Brown R D
J Clin Pharmacol. 1981 Nov-Dec;21(11):620-7. doi: 10.1002/j.1552-4604.1981.tb05674.x.
Comparisons were made of the effects of various doses of intravenous bumetanide and furosemide on the primary auditory afferent activity (N1) and cochlear microphonics (CM) of beagles. The dose-response relationships of the N1 depressions to bumetanide and furosemide are parallel; those of the CM depressions are also parallel but have a much shallower slope than those of the N1 depressions. With both drugs, N1 depression occurs at lower doses than does CM depression. The N1 depression produced by a particular dose of bumetanide or furosemide bore a linear relationship to the CM depression produced. This finding supports the postulate that the cochlear site and mechanism of ototoxic action of the loop diuretics are directed at an earlier step of the cochlear transduction process than N1. Using N1 depression as the gross electrophysiologic index of ototoxicity, the acute ototoxic potency of bumetanide in beagles is approximately 6.5 times that of furosemide, whereas its diuretic potency is 40 to 60 times that of furosemide. Therefore, when clinical dosages of the two drugs are considered, the relative acute ototoxic potency of bumetanide in the beagle is 0.11 to 0.16 that of furosemide. This range is identical to the relative ototoxic potency of 0.11 to 0.16 previously obtained in the cat. Serum concentrations of bumetanide and furosemide increased linearly with the doses of the two drugs, except for the highest dose given (100 mg/kg for both drugs). The serum concentrations at that dose of both drugs are less than the mathematically predicted values. Histologic (light-microscopic) examination of the cochleas did not reveal any significant pathology.
比较了不同剂量静脉注射布美他尼和呋塞米对比格犬初级听觉传入活动(N1)和耳蜗微音器电位(CM)的影响。N1抑制对布美他尼和呋塞米的剂量 - 反应关系是平行的;CM抑制的剂量 - 反应关系也是平行的,但斜率比N1抑制的斜率浅得多。使用这两种药物时,N1抑制比CM抑制发生在更低的剂量。特定剂量的布美他尼或呋塞米产生的N1抑制与所产生的CM抑制呈线性关系。这一发现支持了这样的假设,即袢利尿剂的耳毒性作用的耳蜗部位和机制比N1针对耳蜗转导过程的更早步骤。以N1抑制作为耳毒性的总体电生理指标,布美他尼在比格犬中的急性耳毒性效力约为呋塞米的6.5倍,而其利尿效力为呋塞米的40至60倍。因此,当考虑两种药物的临床剂量时,布美他尼在比格犬中的相对急性耳毒性效力是呋塞米的0.11至0.16。这个范围与之前在猫中获得的0.11至0.16的相对耳毒性效力相同。布美他尼和呋塞米的血清浓度随两种药物的剂量呈线性增加,但最高剂量(两种药物均为100mg/kg)除外。两种药物在该剂量下的血清浓度低于数学预测值。耳蜗的组织学(光学显微镜)检查未发现任何明显病变。