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Furosemide Application

Chronic heart failure, pulmonary edema, hypertonic crisis, hydropic-ascitic syndrome with cirrhosis of the liver, kidney failure, nefrotichesky syndrome, expressed gipernatriemiya, hypercalcemia and gipermagniemiya.

Contraindications: Hypersensitivity (including to a sulfonamide), hepatic coma, severe violations of electrolyte balance, gipokaliemiya expressed the inadequacy of the functions of the liver and kidneys, oliguria for more than 24 h, anuria, gout, giperurikemiya, diabetes, or breach of tolerance to carbohydrates , decompensated mitral or aortic stenosis, increased pressure in the jugular vein over 10 mm Hg, hypertrophic cardiomyopathy with obstruction of left ventricular output tract, hypotension, myocardial infarction, systemic lupus erythematosus, pancreatitis, metabolic alkalosis.

Adverse effects: Hypertension, including postural, collapse, thromboembolism, throm (mostly elderly), gipokaliemiya, gipomagniemiya, hyponatremia, a breach of tolerance to glucose, giperurikemiya, gout, increased levels of cholesterol LPNP (at high doses), the violation KSCHS (gipohloremichesky alkalosis), giperkaltsiuriya, the violation of the functions of the liver , intrahepatic cholestasis, pancreatitis, diarrhea, constipation, nausea, vomiting, anorexia, loose inner ear, hearing loss, zatumanivanie vision, confusion, nervousness, headache, dizziness, paresthesia, weakness, muscle spasm, spasm of the bladder, chills, fever , thrombocytopenia, aplastic anemia, leukopenia, systemic vasculitis, interstitial nephritis, gematuriya, nekrotiziruyuschy angiitis, eksfoliativny dermatitis, erythema mnogoformnaya, impotence, photosensitization, hives, itchy skin.

Interaction: aminoglycosides, ethacrynic acid and cisplatin increased the ototoksichnost (especially when impaired renal function). Increases risk of kidney lesions on a background of amphotericin B. In the appointment of high doses of salicylates increases the risk of developing salitsilizma (competitive renal excretion), cardiac glycosides - gipokaliemii and related arrhythmias, corticosteroids - electrolyte imbalance. Decreases miorelaksiruyuschuyu activity tubokurarina, potentiator effect suktsinilholina. Decreases renal clearance (and increases the likelihood of intoxication) of lithium. Under the influence of furosemide increased the effect of inhibitors and antihypertensive APF funds, warfarin, diazoksida, teofillina declines - protivodiabeticheskih drugs, noradrenaline. Sukralfat and indometacin (due to inhibition of PG synthesis, disturbance in the plasma levels of renin and aldosterone excretion) reduce the effectiveness. Probenecid increases the concentration in serum (blocking excretion).

Overdosage: Symptoms: Hypertension, lowering OTSP, gipokaliemiya and gipohloremichesky alkaloz.Lechenie: the maintenance of vital functions.

Dosing and Administration: inside, in a daily dose of 20-60 mg, if necessary, may increase dose by 20-40 mg every 6-8 hours (high dose is divided into reception 2-3). V / m or / in - once, 20-40 mg (if needed - increasing doses of 20 mg every 2 h). Jet in / to make the introduction slowly, within 1-2 minutes. In high doses (80-240 mg or more) into the / in drops, at a rate no higher than 4 mg / min. The maximum daily dose - 600 mg.

Precautions: If there is ascites without peripheral edema recommended doses for further diuresis in the volume of no more than 700-900 ml / day to avoid the development of oliguria, azotemii and violations of electrolyte metabolism. To exclude the phenomenon of "rebound" in the treatment of hypertension appoint at least 2 times a day. It should be borne in mind that a long reception can lead to weakness, fatigue, lowering blood pressure and cardiac output, and excessive diuresis with myocardial infarction with stagnant phenomena in the small circle of blood circulation may contribute to the development kardiogennogo shock. There is a need for a temporary lifting of (several days) before the appointment of inhibitors of APF. During the first months of treatment is recommended to control blood pressure, levels of electrolytes (especially potassium), CO2, creatinine, urea nitrogen, uric acid, periodic determination of activity of liver enzymes, the level of calcium and magnesium content of glucose in the blood and in urine (diabetes). When you save oliguria within 24 h of furosemide should be abolished. It should not be used during the drivers of vehicles and people, a profession which is related to increased concentration.

