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Sept 14, 1963, Vol 185, No. 11 >
ARTICLE | Sept 14, 1963

Methylenebutyryl Phenoxyacetic Acid: Title and subTitle BreakNovel and Potent Natriuretic and Diuretic Agent FREE

Paul J. Cannon, MD; Richard P. Ames, MD; John H. Laragh, MD
[+] Author Affiliations

New York

From the Department of Medicine, College of Physicians and Surgeons, Columbia University, and Presbyterian Hospital.


JAMA. 1963;185(11):854-863. doi:10.1001/jama.1963.03060110058019
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References

PHARMACOLOGICAL AGENTS which increase salt and water excretion by the kidney represent one of the most significant therapeutic advances in the past decade. Investigation of the nature of the action of these drugs has helped to clarify the mechanisms involved in renal transport of electrolyte and water and has provided information about the homeostatic processes controlling salt and water balance, upset of which results in edema formation.

Four major categories of diuretics which act on renal tubular transport systems are recognized: (1) the organic mercurials, (2) the chloruretic sulfonamides (thiazide derivatives), (3) sulfonamides which inhibit carbonic anhydrase, and (4) aldosterone antagonists, —17 spironolactones. Recently, a chemically different group of agents has been developed, alpha, beta unsaturated ketone derivations of aryloxyacetic acids.1 These compounds were found to be highly effective diuretic agents when administered to the dog, but were inactive in the rat. Compounds of the group with a significant

REFERENCES

1 +
Mean of five patients in which CFH2O fell after methylenebutyryl phenoxyacetic acid.
2 +
Schultz, E.M., et al:  Alpha, Beta-Unsaturated Ketone Derivatives of Aryloxyacetic Acids, New Class of Diuretics , J Med Pharm Chem 5:660, 1962;.
3 +
Laragh, J.H.:  Mode of Action and Use of Chlorothiazide and Related Compounds , Circulation 26:121, 1962;.
4 +
Laragh, J.H.; Heinemann, H.O.; and Demartini, F.E.:  Effect of Chlorothiazide on Electrolyte Transport in Man and Its Use in Treatment of Edema of Congestive Heart Failure, Nephrosis and Cirrhosis , JAMA 166:145, 1958;.
5 +
Heinemann, H.O.; Demartini, F.E.; and Laragh, J.H.:  Effect of Chlorothiazide on Renal Excretion of Electrolytes and Free Water , Amer J Med 26:853, 1959;.
6 +
Sonnenblick, E.H.; Cannon, P.J.; and Laragh, J.H.:  Nature of Action of Intravenous Aldosterone: Evidence for Role of Hormone in Urinary Dilution , J Clin Invest 40:903, 1961;.
7 +
Praetorius, E., and Poulsen, H.:  Enzymatic Determination of Uric Acid with Detailed Directions , Scand J Clin Lab Invest 5:273, 1953;.
8 +
VanSlyke, D.D., and Neill, J.M.:  Determination of Gases in Blood and Other Solutions by Vacuum Extraction and Manometric Measurement , J Biol Chem 61:523, 1924;.
9 +
Seligson, D., and Hirahara, K.:  Measurement of Ammonia in Whole Blood, Erythrocytes and Plasma , J Lab Clin Med 49:962, 1957;.
10 +
Laragh, J.H., et al:  Aldosterone Secretion and Primary and Malignant Hypertension , J Clin Invest 39:1091, 1960;.
11 +
Smith, H.W.: Principles of Renal Physiology , New York: Oxford University Press, 1956;.
12 +
Wesson, L.G., Jr., and Anslow, W.P.:  Effect of Osmotic and Mercurial Diuresis on Simultaneous Water Diuresis , Amer J Physiol 170:255, 1952;.
13 +
Berliner. R.W., et al:  Dilution and Concentration of Urine and Action of Antidiuretic Hormone , Amer J Med 24:730, 1958;.
14 +
Gottschalk, W.:  Osmotic Concentration and Dilution in Mammalian Nephron , Circulation 21:861, 1960;.
15 +
Demartini, F.E., et al:  Effect of Chlorothiazide on Renal Excretion of Uric Acid , Amer J Med 32:572, 1962;.
16 +
Gutman, A.B., and Yu, T.F.:  Renal Function in Gout. With Commentary on Renal Regulation of Urate Excretion and Role of Kidney in Pathogenesis of Gout , Amer J Med 23:600, 1957;.
17 +
Yu, T.F.; Berger, L.; and Gutman, A.B.:  Renal Function in Gout. II. Effect of Uric Acid Loading on Renal Excretion of Uric Acid , Amer J Med 33:829, 1962;.
18 +
Wilkins, R.W.:  New Drugs for Hypertension with Special Reference to Chlorothiazide , New Eng J Med 257:1026, 1957;.
19 +
Cranston, W.I., and Juel-Jensen, B.E.:  Effects of Spironolactone and Chlorthalidone on Arterial Pressure , Lancet 1:1161, 1962;.
20 +
Atkins, E.L., and Schwartz, W.B.:  Factors Governing Correction of Alkalosis Associated with Potassium Deficiency; Critical Role of Chloride in Recovery Process , J Clin Invest 41:218, 1962;.
21 +
Schwartz, W.B., et al:  Effects of Chronic Hypercapnia on Electrolyte and Acid-Base Equilibrium. II. Recovery, with Special Reference to Influence of Chloride Intake , J Clin Invest 40:1238, 1961;.
22 +
Berliner, R.W., and Orloff, J.:  Carbonic Anhydrase Inhibitors , Pharm Rev 8:137, 1956;.
23 +
Bartter, F.C., Ed: The Clinical Use of Aldosterone Antagonists . Springfield, Ill.: Charles C Thomas, 1960;.
24 +
Crosley, A.P., Jr., et al:  Studies of Mechanism of Action of Chlorothiazide in Cardiac and Renal Diseases. II. Acute Effects on Electrolyte and Acid-Base Metabolism , J Lab Clin Med 55:191, 1960;.
25 +
Pitts, R.F., et al:  Studies on Mechanism of Diuretic Action of Chlorothiazide , J Pharm Exp Ther 23:89, 1958;.

