Furosemide, a loop diuretic, causes a rapidly advancing, short-term and violent diuresis. This drug blocks the reabsorption of chlorine and sodium ions, both in the distal and in the proximal areas of the renal tubules, as well as in the thick segment of the ascending part of the Gentle loop.
Furosemide - instructions for use in various dosage forms
Instructions for use Furosemide as a solution
According to the instructions for use of Furosemide, the drug is administered intravenously and intramuscularly, and is also ingested. The dosage regimen depends on the patient's age, indications, and the clinical situation is set individually. The dosage regimen during the treatment, depending on the magnitude of the diuretic response and the dynamics of the patient's condition, is corrected. Inside( before meals, in the morning), adults: the initial dose is 20-40 mg;if necessary, it is possible to increase the dose by 20-40 mg every 6-8 hours( divide large doses into 2-3 doses).
Children: a single initial dose of 1-2 mg per kilogram of body weight, the maximum dose at the same time is 6 mg per kilogram of body weight. Intramuscularly or intravenously, 20-40 mg( dose is increased every 2 hours if necessary for 20 mg).Injection is administered intravenously slowly, for 1-2 minutes. In high doses( 80-240 mg and more) intravenously injected drip, with the speed should not exceed 4 mg / min. The initial daily dose for children for parenteral administration of Furosemide is 1 mg per kilogram of body weight.
Instruction for the use of Furosemide in the form of tablets
It is recommended to use Furosemide in ascites without peripheral outflows in doses that can provide an additional diuresis in the volume of not more than 700-900 milligrams per day in order to prevent the development of disturbances of electrolyte metabolism, oliguria and development of azotemia. In the treatment of hypertension, in order to rule out the phenomenon of ricochet, Furosemide is prescribed at least twice a day. You should also know that prolonged use of Furosemide can result in the development of weakness, fatigue, lowering of blood pressure and cardiac output, and excessive diuresis may cause the development of myocardial infarction of cardiogenic shock with congestive phenomena in the small circulation.
Before initiating the administration of ACE inhibitors, a temporary cancellation of Furosemide should be performed( only a few days).To prevent the development of hypokalemia, it is advisable to use potassium-sparing diuretics together with Furosemide, and also prescribe potassium preparations. It is recommended to adhere to a potassium-rich diet while treating Furosemidon. At the course of treatment with this drug, control over the level of urea nitrogen, uric acid, creatinine, electrolytes( in particular potassium), CO2, arterial pressure, periodic determination of glucose, calcium and magnesium levels in blood and urine( with diabetes) is recommended.the degree of activity of liver enzymes. Patients suffering from hypersensitivity to sulfonamides and sulfonylurea derivatives may also have a cross-over hypersensitivity to Furosemide. If the oliguria is preserved during the day, the drug Furosemide should be discarded. It is not advisable to use this drug in the management of vehicles, as well as if professional activity is associated with concentration of attention and increased reaction speed.
Indications, contraindications, side effects of Furosemide
Indications for use Furosemide
Furosemide preparation is perforated for use with:
- Carrying out forced diuresis, including poisoning with chemical compounds, which are excreted unchanged by the kidneys;
- Severe arterial hypertension;
- Some forms of hypertensive crisis;
- Cardiac asthma;
- Brain edema;
- Osteal syndrome with nephrotic syndrome, liver cirrhosis, chronic heart failure 2-3 stages, acute heart failure;
- Pulmonary edema.
The preparation Furosemide is taken orally in the following cases:
- Acute renal failure( including with burns and pregnancy, to maintain the excretion of fluid);
- Otitis syndrome of various origins, including liver diseases( including cirrhosis of the liver), nephrotic syndrome( but in this case, treatment of the underlying disease is in the forefront), chronic heart failure, chronic renal failure;
- Arterial hypertension.
Contraindications to the use of Furosemide
The drug Furosemide is contraindicated in the following cases:
- Age to three years( tablets);
- Hypertrophic obstructive cardiomyopathy, hyperuricemia, increase in pressure in the jugular vein of more than 10 mm PT.st.;
- Acute glomerulonephritis;
- Decompensated mitral or aortral stenosis;
- Sharply expressed urinary efflux of any origin( including unilateral urinary tract damage);
- Digistally toxic intoxication;
- Severe violations of electrolyte balance( including pronounced hypokalemia and hyponatremia);
- Hypovolemia or dehydration;
- Hepatic coma or precoma;
- Renal failure with anuria;
- Severe hepatic impairment;
- Hypersensitivity( including sulfonamides, as well as derivatives of sulfonylureas).
Side effects of Furosemide
The use of Furosemide may result in the following side effects:
- Blood and circulatory system: aplastic anemia, hemolytic anemia, eosinophilia, thrombocytopenia, agranulocytes, leukopenia, decreased circulating blood volume, tachycardia, arrhythmia, lowering blood pressureincluding orthostatic hypotension), collapse;
- Water-electrolyte metabolism: dehydration( risk of thrombosis and thromboembolism, more often in elderly patients), increased LDL cholesterol, gout, hypercholesterolemia, hyperuricemia, hyperglycemia, hyperchloremia, hypocalcemia, hyponatremia, hypokalemia, hypomagnesemia, hypovolemia;
- Digestive system: irritation and dryness of the oral mucosa, colic, anorexia, increased activity of liver enzymes, hepatic encephalopathy in patients with hepatocellular insufficiency, exacerbation of pancreatitis, cholestatic jaundice, constipation and diarrhea, vomiting, thirst, nausea, decreased appetite;
- Nervous system and sensory organs: blurred vision, xanthopsia, tinnitus, hearing loss, inner ear damage, hearing impairment, muscle weakness, calf muscle cramps, drowsiness, confusion, lethargy, adynamia, weakness, apathy, headache, paresthesia, dizziness.
