Generic Name: furosemide Brand Name: Lasix Subclass:Diuretics 1: Loop Mechanism of Action inhibits loop of Henle and proximal

and distal convoluted tubule sodium and chlo ride resorption Furosemide is a loop diuretic (water pill) that prevents your body from absorbin g too much salt, allowing the salt to instead be passed in your urine. Furosemide treats fluid retention (edema) in people with congestive heart failur e, liver disease, or a kidney disorder such as nephrotic syndrome. This medicati on is also used to treat high blood pressure (hypertension). Dosage forms: 20,40,80; 10/mL; 40/5 mL; IM; IV edema [PO route]Dose: 40-120 mg/day PO div qd-bid; Start: 20-80 mg PO x1, incr. 20-40 mg q6-8h; Max: 600 mg/day; Info: for pts w/ CHF, hepatic dz or renal dz; maint. dose may be given intermittently [IM/IV route]Start: 20-40 mg IM/IV x1, incr. 20 mg q2h; Alt: 0.1 mg/kg IV x1, th en 0.1 mg/kg/h, then double dose q2h up to 0.4 mg/kg/h; Info: for pts w/ CHF, he patic dz or renal dz pulmonary edema, acute [80 mg IV q1h]Start: 40 mg IV x1 HTN [10-40 mg PO bid]Start: 40 mg PO bid; Alt: start 10-20 mg PO bid; Max: 600 mg/da y; Info: refer to JNC 7 guidelines hypercalcemia [120 mg/day PO div qd-tid]Alt: 80-100 mg IM/IV q1-2h; Info: give w/ saline renal dosing [no adjustment]anuria: contraindicated; HD/PD: no supplement hepatic dosing [not defined]cirrhosis/ascites: caution advised Nursing Interventions: Assess fluid status during therapy. Monitor daily weight, intake and output rat ios, amount and location of edema, lung sounds, skin turgor and mucouse memebranes. Notify physician if if thirst, dry mouth, lethargy, weakness, hypotension or oliguria occurs. Monitor pulse pulse before and during administration. Monitor frequency of prescription refills in patients treated for hypertention. Assess patients receiving digoxin for anorexia, nausea, vomiting, muscle cramps, paresthesia and confusion. Patients taking digoxin are at increased risk of digoxin toxicity due to potassium depleting eff ect of the diuretic. Potassium supplements or potassium sparing diuretics may be used concurrently to prevent hypokalemia. Assess patient for tinnitus and hearing loss. Hearing loss is most common follow ing high dose or rapid IV administration with patients with decreased renal function or those taking ototo xin drugs. Assess for allergies to sulfonomides.

Side effects diarrhea, constipation, or stomach pain; headache; numbness, burning, pain, or tingly feeling; dizziness; or blurred vision. Adverse reactions: hypokalemia, severe electrolyte imbalance, severe metabolic alkalosis hypovolemia/dehydration ototoxicity thrombocytopenia anemia, hemolytic aplastic anemia leukopenia agranulocytosis anaphylaxis vasculitis interstitial nephritis necrotizing angiitis erythema multiforme exfoliative dermatitis Stevens-Johnson syndrome toxic epidermal necrolysis pancreatitis cholestatic jaundice SLE exacerbation thrombosis eosinophilia Contraindications/Cautions . hypersens. to drug/class/compon. anuria hepatic coma electrolyte imbalances caution if hypersens. to sulfonamides caution if diabetes mellitus caution if acute MI caution if arrhythmias caution if hearing impairment caution if concurrent ototoxic agents caution if SLE caution if hepatic impairment caution if renal dz, severe caution if urinary retention caution if gout hx caution if pancreatitis hx caution in gestational HTN caution in premature neonates caution in elderly pts caution if iodinated contrast FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Before taking furosemide, tell your doctor if you are pregnant o r plan to become pregnant during treatment. Furosemide can pass into breast milk and may harm a nursing baby.

Drug Interactions . Avoid/Use Alternative aminoglycosides, oral aminoglycosides, parenteral lithium