Heart attacks and strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die because of blockage of the arteries of the heart or brain. Particularly frightening is the fact that a lot of people do not even suspect that they have hypertension. And they miss the opportunity to correct something, just dooming themselves to perdition.
Lasix is a trade name for a drug which active ingredient is Furosemide. It is taken to reduce edema caused by heart failure, kidney problems, liver cirrhosis. Some people take Lasix to treat hypertension, to provide emergency care for hypertensive crises. Below, you will find instructions for the use of this drug. Study the drug's indications, contraindications and side effects. Learn how to take Lasix the right way in order to get the desired effect.
What is lasix used for?
The drug should be taken if you have one of the mentioned health problems:
• Ocular syndrome of various genesis, incl. with chronic heart failure II-III stage,
• cirrhosis (portal hypertension syndrome),
• nephrotic syndrome,
• Pulmonary edema,
• cardiac asthma,
• cerebral edema,
• conduction of forced diuresis,
• severe hypertension,
• some forms of hypertensive crisis,
It is undesirable to take furosemide-based drugs for the treatment of small children. In the treatment of cardiac, renal insufficiency, babies should be prescribed other safer drugs without an extensive list of adverse reactions.
Lasix (Furosemide) as a diuretic: action on the body
It disrupts the reabsorption of sodium, chlorine ions in the thick segment of the ascending part of the Henle loop. Due to the increase in the release of sodium ions, a secondary (osmotically bound water-mediated) enhanced water removal and an increase in the secretion of potassium ions in the distal part of the renal tubule occur. At the same time, the excretion of calcium and magnesium ions increases.
Furosemide has secondary effects due to the release of intracellular mediators and redistribution of the intrarenal blood flow. Against the background of course treatment, there is no weakening of the effect. With heart failure, it quickly leads to a decrease in preload on the heart through the expansion of large veins. Lasix has hypotensive effect due to an increase in the elimination of sodium chloride and a decrease in the response of the smooth muscles of the vessels to vasoconstrictive effects and as a result of a decrease in BCC.
The action of furosemide after intravenous administration occurs in 5-10 minutes; after oral administration - after 30-60 minutes, the maximum effect - after 1-2 hours, the duration of the effect - 2-3 hours (with reduced renal function - up to 8 hours). During the period of action, excretion of sodium ions increases significantly, but after its termination, the elimination rate decreases below the initial level ("rebound" syndrome, or "cancellation").
The phenomenon is caused by a sharp activation of the renin-angiotensin and other antinatriuretic neurohumoral regulating units in response to massive diuresis; stimulates arginine-vasopressive and sympathetic systems. It decreases the level of the atrial natriuretic factor in the plasma, causes vasoconstriction.
Due to the phenomenon of "ricochet" when taken 1 time / day may not have a significant effect on the daily excretion of sodium and AD. When IV introduction causes dilatation of peripheral veins, reduces preload, reduces the filling pressure of the left ventricle and pressure in the pulmonary artery, as well as systemic blood pressure. Diuretic action develops 3-4 min after IV introduction and lasts 1-2 hours; after oral administration - after 20-30 minutes, lasts up to 4 hours.
What forms does Lasix come in? Lasix 40mg and 100mg
Lasix is available in the form of tablets 40 and 100 mg and a solution for injection. This drug is usually prescribed for the first time when the patient is in a critical acute condition. You can remove the hypertensive crisis by injecting a dose of the drug intravenously. Then, when the patient's condition is stabilized, it is recommended to take pills. With chronic hypertension, experts recommend taking Lasix in tablets even with a slight increase in blood pressure.
The effect of the drug in this form begins later than with Lasix in injections. Keep in mind that intravenous injections are performed only by medical personnel. The fastest action and the minimum of negative consequences are possible with the introduction of the drug with a dropper slowly for 1-3 hours.
In this case, the patient has strong urge to urinate. Lasix is available in the dosage of 40 mg and 100 mg. Tablets are white or almost white, round, with engraved "DLI" above and below on one side. 1 tablet of Lasix 40 mg contains 40 mg furosemide and the following excipients: corn starch, starch, pregelatinized corn, lactose, silicon colloidal anhydrous, talc, magnesium stearate. The drug is produced in tablets. Lasix 100 mg contains the same additional ingredients. As for the main active substance Furosemide-there is 100 mg in one pill.
A solution of Lasix for injection (20 mg / 2 ml). It is transparent and colorless being available in ampoules of 10 pcs. You should consult the doctor concerning the most effective form of Lasix for you to use. Injections are more effective and they are used for severe cases. If you have just a beginning of a diseases that Lasix in tablets can cope with, you'd better take pills.
