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Drug Study Contraindicatio Mechanism of Action n -Inhibits sodium and water reabsorption in the loop of Henle and increases urine formation. As the body’s plasma volume decreases, aldosterone production increases, which promotes sodium reabsorption and the loss of potassium and hydrogen ions. Furosemide also increases the excretion of calcium, magnesium, bicarbonate, ammonium, and phosphate. By reducing intracellular and extracellular fluid volume, the drug reduces blood pressure and decreases cardiac output. Over time, cardiac output returns to normal. -Anuria unresponsive to furosemide; -hypersensitivity to furosemide, sulfonamides, or their components Incompatibilitie s Don’t mix furosemide (a milky, buffered alkaline solution) with highly acidic solutions.

Side effect Adverse Reaction CNS: Dizziness, fever, headache, paresthesia, restlessness, vertigo, weakness CV: Orthostatic hypotension, shock, thromboembolism, thrombophlebitis EENT: Blurred vision, oral irritation, ototoxicity, stomatitis, tinnitus, transient hearing loss (rapid I.V. injection), yellow vision ENDO: Hyperglycemia GI: Abdominal cramps, anorexia, constipation, diarrhea, gastric irritation, hepatocellular insufficiency, indigestion, jaundice, nausea, pancreatitis, vomiting GU: Bladder spasms, glycosuria HEME: Agranulocytosis (rare), anemia, aplastic anemia (rare), azotemia, hemolyticanemia, leukopenia, thrombocytopenia MS: Muscle spasms SKIN: Bullous pemphigoid, erythema multiforme, exfoliative dermatitis, photosensitivity, pruritus, purpura, rash, urticaria Other: Allergic reaction (interstitial nephritis, necrotizing vasculitis, systemic vasculitis), dehydration, hyperuricemia, hypochloremia, hypokalemia, hyponatremia, hypovolemia

Nursing responsibilities

Generic Name: Furosemide

-To reduce edema caused by cirrhosis, heart failure, and renal disease, including nephrotic syndrome -To manage mild to moderate hypertension, as adjunct to treat acute pulmonary edema and hypertensive crisis

Pharmacologi c class: Sulfonamide Therapeutic class: Antihypertensiv e, diuretic Pregnancy risk category C

Brand Name: ApoFurosemide (CAN), Furoside (CAN), Lasix, Lasix Special (CAN), Myrosemide, Novosemide (CAN), Uritol (CAN)

WARNING Use furosemide cautiously in patients with advanced hepatic cirrhosis, especially those who also have a history of electrolyte imbalance or hepatic encephalopathy; drug may lead to lethal hepatic coma. •Obtain patient’s weight before and periodically during furosemide therapy to monitor fluid loss. • For once-a-day dosing, give drug in the morning so patient’s sleep won’t be interrupted by increased need to urinate. • Prepare drug for infusion with normal saline solution, lactated Ringer’s solution, or D5W. • Administer drug slowly I.V. over 1 to 2 minutes to prevent ototoxicity. • Expect patient to have periodic hearing tests during prolonged or high-dose I.V. therapy. •Monitor blood pressure and hepatic and renal function as well as BUN, blood glucose, and serum creatinine, electrolyte, and uric acid levels, as appropriate. • Be aware that elderly patients are more susceptible to hypotensive and electrolytealtering effects and thus are at greater risk for shock and thromboembolism. • If patient is at high risk for hypokalemia, give potassium supplements along with furosemide, as prescribed. • Expect to discontinue furosemide at maximum