BACKGROUND: Diuretic agents are widely used in the treatment of variable diseases. Although some diuretics may cause photosensitive reactions, this has been a relatively neglwted area of investigation. OBJECTIVE: The study was undertaken to examine whether or not the diuretic agents could cause phototoxicity with the photohemolysis test and with the Candida albica as test. METHOD: Photohemolysis test: Fresh human red blood cells (RHC) were washed and diluted to 200 fold of original volume with TCM buffer. Test compound suspension, were added to the diluted blood at the final concentration of 10 M. Each sample was irradiated with 50 J/cm of UVA, and control samples were incubated in water bath with light shielding. After additional incubation in a dark water bath for 30 minutes the sarnples were centrifuged. After adding Drabkins reagent, measurement of absorbance of the supernatents by speetrophotometer at 420, 540, 550nm were performed. The degree of photohemolysis was determined by comparing the results wiith the control solution. Candide elbicens test wenty microliter of each solution of arious diuretics were applied to Sabourauds dextrose agar plate in which Candida albicanp had been diffusely applied previously. Four hours after the application, 80 J/cm of UVA was irradiated. The irraicated plates and nonirradiated controls were incubated in a darlI room for 48 hours, and were examined clearzones arround the drugs as the mean of positive results fcir the phototoxic potential of the drugs. RESULTS: The photohemolyeii; vaIues of azosemide, spironolaetonet, iamterene, and xipamide at 420, 540, and 550nm were 70.57%/28.36%/31.61%/83.65%/16.40%/15.21%/75.66%/25.40%/28.17%, and 14.02%/9.11%/8.99% respectively, which exceeds the mear,injful positive value of above 5 , With the Candida olbicans test all teat solution at concentration of 1% and 5% showed negstive results. CONCLUSION: A phototoxic reaction may be triggered by azosemide, spironolactone, triamterene, and xipamide, and the possible mechanism concerned may be directed to cellular membranes. However with the negative result of knowed photosensitizers like hydrochlorthiazid and furosemide, there may be other possibilities for the explenation of phototoxicity. Thus further stirdies may be necessary to investigate more details about the cliscrepancies in greates detail.
Agar ; Baths ; Candida albicans* ; Candida* ; Dermatitis, Phototoxic ; Dermis ; Diuretics ; Erythrocytes ; Furosemide ; Glucose ; Humans ; Membranes ; Photosensitizing Agents ; Spironolactone ; Triamterene ; Water ; Xipamide

BACKGROUND: Diuretic agents are widely used in the treatment of variable diseases. Although some diuretics may cause photosensitive reactions, this has been a relatively neglwted area of investigation. OBJECTIVE: The study was undertaken to examine whether or not the diuretic agents could cause phototoxicity with the photohemolysis test and with the Candida albica as test. METHOD: Photohemolysis test: Fresh human red blood cells (RHC) were washed and diluted to 200 fold of original volume with TCM buffer. Test compound suspension, were added to the diluted blood at the final concentration of 10 M. Each sample was irradiated with 50 J/cm of UVA, and control samples were incubated in water bath with light shielding. After additional incubation in a dark water bath for 30 minutes the sarnples were centrifuged. After adding Drabkins reagent, measurement of absorbance of the supernatents by speetrophotometer at 420, 540, 550nm were performed. The degree of photohemolysis was determined by comparing the results wiith the control solution. Candide elbicens test wenty microliter of each solution of arious diuretics were applied to Sabourauds dextrose agar plate in which Candida albicanp had been diffusely applied previously. Four hours after the application, 80 J/cm of UVA was irradiated. The irraicated plates and nonirradiated controls were incubated in a darlI room for 48 hours, and were examined clearzones arround the drugs as the mean of positive results fcir the phototoxic potential of the drugs. RESULTS: The photohemolyeii; vaIues of azosemide, spironolaetonet, iamterene, and xipamide at 420, 540, and 550nm were 70.57%/28.36%/31.61%/83.65%/16.40%/15.21%/75.66%/25.40%/28.17%, and 14.02%/9.11%/8.99% respectively, which exceeds the mear,injful positive value of above 5 , With the Candida olbicans test all teat solution at concentration of 1% and 5% showed negstive results. CONCLUSION: A phototoxic reaction may be triggered by azosemide, spironolactone, triamterene, and xipamide, and the possible mechanism concerned may be directed to cellular membranes. However with the negative result of knowed photosensitizers like hydrochlorthiazid and furosemide, there may be other possibilities for the explenation of phototoxicity. Thus further stirdies may be necessary to investigate more details about the cliscrepancies in greates detail.
Agar ; Baths ; Candida albicans* ; Candida* ; Dermatitis, Phototoxic ; Dermis ; Diuretics ; Erythrocytes ; Furosemide ; Glucose ; Humans ; Membranes ; Photosensitizing Agents ; Spironolactone ; Triamterene ; Water ; Xipamide

Liddle's syndrome was described in 1963 by Liddle, et al., as the disease featuring a hypertension and hypokalemia but with negligible secretion of aldosterone. This syndrome, which morphologically belongs to an abnormal intrinsic tubular disorder with normal renal function, is characterized by hypokalemia, metabolic alkalosis, and hypertension due to the abnormal increase in excretion of potassium in distal tubules or collecting duct and the increase in reabsorption of sodium in distal tubules. This syndrome, which is rare disease, is observed with the low level of plasma and urinary aldosterone and suppressed plasma renin level and is known as dominant mode of inheritance with a family background. The authors paid attention to a 79-year-old man who showed a high blood pressure of 210/130mmHg as well as musle weakness, especially lower extremities due to metabolic alkalosis featuring a hypokalemia level of 2.0mEq/L when he was admitted to our hospital, Because his serum potassium were not improved with the medication of intravenous potassium supply, and his blood pressure continued to be high without the improvement of muscle weakness, we prescribed 300mg of spironolactone for two weeks. His symptom, however, was not cured. Then, instead of spironolactone, we prescribed 150mg of triamterene and a low salt diet which finally improved his symptoms. Because there has been no reported case in the Korean medical literature, we report a case of successfully treated Liddle's syndrome due to triamterene administration.
Aged ; Aldosterone ; Alkalosis ; Blood Pressure ; Diet ; Humans ; Hypertension ; Hypokalemia ; Lower Extremity ; Muscle Weakness* ; Plasma ; Potassium ; Rare Diseases ; Renin ; Sodium ; Spironolactone ; Triamterene ; Wills

AIMTo establish a method for the determination of the five components (reserpine, chlordiazepoxide, hydrochlorothiazide, dihydralazine sulfate, triamterene) in compound hypotensive tablet.

METHODSThe chromatography was performed using a CN column with acetontrile-0.1 mol L(-1) sodium heptasulfonate solution (7:3) and (5:5) as the mobile phases. The detection wavelength was 267 nm for reserpine, chlordiazepoxide and hydrochlorothiazide, 310 nm for dihydralazine sulfate, 360 nm for triamterene.

RESULTSThe linear range of each component was tested, and the recovery and stability of each component was satisfactory, three lots of samples were determined using the method.

CONCLUSIONThis is an accurate and credible quality control method for compound hypotensive tablet.

Antihypertensive Agents ; administration & dosage ; chemistry ; Chlordiazepoxide ; analysis ; Chromatography, High Pressure Liquid ; methods ; Dihydralazine ; analysis ; Drug Combinations ; Hydrochlorothiazide ; analysis ; Quality Control ; Reserpine ; analysis ; Tablets ; Triamterene ; analysis