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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Opiates and loop diuretics are the mainstay of treatment of acute pulmonary oedema, but it is now recognized that immediate response to intravenous loop diuretics is acute vasoconstriction with impaired cardiac performance. It therefore seemed appropriate to compare the effects of intravenous isosorbide 5-mononitrate and frusemide on systemic and coronary haemodynamics in a group of patients with chronic cardiac failure at cardiac catheterization. Intra-arterial blood pressure was recorded from the ascending aorta, pulmonary capillary wedge pressure and cardiac output were measured using a Swan-Ganz thermodilution catheter. Coronary venous blood flow was measured using a thermodilution technique and A-V oxygen difference across the myocardium was obtained from simultaneous blood sampling in the aorta and coronary sinus. Absolute myocardial nutrient blood flow was measured using a 133Xe clearance technique. Frusemide in a dosage of 0.5 mg/kg given intravenously provoked acute vasoconstriction with falls in cardiac output and stroke volume. Pulmonary capillary wedge pressure was unchanged in the first 60 min after administration of frusemide. Isosorbide 5-mononitrate in a dosage of 15 mg intravenously, significantly reduced the pulmonary capillary wedge pressure within 5 min, and with the subsequent fall in systolic arterial blood pressure, cardiac output was maintained. These results suggest that intravenous isosorbide 5-mononitrate could well be of value in the immediate management of the patient with acute pulmonary oedema.
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PMID:A comparison of intravenous elantan and frusemide in patients with chronic cardiac failure. 360 6

Adverse drug reactions (ADRs) may be more frequent in patients who present some diseases. By means of an intensive prospective drug surveillance work, 492 patients with heart diseases, hospitalized at the Department of Medicine of the Clinical Hospital of the University of Chile, were studied in order to determine the frequency and characteristics of ADRs. ADRs were significantly more frequent in patients with heart failure (HF) (30.0%) than in those without HF (22.7%)(p less than 0.05). Patients presenting HF developed more metabolic disturbances than patients not presenting HF (p less than 0.001). Furosemide was the most frequently used drug in both groups, but treatment with it was longer in patients with HF who presented a significantly higher frequency of adverse reactions to this diuretic (p less than 0.05). 89.9% of ADRs in patients without HF and 93.8% of ADRs in those with HF, were dose-related effects. Analyses of some predisposing factors to ADRs, such as age, number of drugs administered, duration of hospitalization, ADR or allergy histories and presence of a renal failure, did not explain differences found between ADRs in patients without and with HF. These findings suggest that heart failure may be a determinant of frequency and characteristics of ADRs.
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PMID:Adverse drug reactions (ADRs) in patients with heart diseases. Comparison between patients without and with heart failure. 650 Jul 56

Nineteen ambulant patients in cardiac insufficiency stages III to IV, eleven of them concomitantly presenting hypertension, were treated with Osyrol 50-Lasix for a period of three months. With a maintenance dose consisting on average of one capsule Osyrol 50-Lasix daily, effective and reliable elimination of edema and adequate recompensation of the heart was achieved by way of reduction of the body weight, decrease in ankle circumference, congestion of the liver and improvement of dyspnoea. In the eleven patients with hypertension grade I, the systolic and diastolic blood pressure was normalized under Osyrol 50-Lasix medication, whilst the blood pressure values of normotensive patients were practically unchanged. The serum potassium values at the beginning of the study were 4.29 mmol/l on average and increased moderately to 4.83 mmol/l after three months' therapy. Compared to pre-trial controls the serum values of creatinine and uric acid showed no changes attributable to the drug after three months' therapy with Osryol 50-Lasix. No significant change of the fasting blood glucose values was ascertained either in the nondiabetic or in the diabetic patients. Based on the clinical and laboratory-chemical parameters the success of therapy was considered to be good in 18 patients and satisfactory in one case. Tolerability was also considered to be good in 18 cases. Transient side effects were observed in two patients. Hypotension was diagnosed in one case after four weeks' treatment and in a further patient an increased serum potassium level was found. After reducing the dose the values reverted to normal in both cases.
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PMID:[Long term experiences with a solid spironolactone-furosemide combination in heart insufficiency and hypertension]. 680 28

