Bumetanide is nearly totally absorbed from the gastro-intestinal tract. After peroral administration, a bioavailability of between 80-95% is observed. Diuresis begins within ½-1 hour with a peak effect between 1 and 2 hours. The diuretic effect lasts up to about 4 hours. Bumetanide is eliminated with half-life ranging from between 1 to 2 hours after oral administration of a dose of -2 mg. It is strongly bound to plasma proteins and renal excretion of unchanged drug accounts for about half of the total clearance. The hepatic metabolism and biliary excretion accounts for the other half. The primary metabolites are conjugated alcohols of bumetanide. No active metabolites have been found. Bumetanide has a steep dose response curve.
In mild cases of toxicity (atrial fibrillation with a slow ventricular response or occasional ectopic beats), temporary withdrawal of the drug and electrocardiogram monitoring is sufficient. 6 Gastric lavage or emesis together with supportive measures, such as electrolyte replacements, antiarrhythmics (eg, lidocaine, phenytoin), and atropine, have been used to manage acute poisonings. Digoxin-specific Fab antibody fragments may be used in managing acute intoxications caused by digitalis and related cardioactive glycosides; however, their efficacy remains unproven by controlled clinical trials. 13 , 25 , 28 , 29
Talong is a coarse, usually branched, prickly or unarmed, erect, half-woody plant, growing to a height of to 1 meter. Leaves are ovate to oblong-ovate, 10 to 25 centimeters long, stellate-hairy beneath, and irregularly or shallowly lobed at the margins. Flowers are axillary, purplish, about centimeters long. Fruit is fleshy, smooth, purple, up to 25 centimeters long, extremely variable in shape, round, oblong, or cylindric-oblong.
- Cultivated throughout the Philippines for the edible fruit; the elongated variety, the most cultivated.
- Nowhere spontaneous.
- Cultivated in all warm countries.