Butemanide

Bumetanide

Brand Name: Bumex, Burinex (CAN)

Pregnancy Category C

 

Drug class: Loop (high ceiling) diuretic

 

Therapeutic actions

Inhibits the reabsorption of sodium and chloride from the proximal and distal renal tubules and the loop of Henle, leading to a natriuretic diuresis.

Indications

· Edema associated with CHF, cirrhosis, renal disease

· Acute pulmonary edema (IV)

· Unlabeled use: treatment of adult nocturia (not effective in men with BPH)

 

Contraindications

· Allergy to bumetanide; electrolyte depletion; anuria, severe renal failure; hepatic coma; SLE; gout; diabetes mellitus; lactation.

 

Adverse effects

Asterixis, dizziness, vertigo, paresthesias, confusion, fatigue, nystagmus, weakness, headache, drowsiness, fatigue, blurred vision, tinnitus, irreversible hearing loss, Orthostatic hypotension, volume depletion, cardiac arrhythmias, thrombophlebitis, Nausea, anorexia, vomiting, diarrhea, gastric irritation and pain, dry mouth, acute pancreatitis, jaundice, Polyuria, nocturia, glycosuria, renal failure, Hypokalemia, leukopenia, anemia, thrombocytopenia

 

 

Drug Interactions

· Decreased diuresis and natriuresis with NSAIDs

· Increased risk of cardiac glycoside toxicity (secondary to hypokalemia)

· Increased risk of ototoxicity if taken with aminoglycoside antibiotics, cisplatin

 

Nursing considerations

· Give with food or milk to prevent GI upset.

· Mark calendars or use reminders if intermittent therapy is best for treating edema.

· Give single dose early in day so increased urination will not disturb sleep.

· Avoid IV use if oral use is possible.

· Arrange to monitor serum electrolytes, hydration, liver function during long-term therapy.

· Provide diet rich in potassium or supplemental potassium.