Many diseases either cause or become the cause of such a pathological condition as fluid retention in the body. Then special medicines are prescribed to the person. The article describes what Furosemide is and what it is for.
Excess fluid pills
Water is the basis of our whole life, it is necessary for every cell of the human body. But sometimes, due to certain disturbances in the functioning of some structures of the body, water is poorly excreted, accumulating in tissues and serous cavities. This very badly affects the appearance of a person, as edema appears, and the work of many organs and systems. Increased urine output is produced using drugs belonging to the group of diuretics. There are several types of them:
- “loop” diuretics acting on the cortical segment of the Henle loop;
- potassium-sparing diuretics;
- osmotic diuretics.
Each type of such drugs works according to its own principle, providing activation of the structures responsible for the production and excretion of urine from the body. The doctor prescribes each such drug only after finding out the cause of fluid retention in the body. In some cases, the drug "Furosemide" is recommended to the patient. What is it, how it works, and in which cases it can and cannot be taken, will be considered in the article point by point.
Pharmacological affiliation of the drug
As already mentioned, diuretics are drugs that promote the activation of urine production and its removal from the body. Such a drug as an active component may have different substances that have a diuretic effect. The prescription of the drug "Furosemide" in Latin will be written like this: Furosemidum. This information is important only for specialists, since a prescription for it is not required from a doctor to buy a medicine. Many potential buyers ask pharmacists if Furosemide can be taken without a doctor's prescription. But any symptom, including edema, has its own reasons. A diagnosis will not only eliminate the external manifestations of the disease, but also receive adequate treatment to maintain health for many years.
What is the dosage form?
When answering the question: "Furosemide, what is it?", It is immediately necessary to mention the dosage form in which this drug is produced. The pharmaceutical industry produces it in two forms - in the form of an injection solution in ampoules and in the form of tablets for oral administration. This diuretic is produced by many pharmaceutical companies, so in some cases a brand name is added to the very name of the drug, for example, "Furosemide-Ferein".
What works in a liquid excretion medicine?
For tablets and Furosemide injection solution (20 mg), the instructions for use indicate one active component. It is by his name that the drug itself is named - this is furosemide. Its chemical formula is as follows: 5- (Aminosulfonyl) -4-chloro-2 [(2-furanylmethyl)] - aminobenzoic acid. If the formula, then it looks like this: C 12 H 11 ClN 2 O 5 S. As the resulting chemical compound, this substance is a crystalline white or almost white powder. It dissolves well in dilute alkali solutions, although it is insoluble in dilute acid solutions. It also does not dissolve well in ethanol, but is practically insoluble in water.
How does the medicine work?
One of the popular diuretics that can be found in many home medicine chests is the Furosemide drug. What is it and how does it work in the preparation, that it effectively solves the problem of edema? The substance, by the name of which the medicine is named, belongs to the pharmaceutical group of diuretics. The group is quite extensive, in it all components are divided into three parts according to the principle of work to obtain the expected result. As the instruction for a solution and tablets "Furosemide" (40 mg) says, they belong to loop diuretics. What does this mean?
Kidneys - a paired organ related to the urinary system. Although the production of urine is not the only function of this structure, it is the work of the kidneys that ensures the removal of excess fluid from the body, and with it many unnecessary substances. The stagnation of this biological fluid affects the general well-being, the work of many body systems. The structural unit of the kidney is nephron. This is a complex organization for the production of kidney secretion - urine. It is the nephron that contains the so-called Henle loop - a formation that has the shape of a spike-like bend and is designed to conserve ions in urea by the countercurrent mechanism in the brain layer of the kidney. There are millions of nephrons in one kidney, the same number of such formations as the Henle loop. This structure, as already mentioned, has a spike-like shape and is divided into two main departments - descending and ascending. The descending begins from the proximal tubule, and returning, the ascending section is connected to the distal tubule. And if problems begin in the work of this small, but very important component of the urinary system, this affects the functionality of the entire kidney and urinary structure as a whole. The loop of Henle directly provides the following functions:
- reverse absorption of Na, Cl and K;
- reabsorption of almost 20% of the initial amount of Na ions, which provide "stretching" of the liquid;
- absorption back into the body when passing through the ascending portion of calcium and magnesium;
- as a result of the metabolic process, urea is excreted from the body, which enters the distal tubule and combines with the fluid there, forming urine.
Primary urine is formed approximately 200 liters per day. But only 1.5-2 liters are excreted from the human body. The rest of the liquid is absorbed back, enriched with glucose, proteins, mineral elements. All this happens including in the loop of Henle. That is why the functionality of this very small element of the kidneys is very significant for the whole organism. Experts, answering the question: “Is it possible to take Furosemide for edema?”, Stipulate that the drug belongs to the group of loop diuretics, that is, its functionality is directly related to the Henle loop. So when prescribing a medicine, it is necessary to take into account the indications and contraindications to it.
