Jänicke U A, Krüdewagen B, Schulz A, Gundert-Remy U
Abteilung für Experimentelle und Klinische Pharmakologie, Institut für Arzneimittel, Bundesgesundheitsamt, Berlin, Germany.
Eur J Clin Pharmacol. 1987;33(5):487-91. doi: 10.1007/BF00544241.
In new of previous contradictory results, the possible interaction between the loop diuretic furosemide and theophylline was re-evaluated in 12 healthy volunteers with a steady-state plasma theophylline level. Two doses of furosemide 20 mg at a 4 h interval did not influence the steady-state plasma concentration of theophylline despite causing a moderate diuresis. Urinary recovery of theophylline and its metabolites amounted to 106 +/- 21% of the dose without furosemide and 96 +/- 19% of the dose with furosemide, demonstrating that there was no influence on the enteral absorption of theophylline of the furosemide treatment. After the first dose of furosemide the fractional renal clearance (CLR1) of theophylline (fractional = hourly sampling period) changed in parallel with the urinary flow rate, without a significant difference between treatment with and without furosemide. After the second dose of furosemide, CLR1 was increased in the first hour and then it declined to levels far lower than the control value. This unexpected result could explain the unchanged plasma concentration of theophylline during furosemide treatment.
鉴于之前相互矛盾的结果，在12名血浆茶碱水平处于稳态的健康志愿者中，对袢利尿剂呋塞米与茶碱之间可能的相互作用进行了重新评估。尽管引起了适度利尿，但间隔4小时给予的两剂20毫克呋塞米并未影响茶碱的稳态血浆浓度。在未使用呋塞米时，茶碱及其代谢产物的尿回收率为给药剂量的106±21%，使用呋塞米时为96±19%，这表明呋塞米治疗对茶碱的肠内吸收没有影响。给予第一剂呋塞米后，茶碱的肾清除分数（CLR1）（分数=每小时采样期）与尿流率平行变化，使用呋塞米与未使用呋塞米治疗之间无显著差异。给予第二剂呋塞米后，CLR1在第一小时升高，然后降至远低于对照值的水平。这一意外结果可以解释在呋塞米治疗期间茶碱血浆浓度未发生变化的原因。
