Lasix and dialysis

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    Lasix and dialysis


    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. In a nuclear medicine renal scan, images, or pictures, are taken of fluid going into the kidneys through the bloodstream, the filtered wastes from the blood in the kidneys and the flow or drainage of the waste into the bladder through the ureters (that join the kidneys to the bladder). A nuclear medicine renal scan uses radiopharmaceuticals (radioactive medications) injected into a vein, usually in the arm, to provide clear images of the kidneys taken with a special camera called a gamma camera. The scan can be carried out using one of two different radiopharmaceuticals – DTPA (diethylene triamine pentaacetic acid) or MAG3 (mercaptoacetyletriglycine). They are similar medications, but MAG3 gives significantly clearer images in some patients, particularly very young children and those patients with poor kidney function. Your doctor will refer you for a nuclear medicine renal scan to look at the blood supply, function and flow of urine from the kidneys if it is suspected that there are problems with how your kidneys are working. Reduced kidney function may be shown in abnormal blood tests, high blood pressure or abnormal results obtained from the urine itself. It is important before having the scan that you drink plenty of fluids, so the gamma camera can take images of the fluid as it is collected in the kidneys and discharged through the ureters and into the bladder.

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    Furosemide is contraindicated in patients with anuria. It should be used cautiously in any patient with renal disease such as severe renal impairment or renal. Loop diuretics in high doses are the drugs of choice in the treatment of both acute renal failure ARF and chronic renal failure CRF. Their pharmacokinetic and. For the appropriate dialysis patient, a daily dose of furosemide. minimizes the interdialytic weight gain, may result in better blood pressure BP.

    Testosterone should be used with caution in patients with conditions involving edema, such as impaired kidney function, as the hormone may worsen edema. One of the adverse effects of testosterone is an increase in serum creatinine concentration. Read more Furosemide is a potent diuretic which increases dramatically urine output in most patients. It is most frequently used in patients who are fluid overloaded such as in congestive heart failure. Potassium , sodium and magnesium can be lost in excess with the use of Furosemide and must be closely monitored. It is much stronger than other diuretics used for The main risk is of bleeding within the tumor itself as it happens with persons who have a condition called tuberous sclerosis. Other than that if just occupies space but does not disturb the function of the organ. Read more Depends on the reason the patie t needed to be started on dialysis. Acute renal failure potentially can be recovered from, in which case dialysis is supportive. It is also used for liver cirrhosis, kidney impairment, nephrotic syndrome, in adjunct therapy for swelling of the brain or lungs where rapid diuresis is required (IV injection), and in the management of severe hypercalcemia in combination with adequate rehydration. Furosemide also can lead to gout caused by hyperuricemia. The tendency, as for all loop diuretics, to cause low serum potassium concentration (hypokalemia) has given rise to combination products, either with potassium or with the potassium-sparing diuretic amiloride (Co-amilofruse). Other electrolyte abnormalities that can result from furosemide use include hyponatremia, hypochloremia, hypomagnesemia, and hypocalcemia. Furosemide, like other loop diuretics, acts by inhibiting the luminal Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle, by binding to the chloride transport channel, thus causing sodium, chloride, and potassium loss in urine. The action on the distal tubules is independent of any inhibitory effect on carbonic anhydrase or aldosterone; it also abolishes the corticomedullary osmotic gradient and blocks negative, as well as positive, free water clearance. Because of the large Na Cl absorptive capacity of the loop of Henle, diuresis is not limited by development of acidosis, as it is with the carbonic anhydrase inhibitors. Additionally, furosemide is a noncompetitive subtype-specific blocker of GABA-A receptors. Some of the brand names under which furosemide is marketed include: Aisemide, Apo-Furosemide, Beronald, Desdemin, Discoid, Diural, Diurapid, Dryptal, Durafurid, Edemid, Errolon, Eutensin, Flusapex, Frudix, Frusetic, Frusid, Fulsix, Fuluvamide, Furesis, Furix, Furo-Puren, Furon, Furosedon, Fusid.frusone, Hydro-rapid, Impugan, Katlex, Lasilix, Lasix, Lodix, Lowpston, Macasirool, Mirfat, Nicorol, Odemase, Oedemex, Profemin, Rosemide, Rusyde, Salix, Seguril, Teva-Furosemide, Trofurit, Uremide, and Urex.

    Lasix and dialysis

    Are diuretics, such as Lasix, used in ESRD? National Kidney., The efficacy of diuretics in acute and chronic renal failure. Focus on.

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  6. Furosemide, sold under the brand name Lasix among others, is a medication used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It may also be used for the treatment of high blood pressure.

    • Furosemide - Wikipedia.
    • The Use of Furosemide in Patients on Dialysis - Full Text View..
    • If you give lasix to a dialysis patient, how will it effect..

    Nov 20, 2013. DALLAS—Halving the dosage of furosemide in patients with stable class II/III systolic heart failure and impaired renal function may improve. Administered orally at 500 mg/day to patients in end-stage chronic renal failure treated by hemodialysis, furosemide significantly decreases the weight gain. Medscape - Hypertension-specific dosing for Lasix furosemide. heart failure CHF, liver cirrhosis, and renal disease, including nephrotic syndrome.

     
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