The diuretic effect provided by the drug is significant, but at the same time short-lived and dose-dependent. When taken orally, the diuretic effect reaches a maximum within 1–2 hours and lasts 6–8 hours. If a diuretic is administered to the patient intravenously, then the peak of its activity is observed after about 30 minutes, and the effect of the drug lasts for 2 hours. During this time, significantly the release of sodium ions increases. But then the so-called rebound phenomenon takes effect, when the rate of elimination of sodium ions decreases and becomes even lower than the initial level. Massive diuresis caused by the work of furosemide, causes a sharp activation of renin-angiotensin, as well as other antinatriuretic neurohumoral regulation units. This substance stimulates arginine-vasopressin and sympathetic structures, lowers the level of atrial natriuretic component in plasma and potentiates the narrowing of blood vessels of the circulatory system, especially arteries.
Since the drug with furosemide has the phenomenon of "rebound", its single use does not significantly affect the daily release of sodium ions. This drug is effective in heart failure, and having both acute and chronic form. It significantly increases the functional class of heart failure due to lower filling pressure of the left ventricle. Furosemide reduces peripheral edema, pulmonary vascular resistance and congestion in the lungs. The drug lowers the so-called jamming pressure of the pulmonary capillaries in the pulmonary artery and the right atrium. At a low glomerular filtration rate, it remains effective, and therefore it is used in the treatment of arterial hypertension in patients with renal failure.
The pathway of the drug in the patient’s body
Furosemide is a chemical compound based on an aminobenzoic acid derivative. Based on this substance, pharmaceutical companies produce Furosemide diuretics. How to take this medicine so that it is as effective as possible and brings as few unnecessary side effects as possible? The pharmaceutical form of the drug "Furosemide" involves 2 options - tablets and a solution for intramuscular and intravenous injection. In either case, the drug is absorbed quite quickly and reaches its place of work - renal nephrons: with intravenous administration, this occurs after 5 minutes, with oral administration - after 15-20 minutes, in some cases, the expectation of the effect of the taken pill can be up to half an hour .
The drug substance works throughout the thick segment of the ascending knee of the Henle loop. There, it blocks the reverse absorption of about 20% of filtered Na + ions. Here, furosemide is secreted into the lumen of the proximal renal tubules, thereby increasing the excretion of Ca 2+ , Mg 2+ , K + , phosphates, and bicarbonates. All this increases the acidity of urine. In its action, furosemide as a medicinal substance has secondary effects, which are caused by the release of intrarenal mediators and the redistribution of intrarenal blood flow.
For this drug substance, oral bioavailability averages 60–70%. It binds to plasma proteins at the level of 91–97%. The half-life from the body for furosemide is from 30 minutes to 1 hour. During this time, it undergoes biotransformation, passing through the liver, and forms glucuronides and other inactive metabolites. From the body, this drug is excreted by almost 90% of the kidneys, the rest is excreted in the bile.
In what cases is the drug prescribed?
Those who are faced with the appearance of edema ask the question: "What is Furosemide, what is it taken from and can it help me exactly?" Yes, this medicine can be found in many home medicine chests, as it has already been used in medical practice for more than a dozen years as an effective diuretic. But still, it is not worth taking it without the recommendation of the attending physician, since edema can be a sign of serious problems in the work of some body systems. The drug in which furosemide works is prescribed for use in different dosage forms in various clinical cases. So, in the form of tablets it is recommended to take it with the following problems:
- arterial hypertension;
- liver disease, including cirrhosis;
- nephrotic syndrome;
- swelling during pregnancy;
- swelling with burns;
- edematous syndrome of various origins;
- chronic heart failure;
- chronic or acute renal failure.
In pharmacies, you can buy two pharmaceutical forms of the drug "Furosemide." Why is it needed as an injection? Indications for parenteral administration of the drug will be as follows:
- severe hypertension;
- cardiac asthma;
- hypercalcemia;
- hypertensive crisis;
- nephrotic syndrome;
- acute heart failure;
- edema syndrome in chronic heart failure stage 2 and 3;
- pulmonary edema,
- cerebral edema;
- cirrhosis of the liver;
- eclampsia.
Intravenous administration of the drug "Furosemide" is used to perform forced diuresis, which is necessary, for example, when poisoning with chemical compounds that are excreted from the body unchanged by the kidneys.
And if you can’t take the medicine?
