Selective blockage of the Na+ transport path by Bay g 2821

Effects of the thiazide diuretic bendroflumethiazide on salivary flow rate and composition

Thiazide diuretics are among the first-line alternatives in the treatment of primary hypertension. The effects of thiazide treatment on salivary production are, however, little studied and the results so far available are not decisive. The aim of the present study was to evaluate and compare salivary flow rate and composition during treatment with the thiazide diuretic bendroflumethiazide in a low dose (2.5 mg o.d.) and placebo. The study was performed with a randomized, double-blind, cross-over design (2 x 2 wk) in 34 healthy volunteers. The treatment periods were separated by a wash-out period of 2 wk. Resting and stimulated whole saliva was sampled three times daily on scheduled days during the treatment periods. Flow rate was assessed for resting saliva, whereas flow rate, pH, buffer capacity, amount of total proteins and concentrations of sodium, potassium, calcium, phosphate and magnesium were measured for stimulated whole saliva. No effect of bendroflumethiazide on the resting salivary flow rate could be detected, while the stimulated flow rate was significantly reduced by about 10% during the thiazide treatment. The total sodium output was significantly decreased by approximately 30%, without any detectable change in total potassium output. All other variables of stimulated whole saliva studied were not different from placebo. It is concluded that treatment with bendroflumethiazide in a low dose significantly reduces the stimulated whole salivary flow rate and total sodium output in healthy volunteers.

Effects of a new loop diuretic (muzolimine) in cirrhosis with ascites: comparison with furosemide

Muzolimine is a loop diuretic with both the dose-dependent increasing effectiveness of loop diuretics and the long-lasting effect of thiazides. This is a potential advantage in the treatment of ascites in advanced cirrhosis since these patients have a low tolerance to sudden reductions of blood volume. Equivalent single, oral doses of furosemide (40 mg) and muzolimine (30 mg) were given to 10 cirrhotic patients with ascites and reduced renal perfusion (glomerular filtration rate = 30 to 75 ml per min). The study was preceded by 4 days of equilibration (dietary sodium 40 mmoles per day), and the drugs were alternated via a single-blind, cross-over protocol after a wash-out period of 3 days. Renal function was monitored under basal conditions and after diuretic administration through 4-hr clearance periods for 24 hr. The renin-aldosterone axis was evaluated before diuretic administration and after 8 and 24 hr. Muzolimine led to a 12-hr cumulative diuresis [AUC0-12 = 2.52 +/- 0.42 (S.E.) ml per min] and natriuresis (5.14 +/- 1.05 mmoles per hr), which were comparable to those of furosemide (2.85 +/- 0.29 ml per min and 6.75 +/- 1.63 mmoles per hr). Its effect, however, was distributed over a longer period (8 hr) than furosemide (4 hr). Muzolimine activity mainly differed from furosemide because of: significantly lower 12-hr potassium excretion (AUC0-12 = 0.28 +/- 0.82 vs. 2.69 +/- 0.46 mmoles per hr; p less than 0.005); greater sodium/chloride excretion ratio (0.45 +/- 0.08 vs. 0.26 +/- 0.06; p less than 0.025), and absence of rebound phenomena.(ABSTRACT TRUNCATED AT 250 WORDS)