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1 +
Mean of five patients in which CFH2O fell after methylenebutyryl phenoxyacetic acid.
2 +
Schultz, E.M., et al:  Alpha, Beta-Unsaturated Ketone Derivatives of Aryloxyacetic Acids, New Class of Diuretics , J Med Pharm Chem 5:660, 1962;.
3 +
Laragh, J.H.:  Mode of Action and Use of Chlorothiazide and Related Compounds , Circulation 26:121, 1962;.
4 +
Laragh, J.H.; Heinemann, H.O.; and Demartini, F.E.:  Effect of Chlorothiazide on Electrolyte Transport in Man and Its Use in Treatment of Edema of Congestive Heart Failure, Nephrosis and Cirrhosis , JAMA 166:145, 1958;.
5 +
Heinemann, H.O.; Demartini, F.E.; and Laragh, J.H.:  Effect of Chlorothiazide on Renal Excretion of Electrolytes and Free Water , Amer J Med 26:853, 1959;.
6 +
Sonnenblick, E.H.; Cannon, P.J.; and Laragh, J.H.:  Nature of Action of Intravenous Aldosterone: Evidence for Role of Hormone in Urinary Dilution , J Clin Invest 40:903, 1961;.
7 +
Praetorius, E., and Poulsen, H.:  Enzymatic Determination of Uric Acid with Detailed Directions , Scand J Clin Lab Invest 5:273, 1953;.
8 +
VanSlyke, D.D., and Neill, J.M.:  Determination of Gases in Blood and Other Solutions by Vacuum Extraction and Manometric Measurement , J Biol Chem 61:523, 1924;.
9 +
Seligson, D., and Hirahara, K.:  Measurement of Ammonia in Whole Blood, Erythrocytes and Plasma , J Lab Clin Med 49:962, 1957;.
10 +
Laragh, J.H., et al:  Aldosterone Secretion and Primary and Malignant Hypertension , J Clin Invest 39:1091, 1960;.
11 +
Smith, H.W.: Principles of Renal Physiology , New York: Oxford University Press, 1956;.
12 +
Wesson, L.G., Jr., and Anslow, W.P.:  Effect of Osmotic and Mercurial Diuresis on Simultaneous Water Diuresis , Amer J Physiol 170:255, 1952;.
13 +
Berliner. R.W., et al:  Dilution and Concentration of Urine and Action of Antidiuretic Hormone , Amer J Med 24:730, 1958;.
14 +
Gottschalk, W.:  Osmotic Concentration and Dilution in Mammalian Nephron , Circulation 21:861, 1960;.
15 +
Demartini, F.E., et al:  Effect of Chlorothiazide on Renal Excretion of Uric Acid , Amer J Med 32:572, 1962;.
16 +
Gutman, A.B., and Yu, T.F.:  Renal Function in Gout. With Commentary on Renal Regulation of Urate Excretion and Role of Kidney in Pathogenesis of Gout , Amer J Med 23:600, 1957;.
17 +
Yu, T.F.; Berger, L.; and Gutman, A.B.:  Renal Function in Gout. II. Effect of Uric Acid Loading on Renal Excretion of Uric Acid , Amer J Med 33:829, 1962;.
18 +
Wilkins, R.W.:  New Drugs for Hypertension with Special Reference to Chlorothiazide , New Eng J Med 257:1026, 1957;.
19 +
Cranston, W.I., and Juel-Jensen, B.E.:  Effects of Spironolactone and Chlorthalidone on Arterial Pressure , Lancet 1:1161, 1962;.
20 +
Atkins, E.L., and Schwartz, W.B.:  Factors Governing Correction of Alkalosis Associated with Potassium Deficiency; Critical Role of Chloride in Recovery Process , J Clin Invest 41:218, 1962;.
21 +
Schwartz, W.B., et al:  Effects of Chronic Hypercapnia on Electrolyte and Acid-Base Equilibrium. II. Recovery, with Special Reference to Influence of Chloride Intake , J Clin Invest 40:1238, 1961;.
22 +
Berliner, R.W., and Orloff, J.:  Carbonic Anhydrase Inhibitors , Pharm Rev 8:137, 1956;.
23 +
Bartter, F.C., Ed: The Clinical Use of Aldosterone Antagonists . Springfield, Ill.: Charles C Thomas, 1960;.
24 +
Crosley, A.P., Jr., et al:  Studies of Mechanism of Action of Chlorothiazide in Cardiac and Renal Diseases. II. Acute Effects on Electrolyte and Acid-Base Metabolism , J Lab Clin Med 55:191, 1960;.
25 +
Pitts, R.F., et al:  Studies on Mechanism of Diuretic Action of Chlorothiazide , J Pharm Exp Ther 23:89, 1958;.

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