Kinetic disposition and diuretic effect of frusemide in acute pulmonary oedema

The kinetic disposition and diuretic effect of frusemide was assessed in 16 patients with acute pulmonary oedema utilizing a specific gas-liquid chromatographic assay for the drug. Serum frusemide concentrations decayed biexponentially with wide variation in both alpha half-life (range 15-79 min) and beta half-life (range 127-1190 min). The beta phase half-life was inversely related to creatine clearance. The apparent volume of distribution varied greatly among the patients (range 0.085-0.818 l/kg), and patients with an acute myocardial infarction had a larger peripheral kinetic compartment. Patients with acute myocardial infarction excreted less unchanged drug and had a lesser urinary excretion of sodium and volume compared to patients without infarction. The urinary excretion of sodium, chloride, calcium and volume was linearly related to the urinary excretion of unchanged frusemide.