What question did this study set out to answer?

To assess the pharmacodynamic response and urinary excretion dynamics of furosemide in patients with congestive heart failure compared with normal controls.

August 1, 1980Clinical Pharmacology & Therapeutics

Furosemide in patients with heart failure: Shift in dose-response curves

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Why the study?

Does the natriuretic response and dose-response dynamics to 40 mg of furosemide differ in patients with congestive heart failure compared to normal controls?

Key Points

To assess the pharmacodynamic response and urinary excretion dynamics of furosemide in patients with congestive heart failure compared with normal controls.
Administered 40 mg of furosemide to 10 patients with congestive heart failure and evaluated their responses against normal control subjects.
Measured total 4-hour urinary sodium excretion, furosemide excretion rates, and constructed pharmacodynamic dose-response relationships.
Patients with heart failure excreted significantly less sodium than normal controls over 4 hours (142 ± 36 vs. 245 ± 16 mEq/4 hr, p < 0.05).
Total 4-hour urinary furosemide delivery did not differ significantly between heart failure patients and controls (14.9 ± 2.0 vs. 18.7 ± 2.1 mg/4 hr, p < 0.20), but the delivery time course was altered.
Normal controls displayed a characteristic sigmoid-shaped dose-response curve, whereas 9 of 10 heart failure patients demonstrated shifted curves that differed substantially from normal sigmoid dynamics.

Structured PICO

Does the natriuretic response and dose-response dynamics to 40 mg of furosemide differ in patients with congestive heart failure compared to normal controls?

Population

10 patients with congestive heart failure and an unspecified number of normal controls

Intervention

Furosemide 40 mg

Comparator

Normal controls receiving the same dose

Outcome

Sodium excretion and urinary furosemide delivery over 4 hourssurrogate

Heart failure patients exhibit a blunted natriuretic response and altered dose-response dynamics to furosemide compared to normal subjects, despite similar urinary drug delivery.

Discussion

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Implication

Blunted natriuresis despite equivalent furosemide delivery in HF; hypothesis-generating for tubular resistance and requires prospective validation.

Cite This Study

Brater et al. (1980) studied this question.

synapsesocial.com/papers/6a73e17ecd7b40c8110dd77d https://doi.org/10.1038/clpt.1980.148

Topics

HFrEF treatment Heart failure

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Implication

Blunted natriuresis despite equivalent furosemide delivery in HF; hypothesis-generating for tubular resistance and requires prospective validation.

Furosemide in patients with heart failure: Shift in dose-response curves

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Furosemide in patients with heart failure: Shift in dose-response curves

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider