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Use of Emax model in diuretic studies.

Alvan et al. (1990) reported that intravenously administered bolus doses of frusemide were not the most effective way of adminstering this diuretic. These authors concluded that a controlled infusion, resulting in a frusemide excretion rate at 'maximal efficiency', would produce a response about twice that achieved by a bolus dose. A similar observation has also been reported when comparing bolus vs steady state infusion of the same dose of frusemide over 8 h (Lee et al., 1986) but without resorting to the Em. model or the concept of 'maximally efficient' dose (Kaojarern et al., 1982) employed by Alvan et al. (1990) in their report.