In pharmacies, the drug "Furosemide" is often purchased for home first-aid kits. What is it for? To help the body remove excess fluid, relieve swelling. But as with any other drug, loop diuretic has its own contraindications. It:
- anuria with renal failure;
- hyperuricemia
- hypersensitivity to both the active substance itself and to sulfonylurea derivatives and sulfonamides;
- hypovolemia;
- hypokalemia and hyponatremia, as well as other severe electrolyte imbalances;
- acute glomerulonephritis;
- dehydration;
- digitalis intoxication;
- hypertrophic cardiomyopathy;
- hepatic coma;
- violation of the outflow of urine pronounced of any etiology;
- liver failure;
- increase in pressure in the jugular vein over 10 mm RT. st .;
- hepatic precoma;
- aortic or mitral stenosis in the stage of decompensation.
All relevant information is told about such a drug as diuretic tablets "Furosemide", instructions for use. It indicates that in tablet form, the medicine is not prescribed for children under 3 years of age. The active component of the diuretic is the substance furosemide penetrates the placental barrier. But since it helps to remove excess fluid, which is important for the health of a pregnant woman and her expected child, especially in the second half of the term, a single use by women in the position of a loop diuretic is possible only for medical reasons and taking into account a doctor’s examination and if the risk to the fetus is minimal compared to with the use of the drug for the mother.
The drug belongs to the C category of action on the fetus according to the FDA system, that is, the medicinal substance was tested in animals and showed a potentially adverse effect on their pregnancy. The effect of the drug on pregnant women has not been investigated, but its potential benefit to the mother suggests its possible use in the treatment of pregnant women. A woman in position can take Furosemide after consulting a specialist under strict supervision of the condition of the fetus.
Those women who are breast-feeding a baby need to transfer the baby to artificial feeding if she needs treatment with Furosemide, as the drug can have a negative effect on lactation, reducing the amount of secretion of the mammary glands, and also penetrates into milk.
Possible side effects of treatment
Diuretics help in the treatment of many diseases of the cardiovascular, urinary, and endocrine systems. But they need to be taken only after a thorough examination and diagnosis. No exception and the drug "Furosemide." Side effects of this loop diuretic can cause a deterioration in the patient's well-being. So, in the cardiovascular system, blood formation system and hemostasis, the drug can cause:
- agranulocytosis;
- aplastic anemia;
- arrhythmia;
- collapse;
- leukopenia;
- lowering blood pressure;
- orthostatic hypotension;
- tachycardia;
- thrombocytopenia;
- decrease in circulating blood volume;
Such violations of water-electrolyte metabolism, such as:
- hyperglycemia;
- hypercalciuria;
- hypercholesterolemia;
- hyperuricemia
- hypovolemia;
- hypokalemia;
- hypocalcemia;
- hypomagnesemia;
- hyponatremia;
- hypochloremia;
- dehydration, which can cause the development of thrombosis and thromboembolism;
- metabolic alkalosis;
- impaired glucose tolerance;
- gout;
- increased cholesterol (low density lipoproteins).
The organs of the gastrointestinal tract can respond to therapy with this drug as follows:
- diarrhea;
- thirst;
- cholestatic jaundice;
- constipation;
- vomiting
- decreased appetite;
- dry mouth
- nausea;
- pancreatitis
Taking Furosemide diuretic can cause side effects in the nervous system and sensory organs, such as:
- adynamia;
- apathy;
- lethargy;
- headache;
- dizziness;
- blurred vision;
- hearing impairment;
- paresthesia;
- damage to the inner ear;
- muscle weakness and general;
- drowsiness;
- confusion of consciousness;
- tetany - cramps in the calf muscles.
The genitourinary system may respond inadequately to diuretic therapy, as among the side effects it is registered:
- hematuria;
- interstitial nephritis;
- oliguria;
- decreased potency.
Often prescribed drug-diuretic "Furosemide" after the start of treatment can cause allergic reactions such as:
- necrotizing angiitis;
- vasculitis;
- exfoliative dermatitis;
- itchy skin;
- hives;
- purpura;
- photosensitivity;
- shock anaphylactic;
- erythema multiforme;
Also, drug therapy can affect the appearance of chills, fever. Intravenous administration is fraught with the development of thrombophlebitis, as well as the development of renal calcification in premature babies.
How to take the medicine?
What is Furosemide and how to take it correctly so that the drug works without causing side effects? All information on this issue should be given by the attending specialist who recommends this loop diuretic. In tablets, a drug that helps remove excess fluid from the body is prescribed depending on the patient’s condition, the course of the disease, medical history, and age. The dose at one dose is individually selected, the number of applications in one day. The question of how much Furosemide can be taken is also decided only by a specialist, depending on the results of the therapy. With pathologies of the heart, kidneys or liver in adult patients suffering from the appearance of edema, the drug is recommended to take half or one tablet per day. If the condition is serious, then 2-3 tablets or 3-4 tablets divided into two doses can be prescribed per day.
