, the system restored SL, V, and R within 30 min, resulting in the restoration of normal AP, CO, and Pla. Steady-state deviations from target values were small for AP [4.4 mmHg (SD 2.6)], CO [5.4 ml·min−1·kg−1 (SD 2.4)] and Pla [0.8 mmHg (SD 0.6)]. In conclusion, by directly controlling the mechanical determinants of circulation, our system has enabled simultaneous control of AP, CO, and Pla with good accuracy and stability.

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Feijó, Maria KEF, Karen Brasil Ruschel, Daniela Bernardes, Eduarda B. Ferro, Luis E. Rohde, Andreia Biolo e Eneida Rejane Rabelo da Silva. "Effects of a diuretic adjustment algorithm protocol on heart failure admissions: A randomized clinical trial". Journal of Telemedicine and Telecare 27, n. 5 (9 maggio 2021): 288–97. http://dx.doi.org/10.1177/1357633x211009640.

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Introduction The aim of this study was to evaluate the effectiveness of a diuretic adjustment algorithm (DAA) in maintaining clinical stability and reducing HF readmissions using telemonitoring technologies. Methods Randomized clinical trial of patients with an indication for furosemide dose adjustment during routine outpatient visits. In the intervention group (IG), the diuretic dose was adjusted according to the DAA and the patients received telephone calls for 30 days. In the control group (CG), the diuretic dose was adjusted by a physician at baseline only. Co-primary outcomes were hospital readmission and/or emergency department visits due to decompensated HF within 90 days, and a 2-point change in the Clinical Congestion Score and/or a deterioration in New York Heart Association functional class within 30 days. Results A total of 206 patients were included. Most patients were male ( n=119; 58%), with a mean age of 62 (SD 13) years. Four patients (2%) in the IG and 14 (7%) in the CG were hospitalized for HF (odds ratio (OR) 0.31 (0.10–0.91); p=0.04). Multivariate analysis showed a reduction of 67% in readmissions and/or emergency department visits due to decompensated HF in the IG compared with the CG (95% CI 0.13–0.88; p=0.027). Regarding the combined outcome of HF readmission and/or emergency department visits or clinical instability, the IG had 20% fewer events than the CG within 30 days (IG: n=48 (23%), CG: n=70 (34%); OR 0.80 (0.63–0.93); p=0.03). Discussion Using DAA improved the combined outcome in these outpatients, with favorable and significant results that included a reduction in HF admissions and in clinical instability. (NCT02068937)

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HARDIKAR, SHARWAREE R., e SHAKIL S. MULLA. "OPTIMIZATION OF FORMULATION OF SOLID DISPERSION OF FUROSEMIDE BY FACTORIAL DESIGN". International Journal of Pharmacy and Pharmaceutical Sciences, 2 marzo 2020, 43–48. http://dx.doi.org/10.22159/ijpps.2020v12i4.36428.

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Objective: The present study aimed to improve the rate of dissolution of furosemide by solid dispersion technique. Methods: Solid dispersion of furosemide was prepared by using hydrogel isolated from the seeds of Lepidium sativum as a novel carrier by the solvent evaporation method. Solid dispersion was evaluated to study the improvement in the rate of dissolution. Molecular dispersion of furosemide in the novel carrier was studied by DSC and FTIR studies. Solid dispersion was filled in capsules after stability studies and the formulation was optimized by adopting factorial design. Results: Solid dispersion of furosemide exhibited dissolution improvement from 13.54 % (plain furosemide) to 69.12% (solid dispersion) in the first 60 min. Improvement in dissolution efficiency was found to be retained after stability studies. Capsules were filled with the formulation of solid dispersion using two different grades of lactose-α lactose monohydrate and anhydrous lactose and were found stable after stabilization studies. Conclusion: The dissolution improvement of furosemide was attributed to its molecular dispersion in the novel carrier selected for this study. The recrystallization of furosemide was prevented due to intermolecular interaction between the novel carrier and furosemide. This was confirmed by FTIR. Evaluation of the dissolution data of factorial batches was analyzed by ANOVA. Analysis of the data revealed that selected levels of α lactose monohydrate and anhydrous lactose would be useful to navigate design space.

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