Generic Mechanism of Indications and Contraindications Common Side Nursing Considerations

Name & Action Drug Rationale Effects

Brand Name
Generic Rapid-acting Treatment of
CV: Postural hypotension, Observe patients receiving
Name: potent edema History of parenteral drug carefully;
hypersensitivity dizziness with excessive
Furosemide sulfonamide associated with closely monitor BP and vital
to furosemide or
Brand Name: "loop" diuretic CHF, cirrhosis of diuresis, acute hypotensive signs. Sudden death from
sulfonamides;
Lasix and liver, and kidney cardiac arrest has been
increasing episodes, circulatory
antihypertensive disease, reported.
Classification: with including oliguria, anuria,
collapse. Metabolic: Hypovol
Electrolyte pharmacologic nephrotic fluid and
electrolyte emia, dehydration,  Monitor for S&S of
and water effects and uses syndrome. May hypokalemia (see
balance almost identical be used for depletion states;
hyponatremia hypokalemia, h Appendix F).
agent; loop to those of management of hepatic coma;
pregnancy ypochloremia metabolic  Monitor BP during
diuretic ethacrynic acid. hypertension,
(category C), periods of diuresis and
Available Exact mode of alone or in alkalosis, hypomagnesemia,
lactation. through period of
forms: action not combination
hypocalcemia (tetany), dosage adjustment.
20 mg, 40 clearly defined; with other
mg, 80 mg decreases renal antihypertensive hyperglycemia, glycosuria,  Observe older adults
tablets; 10 vascular agents, and for closely during period of
elevated BUN, brisk diuresis. Sudden
mg/mL, 40 resistance and treatment of
mg/5 mL oral may increase hypercalcemia. hyperuricemia. GI: Nausea, alteration in fluid and
solution; 10 renal blood Has been used electrolyte balance may
vomiting, oral and gastric
mg/mL flow. concomitantly precipitate significant
injection with mannitol burning, anorexia, diarrhea, adverse reactions.
for treatment of constipation, abdominal Report symptoms to
severe cerebral physician.
edema, cramping, acute pancreatitis,  Lab tests: Obtain
particularly in jaundice. Urogenital: Allergi frequent blood count,
meningitis. serum and urine
c interstitial nephritis,
electrolytes, CO2, BUN,
irreversible renal failure, blood sugar, and uric
urinary acid values during first
few months of therapy
frequency. Hematologic: An
emia, leukopenia,
thrombocytopenic
purpura; aplastic anemia,
agranulocytosis (rare). Speci
al 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.
and periodically
thereafter.
 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.
 Monitor urine and
blood glucose &
HbA1C closely in
diabetics and patients
with decompensated
hepatic cirrhosis. Drug
may cause
hyperglycemia.
 Note: Excessive
dehydration is most
likely to occur in older
adults, those with
chronic cardiac disease
on prolonged salt
restriction, or those
receiving sympatholytic
agents.