Cautions: For breeding to be used isotonic solution of sodium chloride or glucose with a pH lower than 5.5.

Trading names of preparations with the active ingredient furosemide * (Furosemide *)

Laziks (Lasix) furosemide-N.S. (Furosemide-NS) furosemide injection 1% (Solutio Furosemidi pro injectionibus 1%), furosemide (Furosemide) furosemide-ratiofarm (Furosemid-ratiopharm) furosemide tablet 0,04 g (Tabulettae Furosemidi 0,04 g) Nikomed furosemide (Furosemide Nycomed ) furosemide-Ros (Furosemid-Ros) Tablets 40 mg furosemide (Furosemide tablets 40 mg) furosemide-Darnitsa (Furosemid-Darnitsa) furosemide-Teva (Furosemide-Teva) furosemide-Milve (Furosemide-Milve) furosemide-Fereyn (Furosemide-Ferein )

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Saturday, July 18, 2009

Furosemide (Furosemidum)

Furosemide (Furosemidum). 4-Chloro-M-(2-furilmetil)-5-sulfamoilantranilovaya acid. Synonyms: Laziks, Furantril, Afsamid, Arasemide, Diusemide, Diuzol, Dryptal, Edefrusex, Errolon, Franyl, Frugex, Frusemide, Frusolon, Furanthril, Furantral, Furfan, Furomex, Furosan, Furosemide, Fusid, Katlex, Kinex, Lasilix, Lasix, Nicorol, Profemin, Protargen, Rasisemid, Renex, Salix, Seguril, Trofurit, Uritol, Urosemid and other white crystalline powder. Insoluble in water. By its chemical structure (presence of chlorine atom and sulfanamidnoy groups with phenyl nucleus) has similarities with dihlotiazidom and close to the compounds. Is a strong diuretic furosemide (salureticheskim) tool. Effective oral and parenteral application. Diuretic effect associated with inhibition reabsorbtsii N and Cl ions, and this inhibition is observed not only in proximal but also in the distal tortuosity canals, and in the ascending loop Genle department. Reabsorbtsiya potassium as oppressed, but to a much lesser extent. Notable oppression is carbonic anhydrase. The product is equally effective in the context of acidosis and alkalosis. Diuretic effect is most pronounced during the first 2 days of taking the medication, but does not disappear even with long-term treatment. The drug acts quickly. After intravenous diuretic effect begins within a few minutes after taking the inside - in the first hour. Duration of action after a single intravenous 1.5 - 3 h after ingestion - 4 h or more. The rapid effect of intravenous furosemide allows use in urgent cases (pulmonary edema, brain, etc.). Furosemide is used as diuretics in the stagnant phenomena in the small and large circle of blood circulation caused by heart failure, liver cirrhosis with portal hypertension with the phenomena, chronic and acute renal failure, pulmonary edema and brain poisoning barbiturates, eclampsia. In contrast to thiazides, furosemide does not lower glomerular filtration, and its use in connection with that in chronic renal failure (if there is testimony to the use of diuretics). In several cases, furosemide has a diuretic effect in the lack of effectiveness of other drugs. Effectiveness of furosemide in the treatment of patients with circulatory insufficiency due not only to the diuretic effect, but also expanding to the direct effect on peripheral vessels. The first (early) phase, growing in the first 30 min after injection of the drug depends on its effect on peripheral vessels, and the second (late) phase, growing in 1 - 2 h after injection, associated with diuretic effects. Furosemide has also antihypertensive effect. The drug is effective in various forms of hypertension, including severe forms, in which other saluretiki ineffective. Mechanism of antihypertensive action is mainly the same as in the application tiazidnyh diuretics. Applied also to furosemide kupirovaniya heavy hypertonic crisis. For long-term therapy of patients with hypertension is recommended dihlotiazid (in connection with its less dramatic and more long-term effect). Furosemide may be used in combination with other antihypertensives drugs. Appoints furosemide inside to eat, intravenously and intramuscularly, selecting doses depending on the severity of the disease and the observed effect. Usually taken by 0.04 g (40 mg = 1 tablet) 1 times a day (morning), with little effect of the dose increased to 0,08 - 0,12 g (up to 0.16 g) per day (in 2 - 3 Admission to the interval 6 h). After reduction of edema given in lower doses with an interval 1 - 2 days. In hypertension, appoint furosemide on 20 - 40 mg (1 / 2 - 1 tablet) 1 times a day. In the accompanying heart failure daily dose can be increased to 80 mg. When you receive along with hypotensive drugs appoint furosemide usually 1 / 2 tablets (20 mg) 1 - 2 times a day. If you can not use of the drug inside (with loss of consciousness, a state of absorption from the intestines) and with the need for a rapid effect of furosemide injected intramuscularly or intravenously. Injected into a vein slowly jet. Doses in the parenteral use of 20 - 60 mg 1 - 2 times a day. After the necessary transition effects to receive the drug inside. In the application of furosemide may be nausea, diarrhea, skin hyperemia, pruritus, hypotension, reversible deterioration of hearing, interstitial nephritis. Due to enhanced diuresis may be dizziness, depression, muscle weakness, thirst. Can develop gipokaliemiya, giperurikemiya, urikozuriya, hyperglycemia. If you have adverse reactions the dose should be reduced or cancel the product. It is inappropriate to combine with Cephalosporins furosemide, gentamicin and other drugs that provide nefrotoksicheskoe operation. Treatment should be conducted against the background of a diet rich in potassium. Side effects: the first half of pregnancy, gipokaliemiya, hepatic coma, terminal stage renal failure, mechanical occlusion of the urinary tract. Method of production: tablets of 0.04 g per pack of 50 pieces, 1% solution in ampoules of 2 ml (0.02 g) per pack of 5 ampoules. Storage: List B.
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Friday, July 17, 2009

