This study characterizes the pharmacokinetics of bumetanide after an intravenous dose of 0.05 or 0.10 mg/kg to 14 neonates (weight range 820-4,000 g; gestational age 26-40 weeks) during the first week of life. Blood samples and urine were collected for up to 12 h after dosing. Estimated serum clearance was 0.2-1.0 ml/min.kg (range), volume of distribution was 0.22 l/kg (range 0.11-0.32 l/kg), and the harmonic mean half-life was 6-7 h (range of 4-19 h). Nonrenal clearance accounted for 58-97% of the serum clearance with the presence of certain oxidative metabolites of bumetanide in the urine. These findings suggest higher dosing requirements and prolonged intervals as compared to adults. Utilizing these pharmacokinetic data, pharmacodynamic and ototoxicity studies should be conducted to establish a safe and effective neonatal dose.
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http://dx.doi.org/10.1159/000244492 | DOI Listing |
Am J Physiol Renal Physiol
December 2024
Hypertension and Vascular Research Division, Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, United States.
In the kidney, the thick ascending limb (TAL) of the loop of Henle plays a vital role in NaCl homeostasis and blood pressure regulation. In human and animal models of salt-sensitive hypertension, NaCl reabsorption via the apical Na/K/2Cl cotransporter (NKCC2) is abnormally increased in the TAL. We showed that NaCl reabsorption is controlled by the presence of NKCC2 at the apical surface of TALs.
View Article and Find Full Text PDFJ Assoc Physicians India
September 2024
Country Head; Medical Affairs, Cipla Ltd., Mumbai, Maharashtra, India.
Loop diuretics are regarded as essential for the treatment of edematous conditions in heart failure, cirrhosis, and renal disease. The principal mechanism of action involves inhibiting the reabsorption of ions (Na+, 2Cl-, and K+) from the ascending loop of Henle. The pharmacokinetic (PK) and pharmacodynamic (PD) features of the commonly used diuretics (torsemide, furosemide, and bumetanide) influence the selection of diuretics in various disease states and dosing regimens.
View Article and Find Full Text PDFBiopharm Drug Dispos
June 2024
Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover, Hannover, Germany.
Bumetanide is used widely as a tool and off-label treatment to inhibit the Na-K-2Cl cotransporter NKCC1 in the brain and thereby to normalize intra-neuronal chloride levels in several brain disorders. However, following systemic administration, bumetanide only poorly penetrates into the brain parenchyma and does not reach levels sufficient to inhibit NKCC1. The low brain penetration is a consequence of both the high ionization rate and plasma protein binding, which restrict brain entry by passive diffusion, and of brain efflux transport.
View Article and Find Full Text PDFBiomed Chromatogr
April 2024
Department of Medicinal Chemistry, MNR College of Pharmacy, Sangareddy, India.
Determining a drug's bioavailability and bioequivalence is important for developing and approving a drug product. The procedure supports applications for generic drug products and novel therapeutic substances, makes important decisions regarding safety and efficacy, and measures a drug's concentration in biological matrices. This study aimed to develop and validate a specific, simple, sensitive, and accurate method using liquid chromatography-tandem mass spectrometry (LC-MS) for measuring bumetanide (BUM) in human plasma.
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