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    The parenteral administration of furosemide is indicated in cases where oral administration is not feasible or not efficient (for example in case of reduced intestinal absorption) or when a quick effect is required. To achieve optimum efficacy and suppress counter-regulation, a continuous furosemide infusion is generally to be preferred to repeated bolus injections. Where continuous furosemide infusion is not feasible for follow-up treatment after one or several acute bolus doses, a follow-up regimen with low doses given at short intervals (approx. 4 hours) is to be preferred to a regimen with higher bolus doses at longer intervals. Generally, Furosemide should be administered intravenously. Intramuscular administration must be restricted to exceptional cases where neither oral nor intravenous administration is feasible. It must be noted that intramuscular injection is not suitable for the treatment of acute conditions such as pulmonary oedema. In the absence of conditions requiring a reduced dose (see below) the initial dose recommended for adults and adolescents over 15 years, is of 20 mg to 40 mg furosemide by intravenous (or in exceptional cases intramuscular) administration; the maximum dose varying according to individual response. In either case, the rate of infusion should not exceed 4mg/minute. amoxil tabs Edema associated with congestive heart failure (CHF), liver cirrhosis, and renal disease, including nephrotic syndrome 20-80 mg PO once daily; may be increased by 20-40 mg q6-8hr; not to exceed 600 mg/day Alternative: 20-40 mg IV/IM once; may be increased by 20 mg q2hr; individual dose not to exceed 200 mg/dose Refractory CHF may necessitate larger doses Excessive diuresis may cause dehydration and electrolyte loss in elderly; lower initial dosages and more gradual adjustments are recommended (eg, 10 mg/day PO)Increase in blood urea nitrogen (BUN) and loss of sodium may cause confusion in elderly; monitor renal function and electrolytes Anaphylaxis Anemia Anorexia Diarrhea Dizziness Glucose intolerance Glycosuria Headache Hearing impairment Hyperuricemia Hypocalcemia Hypokalemia Hypomagnesemia Hypotension Increased patent ductus arteriosus during neonatal period Muscle cramps Nausea Photosensitivity Rash Restlessness Tinnitus Urinary frequency Urticaria Vertigo Weakness Toxic epidermal necrolysis, Stevens-Johnson Syndrome, erythema multiforme, drug rash with eosinophila and systemic symptoms, acute generalized exanthematous pustulosis, exfoliative dermatitis, bullous pemphigoid purpura, pruritus Agent is potent diuretic that, if given in excessive amounts, may lead to profound diuresis with water and electrolyte depletion Careful medical supervision is required; dosing must be adjusted to patient's needs Use caution in systemic lupus erythematosus, liver disease, renal impairment Concomitant ethacrynic acid therapy (increases risk of ototoxicity) Risks of fluid or electrolyte imbalance (including causing hyperglycemia, hyperuricemia, gout), hypotension, metabolic alkalosis, severe hyponatremia, severe hypokalemia, hepatic coma and precoma, hypovolemia (with or without hypotension) Do not commence therapy in hepatic coma and in electrolyte depletion until improvement is noted IV route twice as potent as PO Food delays absorption but not diuretic response May exacerbate lupus Possibility of skin sensitivity to sunlight Prolonged use in premature neonates may cause nephrocalcinosis Efficacy is diminished and risk of ototoxicity increased in patients with hypoproteinemia (associated with nephrotic syndrome); ototoxicity is associated with rapid injection, severe renal impairment, use of higher than recommended doses, concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs To prevent oliguria, reversible increases in BUN and creatinine, and azotemia, monitor fluid status and renal function; discontinue therapy if azotemia and oliguria occur during treatment of severe progressive renal disease FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur In cirrhosis, electrolyte