Furosemide Classification: loop diuretic Drug Action: Inhibits reabsorption of sodium and chloride primarily in loop of Henle and

also in proximal and distal renal tubules; an antihypertensive that decreases edema and intravascular volume Indication/s: Treatment of edema associated with CHF, cirrhosis of liver, and kidney disease, including nephrotic syndrome; For management of hypertension, alone or in combination with other antihypertensive agents, and for treatment of hypercalcemia; Used concomitantly with mannitol for treatment of severe cerebral edema, particularly in meningitis. Contraindication/s: History of hypersensitivity to furosemide or sulfonamides; increasing oliguria, anuria, fluid and electrolyte depletion states; hepatic coma Adverse Reaction/s: Allergic reaction; hyperuricemia; bone marrow depression Nursing Responsibilities: 1) Instruct patient to take with food (swallow whole, do not chew/crush). 2) Lithium generally should not be given with diuretics because they reduce lithium's renal

clearance and add a high risk of lithium toxicity. 3) Monitor for signs of dehydration and electrolyte deplesion. Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism. 4) Be alert for dehydration, blood volume reduction, hypotension, electrolyte imbalance, hypokalemia and hypochloremic alkalosis. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function.