Acetazolamide and furosemide attenuate asthma induced by hyperventilation of cold, dry air

Am Rev Respir Dis. 1992 Dec;146(6):1518-23. doi: 10.1164/ajrccm/146.6.1518.


We investigated the assumption that the efficacy of inhaled diuretics in asthma is dependent upon inhibition of the Na+/K+/2Cl- cotransporter. We compared the protective effect of acetazolamide, a diuretic without significant effect on the loop cotransporter, with the protection provided by inhaled furosemide in a cold, dry air hyperventilation model of asthma. Seven asthmatic subjects underwent a baseline bronchial challenge and then received a nebulized dose of 80 mg of furosemide or 500 mg of acetazolamide or saline placebo in a randomized, double-blind, placebo-controlled crossover design. Repeat challenges were performed immediately and at 2 and 4 h postnebulization. Acetazolamide caused a 47.2% increase in the amount of cold, dry air required to reduce the FEV1, by 20% (expressed in terms of respiratory heat loss as PD20RHL), from 0.79 multiplied or divided by (x/divided by) 1.13 kcal/min (geometric mean x/divided by geometric SEM) at baseline to 1.17 x/divided by 1.09 kcal/min postnebulization (p < 0.025). Furosemide increased the geometric mean PD20RHL by 53.9%, from 0.86 x/divided by 1.12 kcal/min to 1.33 x/divided by 1.12 kcal/min (p < 0.001). There was no significant change after placebo inhalation (0.81 x/divided by 1.15 kcal/min versus 0.87 x/divided by 1.10 kcal/min, NS). Airway responsiveness had returned to baseline by 2 h postnebulization on all 3 days. Furosemide also caused bronchodilatation, producing a 14.1% rise in the mean FEV1 (p < 0.005 versus prenebulization), whereas neither acetazolamide nor placebo altered airway tone significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acetazolamide / administration & dosage
  • Acetazolamide / therapeutic use*
  • Administration, Inhalation
  • Adult
  • Asthma / drug therapy*
  • Asthma / etiology*
  • Asthma / physiopathology
  • Bronchi / drug effects
  • Bronchi / physiopathology
  • Bronchial Provocation Tests
  • Cold Temperature / adverse effects
  • Double-Blind Method
  • Female
  • Forced Expiratory Volume
  • Furosemide / administration & dosage
  • Furosemide / therapeutic use*
  • Humans
  • Humidity
  • Hyperventilation / complications
  • Male
  • Urine


  • Furosemide
  • Acetazolamide