Generic Name: Furosemide Show
Brand Name: ROSEMID® Dosage Form: Injection 20mg/2ml, Injection 40mg/4ml Pharmacological Category: Loop diuretics Therapeutic Category: Antihypertensive Drugs Pregnancy Category: Category C PharmacologyInvestigations into the mode of action of furosemide have utilized micropuncture studies in rats, stop flow
experiments in dogs and various clearance studies in both humans and experimental animals. Pharmacokinetics:
Recent evidence suggests that furosemide glucuronide is the only or at least the major biotransformation product of furosemide in man. Furosemide is extensively bound to plasma proteins, mainly to albumin. Plasma concentrations ranging from 1 to 400 mcg/mL are 91 to 99% bound in healthy individuals. The unbound fraction averages 2.3 to 4.1% at therapeutic concentrations. Indications:Furosemide is indicated in adults and pediatric patients for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal
disease, including the nephrotic syndrome. Furosemide is particularly useful when an agent with greater diuretic potential is desired. If gastrointestinal absorption is impaired or oral medication is not practical for any reason, furosemide is indicated by the intravenous or intramuscular route. Parenteral use should be replaced with oral furosemide as soon as practical. Contraindications:Furosemide Injection is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide. Precautions:Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients. As with any effective diuretic, electrolyte depletion may occur during furosemide therapy, especially in patients receiving higher doses and a restricted salt intake. Hypokalemia may develop with furosemide, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids, ACTH, licorice in large amounts, or prolonged use of laxatives. Digitalis therapy may exaggerate metabolic effects of hypokalemia, especially myocardial effects. All patients receiving furosemide therapy should be observed for these signs or symptoms of fluid or electrolyte imbalance (hyponatremia, hypochloremic alkalosis, hypokalemia, hypomagnesemia, or hypocalcemia): dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Increases in blood glucose and alterations in glucose tolerance tests (with abnormalities of the fasting and 2-hour postprandial sugar) have been observed, and rarely, precipitation of diabetes mellitus has been reported. In patients with severe symptoms of urinary retention (because of bladder emptying disorders, prostatic hyperplasia, urethral narrowing), the administration of furosemide can cause acute urinary retention related to increased production and retention of urine. Thus, these patients require careful monitoring, especially during the initial stages of treatment. In patients at high risk for radiocontrast nephropathy, furosemide can lead to a higher incidence of deterioration in renal function after receiving radiocontrast compared to high-risk patients who received only intravenous hydration prior to receiving radiocontrast. Patients allergic to sulfonamides may also be allergic to furosemide. The possibility exists of exacerbation or activation of systemic lupus erythematosus. Drug Interactions:• cisplatin ; Side Effects:• ringing in your ears, hearing loss; spreads (especially in the face or upper body) and causes blistering and peeling. Storage:• Store below 30 C° Packing:• Injection 20mg/2ml, Injection 40mg/4ml: Box of 5 ampoules (40mg/4ml Ampoule) • Box of 10 ampoules (20mg/2ml Ampoule) What electrolytes are affected by furosemide?Furosemide induces various electrolyte imbalances including hypokalemia, hypomagnesemia, hypocalcemia, hyponatremia, and hyperuricemia3,16). Hypokalemia is caused by the increased distal delivery of potassium and secondary mineralocorticoid excess26).
What three electrolytes should be monitored when administering furosemide?Careful monitoring of the patient's clinical condition, daily weight, fluids intake, urine output, electrolytes, i.e., potassium and magnesium, kidney function monitoring with serum creatinine and serum blood urea nitrogen level is vital to monitor the response of furosemide.
What labs should be monitored with furosemide?Lab Test Considerations:
Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy.
What should I watch when taking furosemide?Tell your doctor right away if you have any of these unlikely but serious side effects: muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, unusual dry mouth/thirst, nausea, vomiting, fast/irregular heartbeat.
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