Sulfonamide derivative's Flashcards
Generic Name: furosemide
Trade Name: Lasix
Classification: Sulfonamide derivative (Loop diuretic)
Medication Purpose: Acts on the ascending loop of Henle in the kidney, inhibiting reabsorption of electrolytes sodium and chloride, magnesium, chloride, water and some potassium. Decreases absorption of sodium and chloride and increases excretion of potassium in the distal tubule of the kidney; responsible for slight antihypertensive effect and peripheral vasodilation. Used for pulmonary edema, edema in HF, nephrotic syndrome, ascites, hepatic disease, hypertension.
Route: PO, IM, IV
Side Effects: Circulatory collapse, renal failure, thrombocytopenia, agranulocytosis, leukopenia, neutropenia, anemia, toxic epidermal necrolysis, erythema muliforme, Stevens-Johnson syndrome
Metabolized: Liver (30%-40%)
Contraindications: Anuria, hypovolemia
Nsg. Considerations: Asses pt. for tinnitus, hearing loss, ear pain; periodic testing of hearing is needed when high doses of this product are given by IV route (Ototoxicty). Monitor for CV, GI, neurologic manifestations of hyponatremia, increased BP, cold/clammy skin, hypovolemia or hypervolemia; anorexia, nausea/vomiting, diarrhea, abdominal cramps, lethargy, increased ICP, confusion, headache, tremors, hyperreflexia (Hypokalemia). Monitor for neurologic, respiratory manifestations of hyperchloremia (weakness, lethargy, coma, deep rapid breathing). Assess fluid volume status: I&O ratios and record, weight, distended red veins, crackles in lung, skin turgor, adequacy of pulses, moist mucous membranes, bilateral lung sounds, peripheral pitting edema, dehydration (symptoms of decreased output) (HF). Monitor electrolytes. Assess BP before and during therapy (Hypertension). Monitor for skin rash often, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme may occur and is life threatening.
Health Teaching: Tell pt. to take early in the day to prevent nocturia, take with food or milk if GI symptoms of nausea or anorexia occur. Teach pt. to maintain a record of weight on a weekly basis and notify physician of weight loss >5lb. Caution the pt. to rise slowly from sitting or reclining positions (orthostatic hypotension). Advise pt. to wear protective clothing and wear sunscreen to prevent photosensitivity. Caution pt. not to use alcohol or OTC medications without physicians approval, teach pt. to contact prescriber if rash, cramps, nausea, dizziness, numbness, weakness occur.
