Drug name

Mechanis m of action Classificati on: Loop diuretics Mode of action:

Furosemide is a potent diuretic (water pill) that is used to eliminate water and salt from the body. In the kidneys, salt (composed of sodium and chloride), water, and other small molecules normally are filtered out of the blood and into the tubules of the kidney. The filtered fluid ultimately becomes urine. Most of the sodium, chloride and water that is filtered out of the blood is reabsorbed into the blood before the filtered fluid becomes urine and is eliminated from the body. Furosemide works by blocking the absorption of sodium, chloride, and water from the

Administrat ion

Indicatio n

Contraindicat ion

Adverse Effects

Nursing responsibilities

Generic Name:

Dosage and route:

Edema Adult: PO 2080 mg in 1 or more divided doses up to 600 mg/d if needed

furosemide
Brand Name:

Lasix

IV/IM 2040 mg in 1 or more divided doses up to 600 mg/d Child: PO 2 mg/kg, may be increased by 1 2 mg/kg q68h (max: 6 mg/kg/dose)

Treatment of edema associated with CHF, cirrhosis of liver, and kidney disease, including nephrotic syndrome. May be used for management of hypertension, alone or in combination with other antihypertensive agents, and for treatment of hypercalcemia. Has been used concomitantly with mannitol for treatment of severe cerebral edema, particularly in meningitis.

History of hypersensitivity to furosemide or sulfonamides; increasing oliguria, anuria, fluid and electrolyte depletion states; hepatic coma; pregnancy (category C), lactation. Furosemide should be used with caution in patients with preexisting electrolyte or water balance abnormalities, impaired hepatic function (may precipitate hepatic coma) and diabetes mellitus. Patients with conditions that may lead to electrolyte or water balance abnormalities (e.g., vomiting, diarrhea, etc.) should be monitored carefully. Patients hypersensitive to sulfonamides may also be hypersensitive to furosemide (not documented in veterinary species).

IV/IM 1 mg/kg, may be increased by 1 mg/kg q2h if needed (max: mg/kg/dose) Neonate: PO 1 4 mg/kg q12 24h IV/IM 12 mg/kg q1224h Hypertension Adult: PO 1040 mg b.i.d. (max: 480 mg/d)

CV: Postural hypotension, dizziness with excessive diuresis, acute hypotensive episodes, circulatory collapse. Metabolic: Hypovolemia, dehydration, hyponatremia hypokalemia, hypochloremia metabolic alkalosis, hypomagnesemia, hypocalcemia (tetany), hyperglycemia, glycosuria, elevated BUN, hyperuricemia. GI: Nausea, vomiting, oral and gastric burning, anorexia, diarrhea, constipation, abdominal cramping, acute pancreatitis, jaundice. Urogenital: Allergic interstitial nephritis, irreversible renal failure, urinary frequency. Hematologic: Anemia, leukopenia, thrombocytopenic purpura; aplastic anemia, agranulocytosis (rare). Special Senses: Tinnitus, vertigo, feeling of fullness in ears, hearing loss (rarely permanent), blurred vision.

Assessment & Drug Effects: Observe patients receiving parenteral drug carefully; closely monitor BP and vital signs. Sudden death from cardiac arrest has been reported.

Monit or BP during periods of diuresis and through period of dosage adjustment. Obse rve older adults closely during period of brisk diuresis. Sudden alteration in fluid and electrolyte balance may precipitate significant adverse reactions. Report symptoms to physician. Lab tests: Obtain frequent blood count, serum and urine electrolytes, CO2, BUN, blood sugar, and uric acid values during first few months of therapy and periodically thereafter.

Frequency:
Q 12 hours

filtered fluid in the kidney tubules, causing a profound increase in the output of urine (diuresis).

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.

Monit or for S&S of hypokalemia . Monit or I&O ratio and pattern. Report decrease or unusual increase in output. Excessive diuresis can result in dehydration and hypovolemi a, circulatory collapse, and hypotension . Weigh patient daily under standard conditions. Monit or urine and blood glucose & HbA1C closely in diabetics and patients with decompensa ted hepatic cirrhosis. Drug may cause hyperglyce mia.