Furosemide has been extensively used in the treatment of heart failure and its effect on cardiovascular dynamics are well established. Clinical relief of the symptoms of pulmonary congestion frequently precedes any demonstrable diuretic effect, suggesting that extra renal factors may also be involved. More recent studies on the extra-renal action of furosemide showed an increase of venous capacitance as an early hemodynamic effect of the drug. In spite of furosemides wide use in the treatment of heart failure and hypertension, there is no information on the electrophysiologic properties of the drug in man. The present study involving 8 human subjects was undertaken to determine what effect intravenously administered furosemide has on the human conduction system.
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PMID:Electrophysiologic properties of furosemide in man. 682 91

Fursosemide kinetics were studied in 25 patients with congestive heart failure. The elimination half-life (t1/2) was longer and the elimination rate constant and the plasma clearance smaller in patients with advanced (n = 15) than in those with moderate (n = 10) failure. Furosemide kinetics with and without hydralazine were compared in eight patients with advanced heart failure. Furosemide t1/2 patients receiving both drugs fell from 96 +/- 16 to 81 +/- 15 min (P less than 0.02), elimination rate constant increased from 0.0186 +/- 0.0056 to 0.0214 +/- 0.0068 min -1 (P less than 0.05), and plasma clearance rose from 72.6 +/- 18.5 to 88.1 +/- 26.9 ml/min (P less than 0.01). Renal clearance rose from 45.4 +/- 12.0 to 60.9 +/- 19.0 ml/min (P less than 0.01) and creatinine clearance was unchanged. We conclude that hydralazine affects furosemide kinetics.
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PMID:Hydralazine and furosemide kinetics. 710 21

The object of this study was to examine whether prolonged-release hard gelatin capsule formulations could be developed for dogs. Different viscosity grades of hydroxypropyl methylcellulose (HPMC) and sodium carboxymethylcellulose (NaCMC) were used to control drug release. Furosemide was chosen because of its wide use in the management of heart failure in dogs. In vitro, selecting different viscosity grades allowed good control of drug release, whereas in vivo the difference between formulations was clearly smaller. Although all formulations gave prolonged release, both inter- and intra-individual variation in the plasma concentration-time curves was high. It is difficult to develop prolonged-release formulations for drugs such as furosemide with highly variable pharmacokinetic properties. However, hard gelatin capsules containing hydrophilic polymers could still be a suitable choice for some drugs.
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PMID:Prolonged-release hard gelatin capsules of furosemide for the treatment of dogs. 775 1

A 84-year-old man was treated with antibiotics including erythromycin and a diuretic (furosemide) because of acute heart failure and pneumonia. During the treatment, he developed moderate anemia (Hb 8.7g/dl). His anemia improved after the treatment. He again developed marked anemia (Hb 6.3g/dl) during the second treatment with erythromycin and furosemide and received blood transfusions. Bone marrow aspiration study revealed severe erythroid hypoplasia (0.2%). He was referred to our hospital, but he was not treated because his hemoglobin levels and reticulocyte count increased (80%) and his bone marrow showed increased erythroblasts (41.5%). His anemia gradually improved without any treatment. We diagnosed the case as drug-induced pure red cell aplasia (PRCA). We cultured bone marrow cells obtained from the present case and four normal healthy volunteers by a plasma clot method to determine the effects of two drugs on the number of erythroid colony forming unit (CFU-E). Furosemide strongly inhibited the CFU-E colony formation in the patient, but the inhibition effect of erythromycin was moderate. Furthermore, CFU-E was markedly suppressed by a combination of erythromycin and furosemide in both patient and control materials. These results indicate that both furosemide and erythromycin were related to the occurrence of PRCA in this patient.
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PMID:[Pure red cell aplasia induced by erythromycin and furosemide effects on in vitro erythroid colony forming unit (CFU-E)]. 806 24

