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Furosemide/Lasix

 


- for Edema, HTN, CHF; 
- loop diuretic that inhibits Na and Cl reabsorption at the loop of Henle; 
- has direct venodilating effect useful in Rx of acute pulmonary edema accompanied by volume overload 
- try 20-40mg IV; 
- CHF/Acute Pulmonary Edema Dose IV Dose: 20-40mg (over 2-5 min) if insufficient response, may double dose q1hr upto total dose of 400mg; 
- Larger initial doses (80-120mg) required if patient on maintenance lasix, severe CHF or severe Renal Failure; 
- PO:20-80mg initially, if insufficient response after 8-12hr, increase dose by 20-40mg 
- Maximum daily dose =600mg/day; 
- Best response by intermittent dosage (2-4 consecutive days/week); 
- Note that doses >100mg should be infused at a rate not exceeding 4mg/min to avoid ototoxicity; 
- Alternative IV Dose: 20-40mg (2-5min) increase this dose by 20mg increments at least 2 hrs after initial dose: adequate dose can be given qd or bid; 
- HTN: intial dosage: 40mg PO bid; adjust dose according to blood pressure; 
- Note that onset of diuresis is 5 min following IV infusion, onset 30min-1hr following PO dose and lasts for several hours; 
- Watch for Hypokalemia, Hyperuricemia, Hepatic encephalopathy 


Renal response to furosemide in critically ill patients.  

Questionable value of furosemide in preventing renal failure 

Renal hemodynamic response to furosemide in septic and injured patients.