What are diuretics? These are drugs with different chemical structures that inhibit the reabsorption of salts and water in the tubules of the kidneys, and also increase their excretion along with urine. In addition, such drugs increase the formation of urine, reduce the water content in serous cavities and other tissues.
The most popular remedy with diuretic properties is the drug "Lasix" (in ampoules). The dosage of this medication, its instructions and indications are discussed below.
Form of the drug, its packaging, composition
What components does the “Lasix” medication contain (in ampoules)? Instructions for use states that the main substance of this drug is furosemide. It also includes sodium chloride, water for injection and sodium hydroxide.
This medication goes on sale in the form of a solution for intramuscular or intravenous administration. It is transparent and has no color.
This product is available in dark glass ampoules with a break point, which are packaged in contour cells made of plastic.
Mechanism of action
How does the drug "Lasix" (in ampoules)? Instructions for use (intramuscularly, this drug should be administered only in a hospital and in special cases) claims that it is a fast-acting diuretic derived from sulfonamide.
This medication is able to block the transport system of potassium, sodium and chlorine ions in the thick section of the Henle loop. That is why the saluretic effect of the aforementioned drug depends on its entry into the renal tubule.
The diuretic properties of the drug in question are associated with the process of inhibiting the reabsorption of sodium chloride in the mentioned segment (Henle loop). As for the secondary effects, they include an increase in urine volume and potassium secretion in the distal parts of the renal tubules. Also, the excretion of magnesium and calcium ions is simultaneously increased.
Repeated administration of this medicine does not reduce its diuretic activity. This is due to the fact that the medication in question is capable of interrupting glomerular-tubular feedback.
It is impossible not to say that the “Lasix” solution causes stimulation (dose-dependent) of the angiotensin-renin-aldosterone system.
Drug features
What features are characteristic for the drug "Lasix" (in ampoules)? The instructions for use claim that with heart failure, this medicine reduces the load, as well as pressure in the arteries (pulmonary) and filling the left ventricle. In addition, this drug has a hypotensive effect, which is due to a decrease in blood volume (circulating), increased sodium excretion and a decrease in the response of muscles (smooth) vessels to vasoconstrictor effects.
Dose-dependent natriuresis and diuresis is observed when taking medication in a dosage of 10-100 mg. After an intravenous effect of 20 mg of the drug, the diuretic effect is noted after ¼ hours and lasts for 180 minutes.
Long-term infusion administration of this drug is more effective than repeated bolus administration. It should also be noted that when doses of the medicine are exceeded, a significant increase in the effect is not observed in patients.
Pharmacokinetic Properties
What are the kinetic parameters inherent in the drug "Lasix" (in ampoules)? Instructions for use indicate that the volume of distribution of the active substance of the drug is 0.1-0.2 l per 1 kg of patient weight.
Furosemide binds well to proteins and is excreted unchanged by secretion in the proximal tubules.
The final half-life of this drug after intravenous infusion is about one and a half hours. The main ingredient of the drug is excreted in breast milk and crosses the placental barrier.
Indications for use of the solution
What diseases are prescribed Lasix injections for? Instructions for use (in vials of v / m and / v) states that the following conditions are indications of this medicine:
- edema syndrome with heart failure of a chronic nature;
- edematous syndrome with chronic renal failure ;
- edematous syndrome with acute heart failure;
- acute renal failure, including burns and pregnancy (in order to support fluid excretion);
- edematous syndrome in various liver diseases (as an additional treatment in conjunction with aldosterone antagonists);
- edematous syndrome with nephrotic syndrome (treatment of the underlying disease);
- swelling of the brain of the head;
- support for forced diuresis in case of chemical poisoning (that is, compounds that are excreted by the kidneys unchanged);
- hypertensive crisis.
Solution Prohibitions
In what cases it is impossible to enter the Lasix solution (in ampoules)? Instructions for use (for children, the use of this drug is discussed separately) states that this medication should not be used for:
- severe hypokalemia;
- renal failure (including with anuria);
- severe hyponatremia;
- hepatic precoma and coma;
- hypovolemia (with low blood pressure or without it) or dehydration;
- pregnancy
- pronounced violations of the outflow of urine of any origin (including with unilateral lesions of the urinary tract);
- breastfeeding;
- hypersensitivity to the main ingredients;
- with allergies to sulfonamides.
