Diuretics

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Furosemide (Lasix) – Loop Diuretics
Generic Name: Furosemide
Brand Name: Lasix

Furosemide also known as Lasix is a loop diuretic commonly use to treat fluid retention and edema. Which can be associated with Congestive Heart Failure (CHF), cirrhosis of the liver, and many kidney disorders. It is also sometimes use to treat hypertension alone or in combination with other anti-hypertensive drugs.
Diuretics are medications that increases the amount of water that passes through the kidneys as urine, thus, it is often called water pill. Lasix belongs to the group known as Loop diuretics. There a few types of diuretics and loop diuretics are just one type. It works by interfering with the sodium, potassium and chloride symporter. A symporter is a protein membrane that manages the transport of molecules across a cell membrane. The symporter that lasix interacts with is found in the thick ascending limb of the loop of Henle. What it does is………. inhibits the reabsorption of salt (Na+) and Chloride (Cl-). Since the Salt and Chloride will be leaving the body system through the loop of henle this means that water will also follow…. causing more water pass through the kidney. Which will ultimately mean, less fluid remaining in the blood stream.

Once Lasix is received the system will then compensate the loss by absorbing any fluid accumulated in the tissues, such as in the lungs or legs, back to the blood stream.

This will cause more fluid to be in the blood stream. Which once again pass through the kidney, which will also be excreted in the urine, since the loop diuretic inhibits its reabsorption.

This mechanism, is what makes loop diuretics a treatment for fluid retention also known as edema. It can therefore, ease symptoms of edema such as breathlessness caused by congestion of fluid in the lungs which patients diagnosed with CHF, cirrhosis of the liver, nephrotic syndrome and other edematous states may encounter.
Lasix is available in forms that can be taken orally and intravenously. When taken intravenously, it is considered to be twice as strong.
Parenteral or intravenous Furosemide is indicated when a fast acting and an intense diuresis is needed such as in acute pulmonary edema and cerebral edema. It also indicated when oral therapy is not possible because of problem with absorption in the intestine or for other reasons. Parenteral administration should be observed only in hospital or outpatient clinics. However, in cases of emergency that furosemide should be given right away outside hospital setting, recommended doses should be closely adhered to and patient must be closely monitored.
Contraindication:
Furosemide should not be taken if your patient cannot urinate.
Severe Hypokalemia – is a major contraindication. This means low potassium. Lasix can cause a dramatic decrease in potassium level which could cause lethal cardiac arrhythmias
Other contraindications include:

Hypotension or low blood pressure
Lasix should be used with extreme caution for patients who have a diagnosis of Systemic Lupus Erythematosus because it may May

In this video we are providing DIURETICS PHARMACOLOGY, which is very important for the GPAT, NIPER, Drug Inspector, Pharmacist, NEET Examination.
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Dr. Mimi Lam explains how diuretics affect potassium levels.

Explains the mechanisms of carbonic anhydrase inhibitors and osmotic diuretics. Also discusses indications for the medications.

ADH or anti diuretic hormone or vasopressin is the main hormone responsible for the volume of urine which is excreted and since its a hormone , we have both agonists and antagonists i.e. both ways to potentiate its action or to negate its action .

http://www.youtube.com/watch?v=z3WUPeTllKQ

All the diuretics acting on a different part of nephron and their uses will be discussed.

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Free Water Clearance and diuretics for NEET/USMLE/FMGE/PLAB

Free Water Clearance:
• Free water clearance is the amount of solute free water generated by the kidney.

• This solute free water is generated in the thick ascending limb and distal convoluted tubule, which are permeable to solutes but impermeable to water. Thus, this solute free water generated in the lumen is called as positive free water clearance.

• Solutes absorbed in thick ascending limb gives rise to medullary hyperosmolarity which absorbs the free water in collecting duct in response to vasopressin. Thus, here solute free water moves out from the lumen in to the body and this is known as negative free water clearance.

• Carbonic anhydrase inhibitors (acetazolamide) deliver more Na+ and water to thick ascending limb and distal convoluted tubule, where only Na+ is absorbed and water remains in lumen. Thus there is an increase in positive free water clearance.

• Loop diuretics (furosemide) and thiazides (chlorothiazide) inhibit Na+ absorption and hence there is more Na than before in lumen as compared to water. Hence loop diuretics and thiazides decrease positive free water clearance.

• Loops decrease Na+/Cl- absorption in thick ascending limb and thus there is a decrease in medullary hyperosmolarity. This decreases absorption of solute free water from the lumen of collecting duct in to the body. Hence loop diuretics decrease negative free water clearance as well.

All the renal drugs we have seen so far lead to hypokalemia and so this group of drugs were introduced to prevent that condition from occurring and are now these drugs are widely used in combination with the other diuretics as a very to increase the beneficial effects of the initial diuretics and prevent potassium loss

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Pharmacology treatment of Congestive Heart Failure includes:
– Ace inhibitors: Lisinopril, Captopril (1:39)
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– Calcium Channel Blockers: Nifedipine, Diltiazem, Verapamil (8:02)
– Digoxin | Cardiac Glycoside (11:14)
– Diuretics l Loop diuretics, Thiazide diuretics, Potassium Sparing diuretics: Furosemide, Hydrochlorothiazide, Spironolactone (18:08)

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Need help with other difficult nursing school topics? Click below. We got you covered 🙂
– Fluid & Electrolytes https://www.youtube.com/playlist?list=PL3NAm8UHLUnLJSqeCM_EJHXZ685sb67bn
– Heart Failure (CHF) https://www.youtube.com/playlist?list=PL3NAm8UHLUnLEVzZvkdBX1IWHPg21Jobw
– Myocardial Infarction (MI) https://www.youtube.com/playlist?list=PL3NAm8UHLUnLLJQsAIsQaHJiOvcLN1cUe
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– Cardiomyopathy https://www.youtube.com/playlist?list=PL3NAm8UHLUnIeh0g_moaGLzXWiOh3fqdi
– IV Fluids: Hypertonic, Hypotonic & Isotonic https://www.youtube.com/playlist?list=PL3NAm8UHLUnIdjUfgMcAE1JIq6Nx29JRX
– Hypertension https://youtu.be/5zg95R8H1oo
– Hyperkalemia https://youtu.be/HdG8lqJzWi4
– SIADH vs Diabetes Insipidus https://youtu.be/hKFGGv0E-5A

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