Furosemide

Mechanism :

Furosemide inhibits primarily the absorption of sodium and chloride not only in the proximal and distal tubules but also in the loop of Henle. The high degree of efficacy is largely due to this unique site of action. The action on the distal tubule is independent of any inhibitory effect on carbonic anhydrase and aldosterone.

Indication :

• Edema
• Congestive heart failure
• Hypertension

Contraindications :

Frusemide is contraindicated in anuria. Although, it can be used in renal insufficiency, any marked increase in blood urea nitrogen or creatinine, or the development of oliguria during therapy of patients with progressive renal disease, is an indication for discontinuation of treatment. Contraindicated in patients in hepatic coma or in states of severe electrolyte depletion until the condition is improved or corrected and in patients hypersensitive to this drug.

Dosing :

Adverse Effect :

Hypersensitivity reactions, systemic vasculitis, interstitial nephritis, nausea, pancreatitis, cramps, jaundice, constipation, diarrhea, vomiting, thrombocytopenia, hemolytic anemia, leukopenia, dizziness, vertigo, blurred vision, headache, tinnitus, hearing loss, paresthesia, orthostatic hypotension.

Interaction :

Ototoxic Drugs: Especially in the presence of impaired renal function, concurrent use of parenterally administered furosemide with aminoglycoside antibiotics should be avoided.
Lithium: Reduce its renal clearance and add a high risk of lithium toxicity.
Probenecid: Pre-treatment with probenecid reduces both the natriuresis and hyperreninemia produced by bumetanide.
Antihypertensives: It may potentiate the effect of various antihypertensive drugs, necessitating a reduction in the dosage of these drugs.
Tubocurarine: Has a tendency to antagonize the skeletal muscle relaxing effect.
Succinylcholine: Potentiates action.

Hepatic Dose :