Naranjo C A, Busto U, Cassis L
Am J Hosp Pharm. 1978 Jul;35(7):794-8.
The frequency and types of adverse reactions (ARs) occurring in hospitalized patients receiving furosemide were surveyed prospectively in a four-year study at the José Joaquin Aquirre Hospital in Santiago, Chile. A team of clinical pharmacists and clinical pharmacologists monitored 533 patients receiving furosemide and recorded patient characteristics, laboratory test results, drugs administered, and suspected ARs. Definite or probably furosemide-induced ARs were detected in 220 (39.8%) patients. No ARs were fatal but 7.6% of patients, all having cirrhosis of the liver, had severe ARs. Of the ARs recorded, 95.2% were dose-related. The most common ARs were electrolyte disturbances (23.5% of patients), extracellular volume depletion (9.0% of patients) and hepatic comma (3.6% of patients). Total and daily furosemide doses, lengthened hospitalization and hepatic disease were significantly associated with the frequency of ARs (p less than 0.001). The dosage of furosemide did not account for the increased frequency of ARs in patients with hepatic disease. The frequency of hypokalemia was not reduced significantly when furosemide was administered with potassium chloride or potassium-sparing diuretics (p less than 0.05). The frequency of severe furosemide-induced ARs is low, but ARs are more common in patients with cirrhosis of the liver. These patients should be closely monitored for furosemide-induced ARs.
在智利圣地亚哥的何塞·华金·阿基雷医院进行的一项为期四年的前瞻性研究中，对住院接受呋塞米治疗的患者发生不良反应（ARs）的频率和类型进行了调查。一组临床药剂师和临床药理学家对533名接受呋塞米治疗的患者进行了监测，并记录了患者特征、实验室检查结果、所使用的药物以及疑似ARs。在220名（39.8%）患者中检测到明确或可能由呋塞米引起的ARs。没有ARs是致命的，但7.6%的患者（均患有肝硬化）出现了严重ARs。在记录的ARs中，95.2%与剂量相关。最常见的ARs是电解质紊乱（占患者的23.5%）、细胞外液容量减少（占患者的9.0%）和肝昏迷（占患者的3.6%）。呋塞米的总剂量和每日剂量、住院时间延长以及肝脏疾病与ARs的发生频率显著相关（p小于0.001）。呋塞米的剂量并不能解释肝病患者中ARs发生频率的增加。当呋塞米与氯化钾或保钾利尿剂合用时，低钾血症的发生频率并未显著降低（p小于0.05）。严重的呋塞米诱导的ARs发生频率较低，但在肝硬化患者中ARs更为常见。应对这些患者密切监测呋塞米诱导的ARs。