and acid/base imbalances may lead to hepatic encephalopathy; prior to initiation of therapy, correct electrolyte and acid/base imbalances, when hepatic coma is present High doses ( 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels In patients at high risk for radiocontrast nephropathy furosemide can lead to higher incidence of deterioration in renal function after receiving radiocontrast compared to high-risk patients who received only intravenous hydration prior to receiving radiocontrast Observe patients regularly for possible occurrence of blood dyscrasias, liver or kidney damage, or other idiosyncratic reactions Cases of tinnitus and reversible or irreversible hearing impairment and deafness reported Hearing loss in neonates has been associated with use of furosemide injection; in premature neonates with respiratory distress syndrome, diuretic treatment with furosemide in the first few weeks of life may increase risk of persistent patent ductus arteriosus (PDA), possibly through a prostaglandin-E-mediated process Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients Increases in blood glucose and alterations in glucose tolerance tests (with abnormalities of fasting and 2 hour postprandial sugar) have been observed, and rarely, precipitation of diabetes mellitus reported Patients with severe symptoms of urinary retention (because of bladder emptying disorders, prostatic hyperplasia, urethral narrowing), the administration of furosemide can cause acute urinary retention related to increased production and retention of urine; these patients require careful monitoring, especially during initial stages of treatment Hypokalemia may develop with furosemide, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids, ACTH, licorice in large amounts, or prolonged use of laxatives Pregnancy category: C; treatment during pregnancy necessitates monitoring of fetal growth because of risk for higher fetal birth weights Lactation: Drug excreted into breast milk; use with caution; may inhibit lactation Loop diuretic; inhibits reabsorption of sodium and chloride ions at proximal and distal renal tubules and loop of Henle; by interfering with chloride-binding cotransport system, causes increases in water, calcium, magnesium, sodium, and chloride Solution: Fructose10W, invert sugar 10% in multiple electrolyte #2 Additive: Amiodarone (at high concentrations of both drugs), buprenorphine, chlorpromazine, diazepam, dobutamine, eptifibatide, erythromycin lactobionate, gentamicin(? ), isoproterenol, meperidine, metoclopramide, netilmicin, papaveretum, prochlorperazine, promethazine Syringe: Caffeine, doxapram, doxorubicin, eptifibatide, metoclopramide, milrinone, droperidol, vinblastine, vincristine Y-site: Alatrofloxacin, amiodarone (incompatible at furosemide 10 mg/m L; possibly compatible at 1 mg/m L), chlorpromazine, ciprofloxacin, cisatracurium (incompatible at cisatracurium 2 mg/m L; possibly compatible at 0.1 mg/m L), clarithromycin, diltiazem, diphenhydramine, dobutamine, dopamine, doxorubicin (incompatible at furosemide 10 mg/m L and doxorubicin 2 mg/m L; possibly compatible at furosemide 3 mg/m L and doxorubicin 0.2 mg/m L), droperidol, eptifibatide, esmolol, famotidine(? ), fenoldopam, gatifloxacin, gemcitabine, gentamicin(? ), hydralazine, idarubicin, labetalol, levofloxacin, meperidine, metoclopramide, midazolam, milrinone, morphine, netilmicin, nicardipine, ondansetron, quinidine, thiopental, vecuronium, vinblastine, vincristine, vinorelbine Not specified: Tetracycline Additive: Cimetidine, epinephrine, heparin, nitroglycerin, potassium chloride, verapamil Syringe: Heparin Y-site: Epinephrine, fentanyl, heparin, norepinephrine, nitroglycerin, potassium chloride, verapamil(? ), vitamins B and C Injection: Inject directly or into tubing of actively running IV over 1-2 minutes Administer undiluted IV injections at rate of 20-40 mg/min; not to exceed 4 mg/min for short-term intermittent infusion; in children, give 0.5 mg/kg/min, titrated to effect Use infusion solution within 24 hours The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