For children, this medicine is recommended in dosages calculated depending on body weight - 1-2 mg per 1 kilogram per day. This amount of medicine is given to the child either once a day or by dividing it into two doses.
For Furosemide solution, the optimal method of administration is a slow intravenous injection, which is carried out for 2 minutes. Intramuscular injection is possible in extremely rare cases, and acute conditions are contraindications for such drug administration. For edema in children over 15 years old and adult patients, 20- 40 milligrams of the drug.If there is no effect, then a new dose is administered every two hours, one and a half times the previous dose, until a diuretic effect is achieved.If the patient needs a dosage exceeding 80 mg, then carry out a drip at a speed of not more than 4 mg per minute.The maximum dose of the active component that the patient can receive per day should not exceed 600 mg.In children, intravenous injections are also calculated by body weight - 0.5-1.5 mg per 1 kg per day.With improvement in patient's urine output, it is recommended that tablets be taken orally, refusing injections.The manufacturers stipulate that the dose should be minimal, ensuring a stable therapeutic effect. An obligatory condition for therapy with loop diuretics and furosemide, including potassium preparations, should become.
Overdose
Furosemide tablets (40 mg) are prescribed for both children and adults. When prescribing a dose less than the specified amount, it is necessary to carefully divide the tablet into equal parts in order to correctly calculate the right amount of medicine. Overdose manifests itself as follows:
- anuria
- blood concentration;
- hypovolemia;
- severe hypotension;
- dehydration;
- collapse;
- violation of heart rhythm and conduction;
- acute renal failure;
- flaccid paralysis;
- decrease in circulating blood volume;
- drowsiness;
- confusion of consciousness;
- thrombosis;
- thromboembolism;
- shock.
If these disorders occur in the patient’s well-being, it is necessary to seek help from medical specialists. This condition requires replenishment of the water-electrolyte balance, acid-base state, the volume of circulating blood, as well as the use of symptomatic therapy. There is no specific antidote to furosemide yet.
Losing weight on dehydration?
Sometimes you can hear from women: "I drank Furosemide - I lost a certain amount of kilograms." In fact, you can find recommendations for such weight loss. But taking a loop diuretic only normalizes the amount of water in the body, and then if it is elevated and the drug is taken correctly in the amount recommended by the doctor. In other cases, the diuretic leads to dehydration, which negatively affects the whole body, the work of many organs and systems. Does not mention the weight adjustment for the drug "Furosemide" (tablets) instructions for use. For weight loss, specialist advice, diet, exercise by stupor and other medicines are necessary.
What do patients say about the medicine?
The drug "Furosemide" in its history has more than a dozen years of use. Those who used it on the recommendation of a doctor leave only positive feedback about the medicine, talking about the effectiveness, convenient mode of administration - only once a day. The affordable price of the medicine is also mentioned. Negative feedback from those who tried using furosemide to normalize weight, and found only health problems due to a violation of the amount of fluid in the body.
Competent opinion
Recommended responses about this drug are left by specialists, indicating its time-tested effectiveness. Yes, the number of side effects is great, but they rarely occur. And therefore, Furosemide has remained one of the popular loop diuretics for many years. What is better to assign to this or that patient depends on many circumstances, and the decision always remains with the attending physician.
Are there any analogues?
Loop diuretics, which are based on the substance furosemide, can be found on the shelves of pharmacies several names - for example, "Lasix", "Furon", "Fursemid" and, of course, "Furosemide". What is better to get, a doctor should recommend. There are diuretics that work on other active substances. These are chemical compounds, and natural, plant components. The choice is left to the specialist after examination and diagnosis.
How to buy and how to store medicine?
Coming to the pharmacy for a diuretic, you absolutely do not need to present a prescription for the drug "Furosemide" in Latin. The tablets and ampoules of this medicine are dispensed without a prescription. Their cost is small - ampoules in the amount of 10 pieces cost about 30 rubles, tablets can be bought at a price of 20 rubles per pack. The medicine is stored in a dark place at a temperature not exceeding 25 0 C. The shelf life of the drug is 2 years, then it can not be taken.
The answer to the question: “Furosemide - what is it?” Is both simple and complex. This is a very popular diuretic, the work of which is based on increasing the functionality of the Henle loop located in the part of the kidneys - the nephron. It is not recommended to take this drug without consulting a specialist .