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Pharmacokinetics and pharmacodynamics of the diuretic bumetanide in the elderly
Author(s) -
Oberbauer Rainer,
Krivanek Peter,
Turnheim Klaus
Publication year - 1995
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/0009-9236(95)90264-3
Subject(s) - bumetanide , diuretic , pharmacokinetics , pharmacodynamics , renal function , pharmacology , urine , bioavailability , endocrinology , volume of distribution , medicine , diuresis , chemistry , sodium , cotransporter , organic chemistry
In a cross‐sectional study of the pharmacokinetics and pharmacodynamics of peroral and intravenous bumetanide (0.5 mg, single dose), total and renal clearance of the diuretic was significantly lower in elderly persons than in young adults, resulting in higher bumetanide plasma levels in the aged. Nonrenal clearance, bioavailability, and the volume of distribution were not significantly changed. Together with the decreased delivery into the urine the diuretic and natriuretic effect of bumetanide was reduced in the elderly. Renal clearance of bumetanide was linearly related with creatinine clearance, hence the decreases in bumetanide clearance and diuretic efficacy in the elderly are attributed to the age‐dependent decline in renal function. The bumetanide concentration in urine and the fractional sodium excretion were not different in the two age groups, suggesting that the decrease in diuretic response in the elderly is a result of a reduction in the number of functioning nephrons, whereas the response of the remaining nephrons to bumetanide is unaltered. Clinical Pharmacology & Therapeutics (1995) 57 , 42–51; doi: