Furosemide

Furosemide

Brand Name: Apo-Furosemide (CAN), Furoside (CAN), Lasix, Myrosemide (CAN)

Pregnancy Category C

Drug class: Loop 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 sodium-rich diuresis.

 

 

Indications

· Edema associated with CHF, cirrhosis, renal disease (oral, IV)

· Acute pulmonary edema (IV)

· Hypertension (oral)

 

 

Contraindications

· Contraindicated with allergy to furosemide, sulfonamides; allergy to tartrazine (in oral solution); electrolyte depletion; anuria, severe renal failure; hepatic coma; pregnancy; lactation.

 

 

Adverse effects

Dizziness, vertigo, paresthesias, xanthopsia, weakness, headache, drowsiness, fatigue, blurred vision, tinnitus, irreversible hearing loss

Orthostatic hypotension, volume depletion, cardiac arrhythmias, thrombophlebitis

Photosensitivity, rash, pruritus, urticaria, purpura, exfoliative dermatitis, erythema multiforme

Nausea, anorexia, vomiting, oral and gastric irritation, constipation, diarrhea, acute pancreatitis, jaundice

Polyuria, nocturia, glycosuria, urinary bladder spasm

Leukopenia, anemia, thrombocytopenia, fluid and electrolyte imbalances

Muscle cramps and muscle spasms

 

Drug Interactions:

· Increased risk of cardiac arrhythmias with digitalis glycosides (due to electrolyte imbalance)

· Increased risk of ototoxicity with aminoglycoside antibiotics, cisplatin

· Decreased absorption of furosemide with phenytoin

· Decreased natriuretic and antihypertensive effects with indomethacin, ibuprofen, other NSAIDs

· Decreased GI absorption with charcoal

 

 

Nursing considerations

CLINICAL ALERT!

Name confusion has occurred between furosemide and torsemide; use extreme caution.

· Administer with food or milk to prevent GI upset.

· Reduce dosage if given with other antihypertensives; readjust dosage gradually as BP responds.

· Give early in the day so that increased urination will not disturb sleep.

· Avoid IV use if oral use is at all possible.

· Do not mix parenteral solution with highly acidic solutions with pH below 3.5.

· Do not expose to light, may discolor tablets or solution; do not use discolored drug or solutions.

· Discard diluted solution after 24 hr.

· Refrigerate oral solution.

· Measure and record weight to monitor fluid changes.

· Arrange to monitor serum electrolytes, hydration, liver function.

· Arrange for potassium-rich diet or supplemental potassium as needed.