DRUG STUDY
NAME OF ROUTE, DOSAGE AND MECHANISM SIDE EFFECTS/ NURSING
INDICATION CONTRAINDICATION
DRUG FREQUENCY OF ACTION ADVERSE EFFECTS CONSIDERATIONS
Generic Name: Edema, HF Action: Uses: Contraindications: Side Effects: Observe the patient’s 10
Furosemide Enhances Treatment of edema Hypersensitivity to Expected: rights of medication
PO: Adults, Elderly: excretion of associated with HF furosemide. Anuria. Increased urinary administration
Brand Name: Initially, 20–80 mg/dose; may sodium, chloride, and renal/hepatic frequency/volume
Lasix increase by 20–40 mg/ dose potassium by disease, acute Cautions: Baseline Assessment:
q6–8h. May titrate up to 600 direct action at pulmonary edema. Hepatic cirrhosis, hepatic Frequent: Check vital signs, esp. B/P,
Classification: mg/ day in severe edematous ascending limb of Treatment of coma, severe electrolyte Nausea pulse, for hypotension before
Pharmaco- states. loop of Henle. hypertension (not depletion, prediabetes, Dyspepsia administration.
therapeutic: Children: Initially, 2 recommended as diabetes, systemic lupus Abdominal cramps Assess baseline renal
Loop diuretic. mg/kg/dose. May increase by Therapeutic initial treatment). erythematosus. Pts with Diarrhea or function, serum electrolytes,
1–2 mg/kg/dose at 6–8 hr Effect: Produces prostatic hyperplasia/ constipation esp. serum sodium,
Clinical: intervals. Maximum: 6 diuresis, lowers urinary stricture. Electrolyte potassium.
Diuretic. mg/kg/dose. B/P. disturbances Assess skin turgor, mucous
Neonates: 1 mg/kg/dose 1–2 membranes for hydration
times/ day Occasional: status; observe for edema.
Dizziness Assess muscle strength,
IV, IM: Adults, Elderly: 20– Light-headedness mental status.
40 mg/ dose; may increase by Headache Note skin temperature,
20 mg/dose q1– 2h. Blurred vision moisture.
Maximum single dose: 160– Paresthesia Obtain baseline weight.
200 mg. Photosensitivity Initiate I&O monitoring.
Children: Initially, 1 Rash
mg/kg/dose. May increase by Auscultate lung sounds.
Fatigue In pts with hepatic cirrhosis
1 mg/kg/dose no sooner than
Bladder spasm and ascites, consider giving
2 hrs after previous dose.
Restlessness initial doses in a hospital
Maximum: 6 mg/kg/dose.
Neonates: 1–2 mg/kg/dose Diaphoresis setting.
q12–24h.
Rare: Intervention:
IV Infusion: Adults, Flank pain Monitor B/P, vital signs,
Elderly: Loading dose bolus serum electrolytes, I&O,
of 40–100 mg over 1–2 min, Adverse effect: weight. Note extent of
followed by infusion of 10–40 Vigorous diuresis may diuresis.
mg/hr; repeat loading dose lead to profound water Watch for symptoms of
before increasing infusion loss/electrolyte electrolyte imbalance:
rate. Maximum: 80–160 depletion, resulting in: Hypokalemia may result in
mg/hr. Hypokalemia changes in muscle strength,
Children: 0.05 mg/kg/hr; Hyponatremia tremor, muscle cramps,
titrate to desired effect. Dehydration altered mental status, cardiac
Neonates: Initially, 0.2 arrhythmias; hyponatremia
mg/kg/hr. May increase by Sudden volume may result in confusion,
0.1 mg/kg/hr q12–24h. depletion may result in thirst, cold/ clammy skin.
Maximum: 0.4 mg/kg/hr. increased risk of: Consider potassium
Thrombosis supplementation if
Hypertension Circulatory collapse hypokalemia occurs.
PO: Adults, Elderly: 40 mg Sudden death
twice daily Patient/Family Teaching:
Acute hypotensive Expect increased frequency,
episodes may occur, volume of urination.
sometimes several Report palpitations, signs of
days after beginning electrolyte imbalances
therapy. (noted previously), hearing
abnormalities (sense of
Ototoxicity (deafness, fullness in ears, tinnitus).
vertigo, tinnitus) may Eat foods high in potassium
occur, esp. in pts with such as whole grains
severe renal (cereals), legumes, meat,
impairment. bananas, apricots, orange
juice, potatoes (white,
Can exacerbate: sweet), raisins.
Diabetes mellitus Avoid sunlight, sunlamps.
Systemic lupus
erythematosus
Gout
Pancreatitis
Blood dyscrasias
have been reported.
References:
Kizior, R. J. & Hodgson, K. J. (2019). Saunders Nursing Drug Handbook 2019. Elsevier Inc.