Furosemide following survey

Do not freeze the medication.

Do not store medicine in the bathroom. Do not expose him exposed to high temperatures, moisture or direct sunlight.

CAPTOPRIL, tsefaleksin, activated charcoal, hlorpropamid, cholestyramine, tsisplatil, digoxin, lithium salts, propranol, teofillin cause "clinically vysokoznachitelnye" or "clinically significant" interaction when used together with this drug. Some other drugs, particularly those relating to the same groups as listed below are described in the interaction with the drug can cause serious side effects. With an increasing number of new drugs approved for sale, and increases the risk of adverse interactions with the joint application, which is often identified with the old drugs. Be vigilant. Be sure to tell your doctor about all medicines you take, and pay special attention to the doctor if you are taking any medications that interact with the drug before.

Immediately call a doctor if you experience: dry mouth, severe thirst, violations of the heart rate, sudden shifts of mood, cramps or pain in muscles, severe stomach pain accompanied by nausea or vomiting, unusual tiredness or weakness, weak pulse, ksantopsiya (yellow pall before my eyes), cough or hoarseness, fever or chills, joint pains, lower back or sides, painful or difficult urination, small red dots on the skin, the noise in the ears or hearing loss, skin rashes or hives, unusual bleeding or bruising, yellow eyes or skin.

Call a doctor if you constantly, for a sufficiently long period of time, you are observed: dizziness, weakness, diarrhea, loss of appetite, discomfort in the stomach, headache, confusion of view, the "veil before the eyes, premature semyaizverzhenie or Erectile Dysfunction.

Ask your physician if any of the following survey, you should periodically take place during the reception of this drug: blood pressure measurement, clinical analysis of blood tests to determine the level of sodium, potassium, chloride ion, calcium, sugar and uric acid, the functional Samples of liver, kidney function tests, hearing checks, weight.

During pregnancy the drug should be used only if absolutely necessary. Before taking this drug should be informed of his attending physician, if you are pregnant or have any suspicion that you are pregnant.

Thursday, July 16, 2009

Furosemide Beta Blockers

If this drug is not reducing the pressure to your desired level, your doctor may appoint one of the beta-blockers such as propranolol instead takes you to the potent diuretics such as furosemide.

Which antihypertensive drugs, you would not have been as soon as your pressure to normal, and will remain so for a year or more, should try to reduce the dosage carefully and pay attention to non-treatment, in accordance with the recommendations of The Medical Letter.

