THE OPTIMAL DOSE OF MERCURIAL DIURETICS

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Abstract
The effects of varying doses and different modes of adm. of mercurial diuretics were studied in 37 ambulatory patients with congestive heart failure. These patients all required diuretics to maintain a reasonable state of comfort. The effects of the diuretics were detd. by wt. loss. With periodic doses it was possible to maintain an equilibrium between the diuresis produced by the mercurial and the edema which accumulated in the period between injs. Alternate injs. of varying doses were made in the same patients and compared; each subject therefore acted as his own control. A sufficient number of injs. were made to give statistically valid data. These results indicate that the relative effectiveness of small doses of mercurial diuretics is greater than that of large doses. For example, the total diuresis produced by a 2 ml. intraven. inj. is on the avg. only 25% greater than that produced by a 1 ml. dose. The use of NH4Cl increased the effectiveness of both 1 and 2 ml. doses by about 15%. The adm. of two 1 ml. doses a week, separated by an interval of 3 or 4 days, produced 20% greater total wt. loss than a single 2 ml. inj. weekly, and also maintained the patient in a state of greater comfort. It was also found that intraven. and intramusc. injs. of the same dose produced the same amt. of diuresis.
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