The effects of frusemide and triamterene on the hypokalaemic and electrocardiographic responses to inhaled terbutaline.
Fifteen normal volunteers were given 5000 micrograms inhaled terbutaline following three separate 4 day oral treatment periods with placebo, frusemide 40 mg, and frusemide 40 mg plus triamterene 50 mg. Serum potassium (K), and electrocardiographic (ECG) responses were measured after 30 min rest and 30 min after inhalation of terbutaline. Frusemide produced significant hypokalaemia compared with placebo (means and 95% CI): 3.58 mmol l-1 (3.5-3.66) vs 3.88 mmol l-1 (3.8-3.96) (P less than 0.001), and this effect was significantly attenuated by the addition of triamterene: 3.80 mmol l-1 (3.72-3.88) (P less than 0.05). Terbutaline alone also caused significant hypokalaemia: from 3.88 mmol l-1 (3.8-3.96) to 3.35 mmol l-1 (3.24-3.46) (P less than 0.001), and a lower absolute level of K was seen when combined with frusemide: 3.13 mmol l-1 (3.02-3.24) (P less than 0.05). The addition of triamterene conferred no significant protection against the combined hypokalaemia: 3.29 mmol l-1 (3.18-3.4). Changes in T wave amplitude during the study periods showed a similar pattern of response to the hypokalaemic effects. These results show that the hypokalaemic response to terbutaline was additive to that of frusemide, and that triamterene attenuated the hypokalaemic response to frusemide, but not terbutaline.
Newnham
D M
DM
Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, Scotland.
McDevitt
D G
DG
Lipworth
B J
BJ
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D004357:Drug Synergism; D004562:Electrocardiography; D005665:Furosemide / Q000494:pharmacology*; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced*; D016037:Single-Blind Method; D013726:Terbutaline / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D014223:Triamterene / Q000494:pharmacology*
D005665:Furosemide; D013726:Terbutaline; D014223:Triamterene