Drug Guide;

This will last for about 6 hours after taking

Diuretics. Diuretics, such as furosemide
(Lasix), decrease the pressure caused by
excess uid in the heart and lungs.
you take furosemide to one that suits you
furosemide. It's nothing to worry about, but if
it's inconvenient for you, change the time
better (provided it's no later than 4pm).

The rst treatment for acute pulmonary

edema is oxygen. Oxygen ows through a If peeing a lot is still a problem for you, talk
face mask or a exible plastic tube with two to your doctor or pharmacist.

openings (nasal cannula) that deliver oxygen

to each nostril. This should ease some Feeling thirsty

symptoms.
It's important not to get dehydrated, but how
much you drink will depend on why you're
A health care provider monitors the oxygen taking furosemide.

level. Sometimes it may be necessary to

assist breathing with a machine such as a Check with your doctor how much liquid you
mechanical ventilator or one that provides can drink while you're taking this medicine.

positive airway pressure.

Dry mouth

Depending on the severity of the condition Chew sugar-free gum or suck sugar-free
and the reason for the pulmonary edema, sweets.

treatment might include one or more of the

following medications:
Headaches

Make sure you rest and drink uids – ask

Pulmonary edema is a condition caused by your doctor how much you can drink while
too much uid in the lungs. This uid collects taking this medicine. Do not drink too much
in the many air sacs in the lungs, making it alcohol.

di cult to breathe.

Ask your pharmacist to recommend a

In most cases, heart problems cause painkiller. Talk to your doctor if the
pulmonary edema. But uid can collect in headaches last longer than a week or are
the lungs for other reasons. These include severe.

pneumonia, contact with certain toxins,

medications, trauma to the chest wall, and
traveling to or exercising at high elevations.
body’s excretion of some electrolytes —
Pulmonary edema that develops suddenly
(acute pulmonary edema) is a medical
emergency that needs immediate care.
Pulmonary edema can sometimes cause
Muscle cramps: Diuretics increase the
including sodium, chloride and potassium —
through the urine. Low levels of these can
cause extreme fatigue and muscle
weakness, as well as achy joints, bones and
muscles.

death. Prompt treatment might help.

Treatment for pulmonary edema depends on Dizzy/Spinning Sensation

the cause but generally includes additional

oxygen and medications.
If furosemide makes you feel dizzy when you
Side E ects:
Diuretics can cause constipation if you don't
stand up, try getting up very slowly or stay
sitting down until you feel better. If you begin
to feel dizzy, lie down so that you do not
faint, then sit until you feel better.

drink enough uids. Diuretics can help you

manage your high blood pressure and other Do not drive, ride a bike or use tools or
conditions, but you need to take them the machinery while you're feeling dizzy

right way

Peeing more than normal

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 Side E ects

Increased urination- ihi ng ihi yung patient Fever

dahil yung lasix ay isang diuretics meaning

isa sa mga action niya ay iexrete mga excess Jaundice - paninilaw ng mata at balat
uid sa katawan
sapagkat isa sa mga dahilan kung bakit
nagkakaroon ng edema ay ang PORTAL
Feeling thirsty- nakakaramdam yung patient SYSTEM OBSTRUCTION DUE TO HEPATIC
ng pagka-uhaw dahil ihi ng ihi yung patient VESSEL CONGESTION at dahil dyan
nababawasan yung uid sa katawan na nagkakaroon ng build-up ng bile sa katawan.
naglelead sa dryness ng mouth
And usually jaundice often occur with clay-
colored stool

Feeling confused or dizzy- nakakaramdam

ng pagkahilo sapagkat isa rin sa ginagamot Electrolyte imbalance

ng Lasix ay hypertension so kapag ininom ni

patient yung Lasix baba yung bp niya or Loss of appetite - nawawalan ng gana
magkakaroon ng hypotension
kumain

