Dosage dependent hormonal counter regulation to combination therapy in patients with left ventricular dysfunction

Journal of Clinical Pharmacy and Therapeutics
A M GalløeK Larsen

Abstract

The present study attempts to assess the efficacy combination therapy for heart failure. Genuine dose-response studies on combination therapy are not available and published studies involved adding one drug on top of 'usual treatment'. Sixteen different dosage combinations of trandolapril and bumetanide was tested in a double blind, double placebo-controlled, randomized, multiple cross-over study in a 16 times six balanced incomplete Latin square design. Patients reported optimal quality of life on the sub maximal dose bumetanide. Bumetanide decreased left ventricular function and increased heart rate and plasma noradrenaline in a dose dependent manner. Doses of bumetanide of more than 0.5 mg, given twice daily significantly decreased the quality of life and increased diuresis. Weight loss was maximal on 0.5 mg bumetanide twice daily. Trandolapril significantly reduced systolic blood pressure with the maximal effect at 0.5 mg daily. Both drugs significantly increased renin concentration with a significant potentiating interaction. It was not possible to detect beneficial effects of combination therapies. The optimal dosage of Bumetanide appeared to be 0.5 mg twice daily based on its effect on quality of life and weight loss. Es...Continue Reading

References

Aug 1, 1977·Circulation·R P LewisH Boudoulas
Mar 15, 1976·Clinica Chimica Acta; International Journal of Clinical Chemistry·A M KappelgaardJ Giese
May 1, 1969·The Journal of Clinical Investigation·A HarleyJ C Greenfield
Apr 1, 1969·The American Journal of Cardiology·A M WeisslerC D Schoenfeld
Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais

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Citations

Apr 9, 2008·The Journal of Oral Implantology·Todd ThiererJames A Rivers
Apr 15, 2010·The International Journal of Clinical and Experimental Hypnosis·Assen Alladin
Jun 5, 2012·The American Journal of Clinical Hypnosis·Catherine G Fine
Jun 5, 2012·The American Journal of Clinical Hypnosis·Assen Alladin
Jun 5, 2012·The American Journal of Clinical Hypnosis·Assen Alladin
Mar 16, 2013·The American Journal of Clinical Hypnosis·Assen Alladin
May 23, 2015·The Cochrane Database of Systematic Reviews·Vijaya M MusiniCiprian D Jauca
Jun 29, 2018·The Cochrane Database of Systematic Reviews·Nicole MartinR Thomas Lumbers
May 23, 2021·The Cochrane Database of Systematic Reviews·Nicole MartinR Thomas Lumbers

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