MAYLYNN ACOSTA RENAL (FUROSEMIDE -LASIX) MONOGRAPH

GENERIC NAME: FUROSEMIDE

PHARMACOLOGIC CLASSIFICATION: BRAND NAME: Lasix THERAPEUTIC CLASSIFICATION:

Loop diuretics. Diuretics.

ACTION: Inhibits the reabsorption of sodium and chloride from the loop of Henle & distal
renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, hydrogen
& calcium. May have renal and peripheral vasodilatory effects. Effectiveness persists in
impaired renal function.

THERAPEUTIC EFFECT:
Diuresis & subsequent mobilization of excess fluid (edema, pleural effusion).
Decreased blood pressure.

SIDE/ADVERSE EFFECTS ROUTE/DOSAGE/ONSET

NURSING DIAGNOSIS:OF ACTION/PEAK/DURATION:
Excess Fluid volume.
Pregnancy Category C Available in Tablets, IM, IV.
CNS: dizziness, encephalopathy, headache, Route/Dosage: Edema – 20-80 mg.day as single dose initially,
insominia, nervousmess may repeat in 6-8 hrs.Hypertension – 40mg twice daily initially
EENT: hearing NURSING INTERVENTIONS: DO NOT CONFUSE
loss, tinnitus (when FUROSEMIDE
added to regimen,WITHdecrease
TORSEMIDE. dosage of other
CV:hypotensionAssess fluid status during therapy. Monitor daily weight, I&O, edema, lung sounds, skin
antihypertensive by 50%). Hypercalcemia turgor and
– 120mg/day mucous
I 1-3
membranes. Notify physician
GI: constipation, diarrhea, dry mouth, dyspepsia,if thirst, dry mouth,
doses. lethargy, weakness, hypotension or oliguria occurs.
Monitor blood pressure and pulse before and
nausea, vomiting during administration.
PO/Onset30-60min. Peak: 1-2In geriatric patients,
hrs.Duration: diuretic use is
6-8 hrs.
associated
GU: excessive urination with increased risk for falls in older adults. Assess falls risk and implement
Mostly metabolized by the liver. Use cautiously in fall prevention
severe liver
strategies.
F&E: dehydration, Administer
hypochloremia, medication in the morning
hypokalemia, to prevent disruption of sleep cycle. Administer
disease. May precipitate hepatic coma; concurrent use with orally with
food or
hypomagnesemia, milk to minimize
hyponatremia, gastric irritation. Tablets
hypovolemia, may be crushed if patient has difficulty
potassium sparing diuretics may be necessary. Geriatric swallowing. Do
not administer discolored solution or tablets.
metabolic alkalosis When using furosemide for hypercalcemia, replace
patients may have increased risk of side effects, especially
HEMAT: blood extracellular
dyscrasia volume and sodium chloride hypotension to maintain fluid
andvolume andimbalance.
electrolyte increase calcium excretion
effectively. Instruct
METAB: hyperglycemia, hyperurecemia patient to take furosemide as directed. Take missed
Drug-drug interaction: Increased does as soon aswith
hypotension possible. Do not
double up doses. Caution
MS:arthralgia, muscle cramps, myalgia patient to change antihypertensives, nitrates or acute ingestion of alcohol. Caution
positions slowly to minimize orthostatic hypotension.
patient
MISC.: increased BUN to use sunscreen and protective clothing to prevent
Increased photosensitivity.
risk of ototoxicity Advise patient to contact
with aminoglycosamides. May
health care professional immediately if muscle weakness, cramps, nausea, dizziness,numbness
increase the effectiveness of warfarin, thrombolytic agents or tingling
or
of extremities occurs. Advise diabetic patients to monitor blood glucose closely, may cause increased
anticoagulants.
blood glucose levels.

Bibliographic citation: Davis Drug Guide

Tenth Edition: pages 558-560