Use with caution
In what cases with special care should be used medication "Lasix" (ampoules)? The instruction for use states that such an administration of the drug should be with:
- conditions for which an excessive decrease in blood pressure is dangerous (for example, with stenotic lesions of the coronary or cerebral arteries);
- arterial hypotension;
- gout
- manifest or latent diabetes mellitus;
- acute myocardial infarction (including with an increased risk of developing cardiogenic shock),
- hepatorenal syndrome;
- systemic lupus erythematosus;
- impaired urine outflow (prostatic hyperplasia, hydronephrosis, narrowing of the urethra);
- hypoproteinemia;
- hearing loss;
- diarrhea and pancreatitis;
- ventricular arrhythmias;
- in premature babies.
The drug "Lasix" in ampoules: instructions for use
The prescription for the drug, in accordance with the selected treatment regimen, should be prescribed only by an experienced specialist. When prescribing this medication, it is necessary to use the lowest dosages that are sufficient to achieve the desired effect.
The medication is administered intramuscularly only in exceptional cases. As a rule, it is infused intravenously (slowly, 4 mg per minute).
How much should the Lasix solution be used in ampoules? The dosage of this remedy depends on the indications.
- Edema syndrome with heart failure of a chronic nature.
The initial dose in this condition should be 20-80 mg per day. As a rule, it is selected depending on the diuretic response. With this diagnosis, the daily dosage of the drug is divided into three times.
- Edematous syndrome with acute heart failure.
The initial dose in this condition is 20-40 mg. If required, it can be adjusted.
- Edematous syndrome with chronic renal failure.
Such patients require careful dose selection. It is increased gradually, so that fluid loss occurs smoothly.
- Acute renal failure (to support fluid excretion).
Before starting therapy, arterial hypotension and hypovolemia, as well as violations of the acid-base and electrolyte conditions, should be eliminated. The initial intravenous dosage for this disease is 40 mg.
- Swelling with nephrotic syndrome.
In this condition, the initial dose of the drug leaves 20-40 mg per day. As a rule, it is selected based on the diuretic response.
- Edematous syndrome with liver diseases.
In this case, the drug is prescribed as a kind of supplement to treatment with aldosterone antagonists.
- Cerebral edema, hypertensive crisis.
How should “Lasix” solution (in ampoules) be administered for such diseases? The instructions for use states that the initial dose of the drug under the conditions mentioned should be 20-40 mg (by bolus intravenous administration). Depending on the effect, the dose may be adjusted.
- Support for forced diuresis in case of chemical poisoning.
This medication is prescribed after intravenous infusion of electrolyte solutions. The initial dosage in this case is 20-40 mg. During treatment, it is necessary to control and also restore fluid loss.
Side effects
Does “Lasix” solution (in ampoules) cause negative effects? Instructions for use report the following side effects:
- hypochloremia, hyponatremia, metabolic alkalosis, hypomagnesemia, hypokalemia, hypercalcemia;
- dehydration, hypovolemia;
- decreased blood pressure, feeling of pressure in the head, dizziness, visual disturbances, headache, tachycardia, drowsiness, collapse, weakness, dry mouth;
- increased triglycerides and cholesterol, as well as blood urea and creatinine;
- decreased glucose tolerance, interstitial nephritis;
- nausea, paresthesia, vomiting, diarrhea, intrahepatic cholestasis, acute pancreatitis, nephrocalcinosis in premature babies;
- hearing impairment, urticaria, tinnitus, itching, exfoliative dermatitis, rash or bullous skin lesions, polymorphic erythema, fever, purpura, photosensitivity, vasculitis;
- thrombocytopenia, leukopenia, eosinophilia;
- agranulocytosis, deposition of calcium salts in the kidneys, aplastic anemia;
- soreness at the injection site.
When to see a doctor?
Now you know what side reactions the Lasix solution (in ampoules) can cause. Instructions for use (in children and adults, this drug contributes to the development of the same effects) claims that changes in the blood picture, as well as severe skin allergic or anaphylactic reactions, can threaten the lives of patients. Therefore, for any negative manifestations, you should immediately consult a doctor.
Precautions
What should I know before using Lasix solution (in ampoules)? Instructions for use (for cats, this tool is not suitable for pets and is not prescribed) states that before starting therapy, it is necessary to exclude the presence of pronounced violations in the outflow of urine.
In the process of treatment, it is advisable to eat food that is rich in potassium. Otherwise, it is necessary to take potassium-sparing agents.
Some side effects can disrupt a person’s ability to concentrate, which is extremely dangerous when working with complex mechanisms and driving.