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Furosemide (furosemidum, furosemidi) is used for treating fluid build-up and swelling caused by congestive heart failure, liver cirrhosis, or kidney disease. It is also used in combination with other medicines to treat fluid build-up in the lungs. Furosemide is a loop diuretic. Loop diuretics make the kidneys eliminate larger amounts of electrolytes (especially sodium and potassium salts) and water than normal (diuretic effect). Loop diuretics are useful for treating many conditions in which salt and water retention (eg, edema, swelling) is a problem.
Furosemide belongs to a class of drugs known as diuretics, or "water pills." Lasix happens to be a strong diuretic, and is indicated to treat excess fluid and swelling in the body caused by conditions such as heart failure, kidney failure, and cirrhosis (a liver disease). Side effects associated with this drug include low blood pressure, and water and electrolyte depletion.
Mode of action - a diuretic natriuretic.
Valid throughout the ascending limb of Henle's loop of thick segment and blocks the reabsorption of 15-20% of the filtered ions Na +. Secreted into the lumen of the renal proximal tubules. Increases the excretion of bicarbonate, phosphate ions, Ca2 +, Mg2 +, K +, increases the pH of urine. It has secondary effects caused by release of mediators and intrarenal redistribution intrarenal blood flow. Quickly and adequately absorbed by any route of administration. Oral bioavailability is typically 60-70%. Binding to plasma proteins - 91-97%. . T1 / 2 0.5-1 hours in the liver biotransformation education inactive metabolites (mainly - glucuronide). Excreted by the kidneys by 88% and 12% - in the bile.
The diuretic effect is characterized by considerable severity, short duration and dose-dependent. After oral administration it occurs within 15-30 minutes, reaching a maximum after 1-2 hours and lasts 6-8 hours on / in the injection is manifested in 5 minutes, peak -. 30 minutes duration - 2 h excretion period. Na + ions increases significantly, however, after its termination rate of excretion of Na + ions is decreased below the initial level (the phenomenon of "rebound" or return). The phenomenon is caused by a sharp activation of the renin-angiotensin and other antinatriuretic neurohormonal regulation units in response to a massive diuresis. Argininvazopressinovuyu and stimulates the sympathetic system, reduces the levels of atrial natriuretic factor in plasma causes vasoconstriction. Due to the "rebound" phenomenon when taking 1 per day can have a significant impact on the daily excretion of ions Na +. Effective in Heart Failure (both acute and chronic), improves the functional class of heart failure, as reducing the pressure of the left ventricle filling. Reduces peripheral edema, congestion in the lungs, pulmonary vascular resistance, pulmonary capillary wedge pressure in the pulmonary artery and the right atrium. Maintains efficiency with low glomerular filtration rate, so is used to treat hypertension in patients with renal insufficiency.
Cardio-vascular system and blood (blood, hemostasis): decrease in blood pressure, including orthostatic hypotension, collapse, tachycardia, arrhythmia, decreased CBV, leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.
From the water-electrolyte metabolism: hypovolemia, hypokalemia, hypomagnesemia, hyponatremia, hyposalemia, hypocalcemia, hypercalciuria, metabolic alkalosis, impaired glucose tolerance, hyperglycemia, hypercholesterolemia, hyperuricemia, gout, increased LDL cholesterol (in high doses), dehydration (risk the development of thrombosis and thromboembolism, often in elderly patients).
From the digestive tract: loss of appetite, dryness of the oral mucosa, thirst, nausea, vomiting, constipation / diarrhea, cholestatic jaundice, pancreatitis (aggravation).
From the nervous system and sensory organs: dizziness, headache, paresthesia, lethargy, weakness, weakness, lethargy, drowsiness, confusion, muscle weakness, leg cramps (tetany), inner ear damage, hearing loss, blurred vision.
With the genitourinary system: oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, reduced potency.
Allergic reactions: purpura, photosensitivity, urticaria, pruritus, exfoliative dermatitis, erythema multiforme, vasculitis, necrotizing vasculitis, anaphylactic shock.
Other: chills, fever; with a / in the introduction (optional) - thrombosis, calcification of the kidneys in premature infants.
Inside, in / m or / in. The batch is individually, depending on indications, clinical situation, patient age. During treatment dosing regimen is adjusted depending on the size and dynamics of the diuretic response of the patient.
Inside (in the morning before eating) for adults: an initial dose of 20-40 mg; if necessary, may increase the dose of 20-40 mg every 6-8 hours (large doses divided into 2-3 doses); if necessary, a single dose may be increased to 600 mg. Children: initial single dose - 1-2 mg / kg, maximum - 6 mg / kg. V / m or / - mono-, 20-40 mg (if necessary - to increase the dose of 20 mg every two hours). Jet / in a produce slowly over 1-2 minutes. At higher doses (80-240 mg or more) is administered / drip at a rate not higher than 4 mg / min. For children, the initial daily dose for parenteral administration - 1 mg / kg.
For breeding, use isotonic solutions of sodium chloride or glucose with a pH of at least 5.5.
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