Effects of imidazole-salicylate on renal function and the diuretic action of furosemide in cirrhotic patients with ascites.
Imidazole-salicylate is a non-steroidal anti-inflammatory drug with limited inhibitory effects on prostaglandin synthesis. The renal effects of this drug were investigated by a double-blind cross-over study in 10 patients with cirrhosis and ascites. Two therapeutic doses of imidazole-salicylate (750 mg each) were given at midnight and 08:00 h and 80 mg of furosemide were injected intravenously at 09:00 h. The same procedure was followed on another day but a placebo replaced imidazole-salicylate. Renal function (creatinine clearance, free water and electrolyte excretions) and urinary excretion of prostaglandin E, 6-keto-prostaglandin F1 alpha and thromboxane B2 were evaluated for 8 h after the first dose of the drug and for 2 h after furosemide injection. Platelet thromboxane production was also determined 9 h after the first administration of drug or placebo. Imidazole-salicylate did not affect renal function or inhibit kidney prostanoid production either under basal conditions or after the stimulating effect of furosemide. On the contrary, imidazole-salicylate significantly inhibited platelet thromboxane production (45.8 +/- 9 vs. 69.4 +/- 7.5 ng/ml, P < 0.05). These results suggest that imidazole-salicylate is an anti-inflammatory drug that can be given to patients with decompensated cirrhosis without risk of inhibiting kidney prostaglandin synthesis or the renal response to furosemide.
Salerno
F
F
Istituto di Medicina Interna, Università di Milano, Italy.
Lorenzano
E
E
Maggi
A
A
Badalamenti
S
S
Minuz
P
P
Degan
M
M
Chinea
B
B
Scotti
A
A
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D001201:Ascites / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D001792:Blood Platelets / Q000378:metabolism; D004232:Diuretics / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005665:Furosemide / Q000494:pharmacology* / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects / Q000502:physiology*; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011460:Prostaglandins F / Q000652:urine; D012459:Salicylates / Q000494:pharmacology* / Q000627:therapeutic use; D013929:Thromboxane B2 / Q000378:metabolism / Q000652:urine; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004232:Diuretics; D007093:Imidazoles; D011460:Prostaglandins F; D012459:Salicylates; C043292:imidazole-2-hydroxybenzoate; D013929:Thromboxane B2; D005665:Furosemide; C100006:prostaglandin F1