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    Apr 27, 2010. Continuous versus bolus dosing of Furosemide for patients hospitalized for heart failure. Allen LA1, Turer AT, Dewald T, Stough WG, Cotter G. buy cialis online overnight delivery Although use in clinical practice is not uncommon, limited published data are available evaluating furosemide prior to or after the administration of blood. IV Lasix Furosemide for Heart Failure Relapse What is heart failure? If you have heart failure, your heart muscles have become weakened and do not pump blood as well as they should. It does not mean that your heart has stopped working. The blood flow that is normally pumped forward backs up into your lungs and other parts of the body.

    IV/IM: Initial dose: 20 to 40 mg IV (slowly over 1 to 2 minutes) or IM once; may repeat with the same dose or increase by 20 mg no sooner than 2 hours after the previous dose until the desired diuretic effect has been obtained. Maintenance dose: Administer the dose that provided the desired diuretic effect once or twice a day. Use: Treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome, especially when an agent with greater diuretic potential is desired. Oral: Initial dose: 20 to 80 mg orally once; may repeat with the same dose or increase by 20 or 40 mg no sooner than 6 to 8 hours after the previous dose until the desired diuretic effect has been obtained. Maintenance dose: Administer the dose that provided the desired diuretic effect once or twice a day (e.g., at 8 am and 2 pm). Maximum dose: 600 mg/day in patients with clinically severe edematous states Comments: -Edema may be most efficiently and safely mobilized by giving this drug on 2 to 4 consecutive days each week. -When doses greater than 80 mg/day are given for prolonged periods of time, careful clinical observation and laboratory monitoring are particularly advisable. Absorption: 60–67% absorbed after oral administration (↓ in acute HF and in renal failure); also absorbed from IM sites. Metabolism and Excretion: Minimally metabolized by liver, some nonhepatic metabolism, some renal excretion as unchanged drug. TIME/ACTION PROFILE (diuretic effect)CNS: blurred vision, dizziness, headache, vertigo EENT: hearing loss, tinnitus CV: hypotension GI: anorexia, constipation, diarrhea, dry mouth, dyspepsia, ↑ liver enzymes, nausea, pancreatitis, vomiting GU: ↑ BUN, excessive urination, nephrocalcinosis Derm: Edema PO: (Adults) 20–80 mg/day as a single dose initially, may repeat in 6–8 hr; may ↑ dose by 20–40 mg q 6–8 hr until desired response. Distribution: Crosses placenta, enters breast milk. 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 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 q 6–8 hr (maximum dose = 6 mg/kg). 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 q 6–12 hr; Continuous infusion– Bolus 0.1 mg/kg followed by 0.1 mg/kg/hr, double q 2 hr to a maximum of 0.4 mg/kg/hr. IM: IV: Children 1–2 mg/kg/dose q 6–12 hr; Continuous infusion– 0.05 mg/kg/hr, titrate to clinical effect. Hypertension PO: (Adults) 40 twice daily initially (when added to regimen, ↓ dose of other antihypertensives by 50%); adjust further dosing based on response. Tablets: 20 mg, 40 mg, 80 mg, 500 mg Cost: Generic: 20 mg $6.50/100, 40 mg $7.11/100, 80 mg $10.83/100Oral solution (10 mg/m L–orange flavor, 8 mg/m L–pineapple–peach flavor): 8 mg/m L, 10 mg/m LCost: Generic: 10 mg/m L $10.40/60 m LSolution for injection: 10 mg/m LLab Test Considerations: Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy. May cause ↓ serum sodium, calcium, and magnesium concentrations. May also cause ↑ BUN, serum glucose, creatinine, and uric acid levels.furosemide is a sample topic from the Davis's Drug Guide.

    Lasix ivp

    Question regarding IV vs. IVP - General Students - allnurses, Furosemide Injection furosemide dose, indications, adverse effects.

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  3. LASIX® furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore.

    • Lasix Furosemide Side Effects, Interactions, Warning, Dosage & Uses
    • IV Lasix furosemide for Heart Failure Relapse - osumc.edu
    • Lasix furosemide dosing, indications, interactions, adverse effects.

    Apr 26, 2018. Recommended routes IM, IV-push, Continuous infusion. Doses up to 6 grams/day have been used in patients with renal failure. Dosing 20 to. nolvadex dosage pct Detailed Furosemide dosage information for adults and children. Includes dosages for Hypertension, Edema, Congestive Heart Failure and more; plus renal, liver and dialysis adjustments. Int J Clin Pharmacol Res. 1998;183121-8. Diuretic effects of furosemide infusion versus bolus injection in congestive heart failure. Pivac N1, Rumboldt Z.

     
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