Muscle cramps- dahil yung Lasix bukod sa Rapid weight loss- mabilis na pagbaba ng
pinapalabas niya ang mga sodium at water timbang dahil mabilis yung paglabas ng mga
sa katawan, pinapalabas niya rin yung uid sa katawan lalo na kung hindi naagapan
potassium which is tumutulong sa maaayos agad ng pag-inom ng water

na pagfunction ng ating kalamnan so sa

paglabas ng potassium there’s a possibility • Low blood pressure warning: This drug
na magkaroon ng mababang potassium sa can cause low blood pressure.
katawan or in medical term hypokalemia
Symptoms include feeling dizzy and
faint after standing up. If this occurs,
Itching or rash- dahil sa pag-inom ng Lasix move slowly when changing positions
yung skin ng patient ay nagiging more after sitting or lying down. If this
sensitive sa sunlight
problem continues, call your doctor.

• Low potassium levels warning: This
Weakness
drug can cause low potassium levels.
(Potassium is a mineral that helps your
Spinning sensation - Umiikot yung paningin
nerves, muscles, and organs work
normally.) Symptoms include tiredness,
Diarrhea - excretion
muscle weakness, and nausea or
vomiting. Call your doctor if you have
Stomach pain - Pananakit ng tyan
these symptoms.

• Low thyroid levels warning: High doses

Constipation - Especially if yung patient hindi (over 80 mg) of furosemide can cause
umiinom ng enough na uid
low levels of thyroid hormones. If you’re
taking high doses of this drug and have
SERIOUS SIDE EFFECTS:
symptoms of thyroid problems, call
Dehydration - Lasix is diuretics speci cally your doctor. These symptoms can
loop diuretic and we all know that this is a include:

high calling diuretic or may kakayahan siya ◦ tiredness

na magcause ng greater degree of diuresis

◦ weakness

◦ weight gain

Dark Urine - dahil yung mga salt nakasama ◦ dry hair and skin

sa urine, Na Sodium
◦ increased feelings of being cold

Clay - colored stool

Nausea or Vomiting - dahil sa low potassium

levels

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 Tell your doctor if you are pregnant or plan to
become pregnant while using Lasix; it is
unknown if it will harm a fetus. Lasix passes
into breast milk and may harm a nursing
baby. Lasix may also slow breast milk
production. Consult your doctor before
breastfeeding.

Anuria which literally means no urine or

without urine.

Cirrhosis or the scarring of the liver caused

by long-term liver damage.

Hepatic coma, a nervous system disorder

brought on by severe liver disease

Hypokalemia or having low blood potassium

levels.

Lasix passes into your breast milk.

Jaundice - furosemide is a drug that can

displace bilirubin and cause unconjugated
hyperbilirubinemia (elevated serum or
plasma bilirubin levels above the reference
range of the laboratory) -> bilirubin has a
pigment or coloring, it causes the yellowing
of skin = Jaundice

MOA SIMPLIFY
Lasix gnagamit to para maeliminate yung
extra water and salt kasi may problema sa
uid retention, meaning po. nirereduce po
ung amount of water in the body by
increasing the ow of urine

Lasix E ects on Lab Results

May increase cholesterol, glucose, BUN,
creatinine, and iris acid levels. May decrease
calcium, hemoglobin, magnesium,
potassium, and sodium levels. May decrease
granulocyte, platelet and WBC counts

