A 53-year-old male patient with stage Ⅳ diabetic nephropathy received an IV infusion of torasemide 40 mg which was put into a small pot once daily for edema of both lower limbs. On the 3rd day of medication, the dose of torasemide was increased to 80 mg/d according to the doctor′s advice due to poor diuretic effect. Eight hours later, the patient developed bilateral visual occlusion and blurred vision. Ophthalmological examination showed normal visual acuity and intraocular pressure in both eyes. The loss of binocular visual field caused by torasemide was considered. Then the drug was discontinued. After 2 days of drug withdrawal, the patient′s visual field loss disappeared. Because of the patient′s disease condition, IV infusion of torasemide 40 mg which was put into a small pot once daily was given again for 6 days, and the patient did not develop symptoms of visual field loss. The change of visual field might be related to the high dose of torasemide.

A 53-year-old male patient with stage Ⅳ diabetic nephropathy received an IV infusion of torasemide 40 mg which was put into a small pot once daily for edema of both lower limbs. On the 3rd day of medication, the dose of torasemide was increased to 80 mg/d according to the doctor′s advice due to poor diuretic effect. Eight hours later, the patient developed bilateral visual occlusion and blurred vision. Ophthalmological examination showed normal visual acuity and intraocular pressure in both eyes. The loss of binocular visual field caused by torasemide was considered. Then the drug was discontinued. After 2 days of drug withdrawal, the patient′s visual field loss disappeared. Because of the patient′s disease condition, IV infusion of torasemide 40 mg which was put into a small pot once daily was given again for 6 days, and the patient did not develop symptoms of visual field loss. The change of visual field might be related to the high dose of torasemide.

OBJECTIVE:To establish a HPLC method for determination of concentration of dextromethorphan hydrobro?mide in human serum.METHODS:The assay was conducted on HiQsil C 18 column(4.6mm?150mm,5?m)with acetonitrile-water-acetic acid(35∶63∶2,V/V/V)as mobile phase.The fluorescence detector measured with the excitation wavelength of280nm and the emission wavelength of320nm,and carvedilol was taken as internal standard.RESULTS:The linear range of calibration curve of dextromethorphan hydrobromide was0.27～21.90ng/ml with a regressive equation of Y=0.1197X+0.0086,r=0.9986.The recovery was high.CONCLUSION:This method is accurate,rapid and simple,and can be used for de?termining the concentration of dextromethorphan hydrobromide in human serum.