Furosemide is frequently administered intravenously to patients with chronic heart failure. However, use of diuretics may cause neuroendocrine activation and by itself may not consistently afford diuresis. Atrial natriuretic factor (ANF) in pharmacologic doses is a vasodilator and has favorable neuroendocrinologic effects in patients with congestive heart failure. To examine whether exogenous ANF might enhance the effects of acute furosemide injection, we studied 14 patients with chronic stable heart failure and measured the effects of the combination of ANF and furosemide on hemodynamics, neuroendocrine activation, and urine output. Eight patients were randomly assigned to receive placebo plus furosemide (1.3 mg/kg intravenously). Six patients received ANF (2 micrograms/kg intravenously) plus furosemide at the same dose in a double-blind manner. The group receiving placebo plus furosemide exhibited a slight increase in mean arterial pressure (92 to 96 mm Hg; p < 0.03), systemic vascular resistance (1989 to 2271 dynes.sec.cm-5; p = 0.0007), and pulmonary capillary wedge pressure (22 to 24 mm Hg; p < 0.04) from baseline to 10 minutes. The group receiving ANF plus furosemide exhibited no change in mean arterial pressure and systemic vascular resistance from baseline to 10 minutes. Pulmonary capillary wedge pressure and mean pulmonary pressure were unchanged. In the group receiving placebo plus furosemide.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Interaction of intravenous atrial natriuretic factor with furosemide in patients with heart failure. 829 8

The clinical syndrome of congestive heart failure remains a therapeutic dilemma and challenge for the physician in 1992. This is a disease process that appears to be increasing in frequency and continues to carry an unacceptably high mortality rate. For years it has been well recognized that the combination of digoxin, Lasix and vasodilator therapy improved symptoms in these patients and decreased hospitalization, but did not increase survival. It was not until 1986 that the combination of digoxin, Lasix, Isordil, and hydralazine was shown to increase survival. Further significant improvement in quality of life and survival has recently been established in three large clinical trials, and it is now safe to say that the standard of care for symptomatic congestive heart failure in 1992 is digoxin, furosemide, and an ACE inhibitor, with the survival trials favoring the ACE inhibitor enalapril. The IV inotropic drug dobutamine remains the mainstay of pharmacological therapy for the treatment of severely refractory heart failure. Unfortunately, the phosphodiesterase inhibitors--amrinone, milrinone, and enoximone--have demonstrated unacceptable clinical side effects and have been withdrawn from further clinical study. In spite of these promising developments, the mortality and morbidity of congestive heart failure remains unacceptably high, and continued investigation in the new fields of pharmacology and the pathophysiology of congestive heart failure still must be aggressively pursued.
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PMID:Inotropic therapy of the failing myocardium. 841 61

Patients with diabetes mellitus have a high morbidity and mortality from acute myocardial infarction, the reason for which is not fully understood. The relationship between congestive heart failure symptoms, left ventricular ejection fraction, and long-term mortality was examined in 578 hospital survivors of acute myocardial infarction, 47 of whom had Type 2 (non-insulin-dependent) diabetes mellitus. None of the patients were treated with insulin. The prevalence of congestive heart failure during hospitalization was similar in patients with and without diabetes, although mean diuretic dose was higher in the former patients. Left and right ventricular ejection fraction was measured with radionuclide ventriculography in the second week after acute myocardial infarction. At discharge from the coronary care unit, patients with and without diabetes had similar left ventricular ejection fraction (with diabetes: median 46% vs without diabetes: median 43%; p = 0.89). Median right ventricular ejection fraction (62%) was within normal limits in both groups and did not differ statistically. Survival data were obtained for all patients. The 5-year mortality was increased in patients with diabetes compared with non-diabetic patients independent of left ventricular ejection fraction. Univariate analysis showed that the cumulative 5-year mortality rate was 53% in the group with diabetes compared with 43% in the non-diabetic group (p = 0.007). Using multivariate regression analysis presence of diabetes was found to have a significant association with long-term mortality after myocardial infarction, that was independent of age, history of hypertension, congestive heart failure symptoms during hospitalization or of either left or right ventricular ejection fractions at discharge. We conclude that the excess mortality in patients with non-insulin-dependent diabetes mellitus is not explained by available risk markers after myocardial infarction. Even though left ventricular ejection fraction and serum creatinine did not differ significantly, the apparent higher dose of Frusemide in patients with than without non-insulin-dependent diabetes mellitus might indicate that heart failure, it present, is more severe in patients with than in those without diabetes. The importance of diastolic dysfunction in this context needs to be determined.
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PMID:Clinical characteristics, left and right ventricular ejection fraction, and long-term prognosis in patients with non-insulin-dependent diabetes surviving an acute myocardial infarction. 873 27


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