In an editorial in the British Medical Journal says: "Treatment of hypertension is the prerogative of preventive medicine, and as with any other preventive strategies, the dynamics of treatment should be regularly monitored by your doctor. Many problems are avoided, if not to initiate drug therapy for hypertension and careful survey of the patient. Patients should not say that the treatment of hypertension should continue throughout life, the possibility of reducing the dose or complete abolition of antihypertensive drugs should be said from the beginning. "

Do not take this medication if you have seen or experienced sensitivity to sulfanilamide.

Inform your physician if you have seen or observed: allergy to medications, diabetes, recent heart attack, gout, kidney disease, liver and pancreas, hearing loss, lupus erythematosus, limiting consumption of sugar and salt.

Tell your doctor what medicines you are taking, including aspirin, herbs, vitamins and other medications.

Talk to your doctor and make sure that you are taking adequate fluids. Since furosemide is a very powerful diuretics, there is a risk of dehydration.

Try, if possible, do not lie in the sun. If you have a rash, hives or any other skin reaction, call your doctor. Acceptance of this medicine may increase your sensitivity to sunlight.

Admission is furosemide washout from the body, potassium is very important to ensure a normal life.

Sunday, July 5, 2009

Furosemide can cause...

This medication may cause dizziness when lifting from a sitting or recumbent position. With the rise of the bed should first overhangs legs and stay in this position a few minutes, then gently lift. When lifting a chair to get up slowly and some time to stand next to a chair until you verify that you are not dizzy.

Furosemide can cause hearing loss, usually temporary, but in some cases irreversible. The risk of hearing loss increases, if you both agree to amphotericin B or an antibiotic group aminoglyukozidov.

If you have a surgery, including dental treatment, inform your doctor that you are taking this medication.

Do not take any other medications without first without consulting your doctor, especially released without prescription anorectics drugs (drugs that reduce appetite), as well as drugs used to treat asthma, colds, cough, hay fever, sinusitis.

This drug may impair the ability of your body to adjust to high temperatures, thus increasing the risk of heatstroke. If you live alone, ask someone from your friends to visit several times a day. The symptoms of heat stroke are dizziness, weakness and a slight fever. If you have seen any of these symptoms should call a doctor.

It should drink more fluids (water, fruit and vegetable juice) than usual - even if you do not want to drink - except the case when the doctor advises not to do so. You should not drink alcoholic beverages.

Take it with food or milk to avoid stomach irritation. You can crush pills and mix them with food or drink.

If you are taking furosemide more than once a day, try to take the last dose of up to 18 hours. Then you do not have to get up the middle of the night to go to the toilet.

If you missed receiving the drug should take it as soon as possible, but if in the near future should take the next dose, skip the inbox. Do not take a double dose.

Furosemide

Furosemide is a potent diuretics with a lot of side effects. It is used to delay treatment of fluid in the body and high blood pressure. If you have more than 60 years, you should apply only when furosemide delayed fluid in the body, and only if you have impaired kidney function, and you've already used more sparing drug such as gidrohlortiazid and its use does not yield results. People over 60 years of age with normal kidney function is not recommended for furosemide, with few exceptions.

WHO does not recommend the use of furosemide to reduce high blood pressure in elderly patients, since there are several reports of the existence of correlation between the use of furosemide and the risk of stroke. Elderly patients are at greater risk trombooborazovaniya, shock, dizziness, blurred of reason, insomnia, and fainting as a result of receiving furosemide.

If you have hypertension, the best way to get rid of the need to receive medications are such measures as changing diet, reducing body weight, regular exercise and reducing the consumption of salt and alcohol. A small rise in pressure can be controlled through proper diet and exercise. If these actions do not lead to sufficient reduction in pressure and you need medication, you should choose gidrohlortiazid, diuretic drug, and begin with a small dose - 12.5 mg / day. The benefits of this drug include the fact that it is cheaper all other antihypertensive drugs. There is convincing evidence that tiazidovye diuretics such as hydrochlorothiazide, significantly decrease the rate of leaching of minerals from bone tissue as in men and women, because they reduce the amount of calcium in urine output. A growing number of researchers also tend to believe that these drugs reduce the risk of fractures.