- Genitourinary system: decreased potency, interstitial nephritis, hematuria, oliguria, acute urinary retention( in patients with prostatic hypertrophy);
- Allergic reactions: systemic hypersensitivity reactions, anaphylactic shock, vasculitis, necrotizing angiitis, erythema multiforme, itchy skin, exfoliative dermatitis, hives, purpura, photosensitivity;
- Other: bullous pemphigoid, chills, fever;
- When administered intravenously: non-proliferation of Botalov duct, nephrolithiasis, nephrocalcinosis in premature infants, thrombophlebitis.
Restrictions on the use of Furosemide
The drug Furosemide is restricted to use in the following cases:
- Conditions in which excessive lowering of blood pressure is considered particularly dangerous( stenosing lesions of the coronary or cerebral arteries);
- Ventricular arrhythmia in history;
- Systemic lupus erythematosus;
- Disorders of urinary outflow( hydronephrosis, prostatic hypertrophy, narrowing of the urethra);
- Hepatorenal syndrome;
- Acute myocardial infarction( the probability of developing a cardiogenic shock increases);
- Diabetes mellitus or impaired tolerance to carbohydrates;
- Arterial hypotension.
How long can I use Furosemide
Duration of application of Furosemide is determined by the physician individually in each case.
Use of Furosemide in Pregnancy
Furosemide may be used during pregnancy, but only for a short time and only if the expected therapeutic benefit for the mother is greater than the potential harm to the fetus( Furosemide passes through the placental barrier, strictly controlled and adequate studies of the use of this drugfunds in pregnant women were not conducted).If necessary during pregnancy Furosemide, then careful monitoring of the fetus is needed. For the period of treatment, this pharmaceutical drug should stop breastfeeding( Furosemide is released with breast milk, and may also affect lactation suppression).
Instructions for use Furosemide for children
Furosemide is contraindicated in children under three years of age.
Drug exposure of Furosemide
According to the instructions for use of Furosemide, this drug has chlororetic and natriuretic effects, increasing the excretion of Mg2 +, Ca2 +, K +.Penetrating the thick segment of the knee of the Gentle loop into the lumen of the renal tubule, it blocks the reabsorption of Cl- and Na +.Owing to the increase in the release of sodium ions, secondary( osmotically mediated by bound water) secondary increase in K + secretion and enhanced water elimination in the distal part of the renal tubule. The simultaneous excretion of Mg2 + and Ca2 + increases. Furosemide also has secondary effects due to the release of intracellular mediators, as well as redistribution of blood flow inside the kidneys. There is no weakening effect on the background of course therapy. With CH, it leads quickly to a decrease in preload in the heart through the expansion of large veins. Has hypotensive effects due to an increase in the degree of excretion of NaCl, as well as a decrease in the response of smooth vascular muscle to vasoconstrictor effects, resulting in bcc.
The effect of Furasemide on the body
Instructions for the use of Furosemide is prescribed that the effect of the drug begins approximately 5-10 minutes after its administration into the body. After taking this drug inside after 30-60 minutes, the maximum effect after 1-2 hours, the duration of the effect is 2-3 hours, and if there are violations of kidney function, the effect can last up to 8 hours. The excretion of Na + during the period of action is significantly increased, but after its termination the rate of inferiority is lowered below the initial value( withdrawal or rebound syndrome).The phenomenon is caused by a sharp activation of the renin-angiotensin and other antinaturnuretic neurohumoral regulatory links in response to massive diuresis;stimulates sympathetic and arginine-vasopressive systems. The degree of atrial natriuretic factor decreases in plasma, it causes a call of vasoconstriction. Due to the phenomenon of rebound in the application of Furosemide once a day can not have a significant effect on the daily release of AD and Na +.
Furosemide formulation has the following analogs for the active substance:
- Furosemide Ferein;
- Furosemide ratiopharm;
- Furosemide Darnitsa;
- Furosemide Vial;
- Furosemide Sopharma;
Reviews of Furosemide
Review of Nelli
I'm the model and most of my girlfriends of the mods have taken and are now taking Fuosemide in order to lose weight. Many people like the emergency measure helps, but not for long. The first time left me exactly 4 kg. Then overnight, an average of 3 kg. My girlfriends also have a minus or plus.
From time to time I accept for 15 years. Because of hormonal failure, the propensity to flow, do not do anything. It is always necessary to simultaneously take panangin.
Review of Svetlana
I have rarely swelling, but recently, due to extreme heat, I drink a lot of fluids and foolishly decided to take one furosemide pill. It was a nightmare! I every 15 minutes all night running to the toilet, did not get enough sleep, and the next day I felt sick and broken. Weighed 1.5 kg, but then everything was restored.