- Increase urine ow

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 Generic Medicine Info
Indications and Dosage
Intravenous
Acute pulmonary oedema
Adult: Adjunct: Initially, 40 mg
via slow inj over 1-2 minutes,
may be increased to 80 mg given
via slow inj if satisfactory
response is not achieved within 1
hour.
Oral
Hypertension
Adult: Alone or in combination
with other antihypertensives:
40-80 mg daily, adjusted
according to patient response.
Alternatively, usual maintenance
dose of 20-40 mg daily may be
given.
Elderly: Initiate at lower doses.
Oral
Oliguria in acute or chronic
renal failure
Adult: In patients with chronic
renal insuf ciency: Initially, 250
mg, may be increased in
increments of 250 mg every 4-6
hours if satisfactory response is
not achieved. Max: 1,500 mg 24
hourly.
Elderly: Initiate at lower doses.
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Renal Impairment
Parenteral:
Oedema: Severe: Max IV
infusion rate: 2.5 mg/minute.
Administration
oral soln: May be taken with or
without food. May be taken w/o
meals for better absorption. May
Reconstitution
IV infusion: Dilute with 0.9%
NaCl, lactated Ringer’s, and 5%
dextrose infusion solutions,
Incompatibility
Incompatible with injections of
amrinone, cipro oxacin,
diazepam, diltiazem
hydrochloride, dobutamine
hydrochloride, dopamine
hydrochloride, droperidol,
doxorubicin, gentamicin,
Contraindications
Hypersensitivity to furosemide
and sulfonamides. Anuria, renal
failure with anuria not
responding to furosemide; renal
failure due to poisoning by
nephrotoxic or hepatotoxic
Special Precautions
Patient with prediabetes or
diabetes mellitus; prostatic
hyperplasia, urinary stricture,
impaired micturition, gout,
hepatorenal syndrome,
 Adverse Reactions
Signi cant: Fluid and electrolyte
depletion, symptomatic
hypotension, asymptomatic
hyperuricaemia, nephrotoxicity,
ototoxicity (e.g. hearing
disorders, tinnitus, deafness
[sometimes irreversible]),
photosensitivity, sulfonamide
allergy, urinary retention, SLE
exacerbation or activation;
nephrocalcinosis or
nephrolithiasis (in premature
infants), decreased glucose
tolerance, transient increase in
free thyroid hormones.
Blood and lymphatic system
disorders: Haemoconcentration.
Rarely, agranulocytosis,
Pregnancy Category (US
FDA)
Patient Counseling
Information
This drug may cause reduced
Monitoring Parameters
Correct hypovolaemia,
hypotension, and severe
electrolyte disturbances prior to
treatment initiation. Monitor
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Overdosage
Symptoms: Profound diuresis
resulting in dehydration, blood
volume reduction, hypotension,
electrolyte imbalance,
hypokalaemia, hypotension,
tachycardia, and hypochloraemic
Drug Interactions
Increased risk of hyperkalaemia
with K-sparing diuretics (e.g.
amiloride, spironolactone) and K
salts. Diuretic effects may be
antagonised by NSAIDs (e.g.
indometacin, ketorolac), and
reduced by phenytoin,
probenecid, methotrexate. May
cause severe hypotension with
ACE inhibitors or angiotensin II
receptor antagonists. Increased
Food Interaction
Hypotensive effect may be
enhanced by alcohol.
Lab Interference
May result in false-negative
aldosterone/renin ratio (ARR).
 Digoxin

Action Morphine

Intubation and mechanical ventilation

Description: Furosemide is an
anthranilic acid derivative and a
Elevate HOB

potent diuretic. It mainly inhibits Administer 100% oxygen by mask

the reabsorption of Na and Monitor VS and O2 Saturation

IV Access

chloride in the ascending loop of Medications

Henle and in both the proximal Ventilation

and the distal renal tubules. It

Furosemide Contraindications

also interferes with the chloride- Pregnancy

binding cotransport system, Dehydration

Hypovolemia

thereby causing its natriuretic Hypokalemia

effect.
Synonym: frusemide.
Onset: Diuresis: 30-60 minutes
(oral); approx 5 minutes (IV).
Symptomatic improvement in
acute pulmonary oedema: Within
Pathophysiology

Fluid collecting in the alveoli and interstitial

area, the balance between hydrostatic and
oncotic pressure in the pulmonary capillaries
is altered. Normally associated with lung and
cardiac diseases

Etiology

Left sided heart Failure, hypoproteinemia

(kidney and liver disease), inhalation of toxic
gases, tumors and blocked lymphatic
drainage

Clinical Manifestations

Cough, crackles, hemoptysis, frothy sputum,

hypoxemia, tachypnea, JVD, cyanosis, S3,
weight gain, tachycardia

Late Signs: confusion and stupor

Chest X-ray: Pleural e usion, edema at the

bases

ECG: Ischemic changes

Management of Cardiogenic Pulmonary

Edema

Diuretics

Nitroglycerin

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