Thursday, May 15, 2014
Fumide , Furomide , Lasix, Luramide
Action:
Rapid-acting potent sulfonamide “loop” diuretic and antihypertensive with pharmacologic effects and uses almost identical to those of ethacrynic acid. Exact mode of action not clearly defined; decreases renal vascular resistance and may increase renal blood flow.
Classification:
ELECTROLYTIC AND WATER BALANCE AGENT; LOOP DIURETIC
Indication:
Treatment of edema associated with CHF, cirrhosis of liver, and kidney disease, including nephrotic syndrome. May be used for management of hypertension, alone or in combination with other antihypertensive agents, and for treatment of hypercalcemia. Has been used concomitantly with mannitol for treatment of severe cerebral edema, particularly in meningitis.
TABLE
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Drug Name
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Dosage & Route
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Action
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Indication
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Adverse Effects
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Contraindication
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Nursing Responsibility
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FUROSEMIDE
(fur-oh'se-mide)
Fumide , Furomide , Lasix, Luramide
Classifications: electrolytic and water balance agent;
loop diuretic
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Edema
Adult: PO 20–80 mg in 1 or more divided doses up to 600 mg/d if needed IV/IM 20–40 mg in 1 or more divided doses up to 600 mg/d Child: PO 2 mg/kg, may be increased by 1–2 mg/kg q6–8h (max: 6 mg/kg/dose) IV/IM 1 mg/kg, may be increased by 1 mg/kg q2h if needed (max: mg/kg/dose) Neonate: PO 1–4 mg/kg q12–24h IV/IM 1–2 mg/kg q12–24h Hypertension Adult: PO 10–40 mg b.i.d. (max: 480 mg/d) |
Rapid-acting
potent sulfonamide "loop" diuretic and antihypertensive with
pharmacologic effects and uses almost identical to those of ethacrynic acid.
Exact mode of action not clearly defined; decreases renal vascular resistance
and may increase renal blood flow
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CV: Postural hypotension, dizziness with excessive diuresis, acute
hypotensive episodes, circulatory collapse. Metabolic: Hypovolemia, dehydration, hyponatremia hypokalemia, hypochloremia metabolic alkalosis,
hypomagnesemia, hypocalcemia (tetany), hyperglycemia, glycosuria, elevated
BUN, hyperuricemia. GI:
Nausea, vomiting, oral and gastric burning, anorexia, diarrhea, constipation,
abdominal cramping, acute pancreatitis, jaundice. Urogenital: Allergic interstitial
nephritis, irreversible renal failure, urinary frequency. Hematologic: Anemia, leukopenia,
thrombocytopenic purpura; aplastic anemia,
agranulocytosis (rare). Special
Senses: Tinnitus, vertigo, feeling of fullness in ears, hearing loss
(rarely permanent), blurred vision. Skin:
Pruritus, urticaria, exfoliative dermatitis, purpura, photosensitivity,
porphyria cutanea tarde, necrotizing angiitis (vasculitis). Body as a Whole: Increased perspiration;
paresthesias; activation of SLE, muscle spasms, weakness; thrombophlebitis,
pain at IM injection site.
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History of hypersensitivity to furosemide or sulfonamides; increasing oliguria, anuria, fluid and electrolyte depletion states; hepatic coma; pregnancy (category C), lactation. |
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Observe patients receiving parenteral drug carefully; closely
monitor BP and vital signs. Sudden death from cardiac arrest has been
reported.
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Monitor BP during periods of diuresis and through period of
dosage adjustment.
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Observe older adults closely during period of brisk diuresis.
Sudden alteration in fluid and electrolyte balance may precipitate
significant adverse reactions. Report symptoms to physician.
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Lab tests: Obtain frequent blood count, serum and urine
electrolytes, CO2, BUN, blood sugar, and uric acid values during
first few months of therapy and periodically thereafter.
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Monitor for S&S of hypokalemia.
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Monitor I&O ratio and pattern. Report decrease or unusual
increase in output. Excessive diuresis can result in dehydration and
hypovolemia, circulatory collapse, and hypotension. Weigh patient daily under
standard conditions.
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Monitor urine and blood glucose & HbA1C closely
in diabetics and patients with decompensated hepatic cirrhosis. Drug may
cause hyperglycemia.
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