How should I use Lasix?
The right dosage is prescribed individually, depending on the indications, the clinical situation, the age of the patient. During the treatment, the dosage regimen can be adjusted depending on the magnitude of the diuretic response and the dynamics of the patient's condition.
If administered orally, the initial dose for adults is 20-80 mg / day, then, if necessary, the dose is gradually increased to 600 mg / day.
For children, a single dose is 1-2 mg / kg. The maximum intake dose for children is 6 mg / kg. With IV (jet) or IM introduction, the dose for adults is 20-40 mg 1 time / day, in some cases - 2 times / day. For children, the initial daily dose for parenteral use is 1 mg / kg.
After oral administration, the absorption is 60-70%. In severe kidney disease or chronic heart failure, the degree of absorption decreases. Vd is 0.1 l / kg. Binding to plasma proteins (mainly with albumins) is 95-99%. It is metabolised in the liver. It is excreted by the kidneys - 88%, with bile - 12%. T1 / 2 in patients with normal kidney and liver function is 0.5-1.5 hours. In case of anuria, T1 / 2 may increase to 1.5-2.5 hours, with combined renal and hepatic insufficiency up to 11-20 hours.
The sodium-lyric reaction of Lasix depends on a number of factors, including the severity of renal failure and the sodium balance, so the effect of the dosage can not be accurately calculated. For patients with chronic renal failure, the dose of Lasix should be carefully titrated, so that the initial loss of fluid is gradual. In adults, this is a dose that leads to loss, approximately 2 kg of body weight (approximately 280 m / mole of sodium) per day due to fluid loss.
Reception of Lasix can lead to a decrease in the rate of reactions and concentration of attention, especially after taking the first doses of the drug or with the simultaneous use of alcohol, this should be taken into account by persons working with complex mechanisms or driving vehicles.
Do not use Lasix during lactation, as the drug can not only penetrate into breast milk, but also inhibit the production of milk. It is advisable to take Lasix in a combination with potassium preparations, to prevent the development of hypokalemia and with constant monitoring of electrolyte blood composition.
What side effects are possible with Lasix (furosemide)?
Lasix can cause a disturbance in the balance of electrolytes (potassium, sodium, magnesium) and / or an excessive decrease in blood pressure. Side effects that may take place are the following: headache, confusion, dizziness, convulsions, muscle weakness, dry mouth, heart rhythm disturbances, rumbling in the abdomen, bloating, flatulence, constipation.
An acute retention of urine may occur. The more severe stage of the heart or kidney failure the patient has as well as the liver disease, the higher the incidence of symptoms listed above. Also, the risk of side effects increases in case of vomiting, diarrhea, malnutrition, and advanced age. Furosemide worsens metabolism, stimulating diabetes, gout and impaired kidney function. The drug may reduce the male potency.
When using Lasix in large doses, there is a decrease in BCC (the volume of circulating blood), resulting in a thickening of the blood and possible thrombosis. A frequent side effect is the development of water-electrolyte disorders: alkalosis (including increased metabolic alkalosis in diabetes mellitus), sodium, chlorine, calcium, and potassium deficiency; violation of biochemical properties of the blood: increased levels of creatinine, cholesterol, triglycerides, uric acid (with exacerbation of gout), glucose (especially in diabetes mellitus).
In case of an overdose of Lasix, arterial hypotension, electrolyte balance disturbance, dizziness, dry mouth, visual impairment are most often observed. The treatment is aimed at restoring the water-electrolyte balance and normalizing the BCC.
Allergic reactions are possible, ranging from skin manifestations (purpura, dermatitis, pruritus, erythema) and up to anaphylactic shock. Rarely there are violations from the blood: leukopenia, eosinophilia, hemolytic changes, agranulocytosis, thrombocytopenia.
In small or premature babies, the use of Lasix in the first weeks of life can lead to the uninfection of the Botallov duct. In the period of pregnancy up to 12 weeks, the use of Lasix is absolutely contraindicated, in later terms, the use of Lasix is possible only on strict indications, since the drug is able to penetrate the placental barrier.
If one or more of the above symptoms is detected, you should immediately call an ambulance. The patient is delivered to the Intensive therapy, where he/she is offered to washed the stomach and intestines, restoring the water and electrolyte balance. At this stage, an active fight against dehydration. The liquid is poured intravenously. When nausea and vomiting pass, the patient is forced to drink a lot, but in small portions. For these purposes, electrolyte solutions are used.