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Wheeless' Textbook of Orthopaedics
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Furosemide/Lasix


- for Edema, HTN, CHF; - loop diuretic that inhibits Na and Cl reabsorption at the loop of Henle; - Pulmonary Edema: - 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 least2hrs 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. Bradley VE. Shier MR. Lucas CE. Rosenberg IK. Surgical Forum. [JC:vb0 25(0):23-4, 1974. Questionable value of furosemide in preventing renal failure. Renal hemodynamic response to furosemide in septic and injured patients.



Original Text by Clifford R. Wheeless, III, MD.