(Furosemide) Loop diuretic that used for treating fluid-up.
Furosemide
Loop diuretic that used
for treating fluid-up
· Furosemide is a type of medicine called a
diuretic.
· Furosemide is used to reduce extra fluid in
the body (edema) caused by conditions such as heart failure, liver
disease and kidney disease.
· Furosemide - high ceiling.
· They are organic compounds containing a benzenesulfonamide with an amine group attached to a benzene ring.
•
Drug Class &
Brand Name
•
Clinical Uses
•
Mechanism of
action
•
Electrolyte
impact
•
Side effects
•
Test your
knowledge
• TL; DR
Drug Class
• Loop Diuretic
• Antihypertensive
Brand Name
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· Absorption: 60-67% absorbed after oral administration.
· Protein Binding: 91-99%.
· Metabolism: Minimally metabolized liver, some
nonhepatic metabolism.
· Excretion: via kidney by glomerular filtration
of tubular secretion.
· Half-life: 30-60 min
· Edema
caused by heart failure, liver scarring or kidney disease
· Hypertension (not very effective due to short duration of
action; the initial fluid loss can be counteracted by activation of the RAAS)
· Ascites due to cirrhosis (use together with spironolactone, unless patient has hyperkalaemia)
· Inhibits reabsorption of sodium and chloride
in the ascending loop of Henle and proximal and distal renal tubules.
· Interfere with the chloride-binding
cotransport system.
· Remove sodium from body (natriuretic effect).
· Osmotic forces drag water out of the body's blood circulation (diuretic effect).
•
Potassium
(Hypokalemia) ↓
That's why sometimes it is used together with potassium-sparing diuretics to keep the K level
normal
•
Sodium
(Hyponatremia) ↓
•
Magnesium
(Hypomagnesemia)↓
•
Calcium
(Hypocalcemia) ↓
• Uric acid (Hyperuricemia) ↑
• Fluid/electrolyte
loss
· If given in excessive amounts, it can lead to
a profound diuresis with water and electrolyte depletion.
• Acute kidney
injury (Risk of AKI due to volume depletion)
• Ototoxicity (Usually
reversible)
· Caused by inhibition of a secretory isoform of the Na-K-2CI co-transporter in the inner ear
Test your knowledge
• Why Furosemide is used together with
Spironolactone in case of cirrhotic ascites?
Frusemide is a loop diuretic which causes
marked natriuresis and diuresis in normal subjects. It is generally used as an
adjunct to spironolactone treatment because of its low efficacy when used alone in cirrhosis.
• What are the optimal ratio of spironolactone-to-furosemide?
The recommended initial dose is spironolactone 100-200 mg/d and furosemide 20-40 mg/d. usual maximum doses are 400 mg/d of spironolactone and 160 mg/d of furosemide. The recommended weight loss in patients without peripheral edema is 300 to 500 g/d. There is no limit to the daily weight loss of patients who have edema.
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