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. Why should the nurse monitor the patients fluid intake and output closely during oxytocin administration?Because oxytocin possesses slight antidiuretic activity, its prolonged i.v. administration at high doses in conjunction with large volumes of fluid, as may be the case in the treatment of inevitable or missed abortion or in the management of postpartum haemorrhage, may cause water intoxication associated with ...
Which of the following is the most serious adverse affect associated with oxytocin administration during labor?– Foetal distress and foetal death: Administration of oxytocin at excessive doses results in uterine overstimulation which may cause foetal distress, asphyxia and death, or may lead to hypertonicity, tetanic contractions or rupture of the uterus.
When should oxytocin be administered?Timing of oxytocin initiation
In the United States, oxytocin is the uterotonic most often administered at birth. It is commonly administered: 1) after delivery of the baby's anterior shoulder, 2) after delivery of the baby but before delivery of the placenta, or 3) after delivery of the placenta.
When determining the duration of a uterine contraction the right technique is to time it from?When timing contractions, start counting from the beginning of one contraction to the beginning of the next. The easiest way to time contractions is to write down on paper the time each contraction starts and its duration, or count the seconds the actual contraction lasts, as shown in the example below.
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