ORAL ADMINISTRATION OF A POTENT CARBONIC ANHYDRASE INHIBITOR ("DIAMOX"). III. ITS USE AS A DIURETIC IN PATIENTS WITH SEVERE CONGESTIVE HEART FAILURE DUE TO COR PULMONALE
Authors: W B SCHWARTZ, A S RELMAN, A LEAF
Journal: Annals of Internal Medicine (1955)

Article1 January 1955ORAL ADMINISTRATION OF A POTENT CARBONIC ANHYDRASE INHIBITOR ("DIAMOX"). III. ITS USE AS A DIURETIC IN PATIENTS WITH SEVERE CONGESTIVE HEART FAILURE DUE TO COR PULMONALEWILLIAM B. SCHWARTZ, M.D., ARNOLD S. RELMAN, M.D., ALEXANDER LEAF, M.D.WILLIAM B. SCHWARTZ, M.D., ARNOLD S. RELMAN, M.D., ALEXANDER LEAF, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-42-1-79 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONThe enzyme carbonic anhydrase, normally present in high concentration in renal tubular cells, is thought to be responsible for the reabsorption of bicarbonate. When this enzyme is temporarily inhibited by administration of unsubstituted sulfonamide compounds, bicarbonate excretion is increased, together with the excretion of sodium and other cations.1 With this loss of bicarbonate the urine becomes alkaline, plasma bicarbonate falls and a metabolic acidosis develops.2The use of a carbonic anhydrase inhibitor as a diuretic was first suggested by Schwartz,3who showed that sulfanilamide produced small diureses in some subjects with congestive heart failure. Recently a new and less...Bibliography1. PittsAlexander RFRS: The nature of the renal tubular mechanism for acidifying the urine, Am. J. Physiol. 144: 239, 1945. CrossrefGoogle Scholar2. BeckmanRossmeislPettingillBauer WWECRBW: A study of the effects of sulfanilamide on acid-base metabolism, J. Clin. Investigation 19: 635, 1940. CrossrefMedlineGoogle Scholar3. Schwartz WB: The effect of sulfanilamide on salt and water excretion in congestive heart failure, New England J. Med. 240: 173, 1949. CrossrefMedlineGoogle Scholar4. FriedbergTaymorMinorHalpern CKRJBM: The use of Diamox, a carbonic anhydrase inhibitor, as an oral diuretic in patients with congestive heart failure, New England J. Med. 248: 883, 1953. CrossrefMedlineGoogle Scholar5. Belsky H: Use of a new oral diuretic, Diamox, in congestive heart failure, New England J. Med. 249: 140, 1953. CrossrefMedlineGoogle Scholar6. LeafSchwartzRelman AWBAS: Oral administration of a potent carbonic anhydrase inhibitor ("Diamox"): I. Changes in electrolyte and acid-base balance, New England J. Med. 250: 759, 1954. CrossrefMedlineGoogle Scholar7. RelmanLeafSchwartz ASAWB: Oral administration of a potent carbonic anhydrase inhibitor (("Diamox"): II. Its use as a diuretic in congestive heart failure, New England J. Med. 250: 800, 1954. CrossrefMedlineGoogle Scholar8. Nadell J: The effects of the carbonic anhydrase inhibitor "6063" on electrolytes and acid-base balance in two normal subjects and two patients with respiratory acidosis, J. Clin. Investigation 32: 622, 1953. CrossrefMedlineGoogle Scholar9. RelmanEtstenSchwartz ASBWB: The regulation of renal bicarbonate reabsorption by plasma carbon dioxide tension, J. Clin. Investigation 32: 972, 1953. CrossrefMedlineGoogle Scholar10. BrazeauGilman PA: Effect of plasma CO2 tension on renal tubular reabsorption of bicarbonate, Am. J. Physiol. 175: 33, 1953. CrossrefMedlineGoogle Scholar11. DormanSullivanPitts PJWJRF: The renal response to acute respiratory acidosis, J. Clin. Investigation 33: 82, 1954. CrossrefMedlineGoogle Scholar12. SchwartzRelman WBAS: Unpublished observations. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts*Received for publication April 19, 1954.From the Medical Services of the New England Center Hospital, the Evans Memorial Hospital, Massachusetts Memorial Hospitals and the Massachusetts General Hospital; the Departments of Medicine of Tufts College Medical School, Boston University School of Medicine and Harvard Medical School.Supported in part by grants from The National Heart Institute of the National Institutes of Health, United States Public Health Service, the American Heart Association and the Greater Boston Chapter of the Massachusetts Heart Association, and Lederle Laboratories Division of the American Cyanamid Company.†Supplied through the courtesy of Dr. J. D. Gallagher, Lederle Laboratories Division, American Cyanamid Company, Pearl River, New York; and Dr. R. O. Roblin and Dr. T. H. Maren, Chemotherapy Division, Stamford Research Laboratories, American Cyanamid Company, Stamford, Connecticut. 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