General Pronunciation: Trade Name(s) Ther. Class. diuretics Pharm. Class. loop diuretics Action Therapeutic Effect(s): Absorption: 60–67% absorbed after oral administration (↓ in acute HF and in renal failure); also absorbed from IM sites. Distribution: Crosses placenta, enters breast milk. Protein Binding: 91–99%. Metabolism and Excretion: Minimally metabolized by liver, some nonhepatic metabolism, some renal excretion as unchanged drug. Half-life: 30–60 min (↑ in renal impairment). TIME/ACTION PROFILE (diuretic effect)
Contraindication/PrecautionsContraindicated in:
Use Cautiously in:
Adverse Reactions/Side EffectsCV: hypotension Derm: ERYTHEMA MULTIFORME, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, pruritus, rash, urticaria EENT: hearing loss, tinnitus Endo: hypercholesterolemia, hyperglycemia, hypertriglyceridemia, hyperuricemia F and E: dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis GI: anorexia, constipation, diarrhea, dry mouth, dyspepsia, ↑ liver enzymes, nausea, pancreatitis, vomiting GU: ↑ BUN, excessive urination, nephrocalcinosis Hemat: APLASTIC ANEMIA, AGRANULOCYTOSIS, hemolytic anemia, leukopenia, thrombocytopenia MS: muscle cramps Neuro: paresthesia, blurred vision, dizziness, headache, vertigo Misc: fever * CAPITALS indicate life-threatening. InteractionsDrug-Drug
Route/DosageEdema PO (Adults): 20–80 mg/day as a single dose initially, may repeat in 6–8 hr; may ↑ dose by 20–40 mg every 6–8 hr until desired response. Maintenance doses may be given once or twice daily (doses up to 2.5 g/day have been used in patients with HF or renal disease). Hypertension– 40 mg twice daily initially (when added to regimen, ↓ dose of other antihypertensives by 50%); adjust further dosing based on response; Hypercalcemia– 120 mg/day in 1–3 doses. PO (Children >1 mo): 2 mg/kg as a single dose; may be ↑ by 1–2 mg/kg every 6–8 hr (maximum dose = 6 mg/kg). PO (Neonates): 1–4 mg/kg/dose 1–2 times/day. IM IV (Adults): 20–40 mg, may repeat in 1–2 hr and ↑ by 20 mg every 1–2 hr until response is obtained, maintenance dose may be given every 6–12 hr; Continuous infusion– Bolus 0.1 mg/kg followed by 0.1 mg/kg/hr, double every 2 hr to a maximum of 0.4 mg/kg/hr. IM IV (Children): 1–2 mg/kg/dose every 6–12 hr; Continuous infusion– 0.05 mg/kg/hr, titrate to clinical effect. IM IV (Neonates): 1–2 mg/kg/dose every 12–24 hr. Hypertension PO (Adults): 40 mg twice daily initially (when added to regimen, ↓ dose of other antihypertensives by 50%); adjust further dosing based on response. Availability (generic available)Oral solution (10 mg/mL–orange flavor, 8 mg/mL–pineapple–peach flavor): 8 mg/mL, 10 mg/mL Cost: Generic: 10 mg/mL $10.40/60 mL Tablets: 20 mg, 40 mg, 80 mg, 500 mg Cost: Generic: 20 mg $6.50/100, 40 mg $7.11/100, 80 mg $10.83/100 Solution for injection: 10 mg/mL Assessment (adsbygoogle = window.adsbygoogle || []).push({});
Lab Test Considerations: Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy. Commonly ↓ serum potassium. May cause ↓ serum sodium, calcium, and magnesium concentrations. May also cause ↑ BUN, serum glucose, serum creatinine, and uric acid levels. Potential Diagnoses
Implementation
IV Administration
Patient/Family Teaching
Evaluation/Desired Outcomes
furosemide is a sample topic from the Davis's Drug Guide. To view other topics, please log in or purchase a subscription. Nursing Central is an award-winning, complete mobile solution for nurses and students. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Complete Product Information. Which client is at greatest risk for the development of hypocalcemia?Who is at risk for hypocalcemia? People with a vitamin D or magnesium deficiency are at risk of hypocalcemia. Other risk factors include: a history of gastrointestinal disorders.
Which drug therapy might be used to manage symptoms of hypocalcemia?In patients with acute symptomatic hypocalcemia, intravenous (IV) calcium gluconate is the preferred therapy, whereas chronic hypocalcemia is treated with oral calcium and vitamin D supplements.
Which intervention with the nurse expect to be prescribed for a patient with hyponatremia?Nursing Interventions for Hyponatremia
Hypervolemic Hyponatremia: Restrict fluid intake and in some cases administer diuretics to excretion the extra water rather than sodium to help concentrate the sodium. If the patient has renal impairment they may need dialysis.
Which client is at greatest risk for the development of hyperkalemia?A person with diabetes mellitus who has hyporeninemic hypoaldosteronism associated with diabetic nephropathy is at high risk for hyperkalemia due to a diminished ability to shift potassium into the intracellular space (insulin deficiency) and impaired renal excretion (aldosterone deficiency).
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