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1 Use Cautiously in: Severe liver disease (may precipitate hepatic coma; concur-
rent use with potassium-sparing diuretics may be necessary); Electrolyte depletion;
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furosemide (fur-oh-se-mide) Diabetes mellitus; Hypoproteinemia (qrisk of ototoxicity); Severe renal impairment
Lasix (qrisk of ototoxicity); OB, Lactation: Safety not established; Pedi:qrisk for renal
Classification calculi and patent ductus arteriosis in premature neonates; Geri: May haveqrisk of
Therapeutic: diuretics side effects, especially hypotension and electrolyte imbalance, at usual doses.
Pharmacologic: loop diuretics Adverse Reactions/Side Effects
Pregnancy Category C CNS: blurred vision, dizziness, headache, vertigo. EENT: hearing loss, tinnitus. CV:
hypotension. GI: anorexia, constipation, diarrhea, dry mouth, dyspepsia,qliver en-
Indications zymes, nausea, pancreatitis, vomiting. GU:qBUN, excessive urination, nephrocalci-
Edema due to heart failure, hepatic impairment or renal disease. Hypertension. nosis. Derm: ERYTHEMA MULTIFORME, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL
NECROLYSIS, photosensitivity, pruritis, rash, urticaria. Endo: hypercholesterolemia,
Action hyperglycemia, hypertriglyceridemia, hyperuricemia. F and E: dehydration, hypo-
Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal calcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovole-
renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, po- mia, metabolic alkalosis. Hemat: APLASTIC ANEMIA, AGRANULOCYTOSIS, hemolytic
tassium, and calcium. Effectiveness persists in impaired renal function. Therapeu- anemia, leukopenia, thrombocytopenia. MS: muscle cramps. Neuro: paresthesia.
tic Effects: Diuresis and subsequent mobilization of excess fluid (edema, pleural Misc: fever.
effusions). Decreased BP.
Pharmacokinetics Interactions
Absorption: 60– 67% absorbed after oral administration (pin acute HF and in re- Drug-Drug:qrisk of hypotension with antihypertensives, nitrates, or acute in-
nal failure); also absorbed from IM sites. gestion of alcohol.qrisk of hypokalemia with other diuretics, amphotericin B,
Distribution: Crosses placenta, enters breast milk. stimulant laxatives, and corticosteroids. Hypokalemia mayqrisk of digoxin
Protein Binding: 91– 99%. toxicity andqrisk of arrhythmia in patients taking drugs that prolong the QT interval.
Metabolism and Excretion: Minimally metabolized by liver, some nonhepatic plithium excretion, may cause lithium toxicity.qrisk of ototoxicity with amino-
metabolism, some renal excretion as unchanged drug. glycosides or cisplatin.qrisk of nephrotoxicity with cisplatin. NSAIDSpeffects
Half-life: 30– 60 min (qin renal impairment). of furosemide. Mayqrisk of methotrexate toxicity.peffects of furosemide when
TIME/ACTION PROFILE (diuretic effect) given at same time as sucralfate, cholestyramine,or colestipol.qrisk of salicyl-
ate toxicity (with use of high-dose salicylate therapy). Concurrent use with cyclo-
ROUTE ONSET PEAK DURATION sporine mayqrisk of gouty arthritis.
PO 30–60 min 1–2 hr 6–8 hr
IM 10–30 min unknown 4–8 hr Route/Dosage
IV 5 min 30 min 2 hr
Edema
Contraindications/Precautions PO (Adults): 20– 80 mg/day as a single dose initially, may repeat in 6– 8 hr; mayq
Contraindicated in: Hypersensitivity; Cross-sensitivity with thiazides and sulfona- dose by 20– 40 mg q 6– 8 hr until desired response. Maintenance doses may be given
mides may occur; Hepatic coma or anuria; Some liquid products may contain alco- once or twice daily (doses up to 2.5 g/day have been used in patients with HF or renal
hol, avoid in patients with alcohol intolerance. disease). Hypertension— 40 twice daily initially (when added to regimen,pdose of
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.
Name /bks_53161_deglins_md_disk/furosemide 02/25/2014 10:00AM Plate # 0-Composite pg 2 # 2
4
Evaluation/Desired Outcomes PDF Page #4
● Decrease in edema.
● Decrease in abdominal girth and weight.
● Increase in urinary output.
● Decrease in BP.
Why was this drug prescribed for your patient?