NURS615_DiureticTableAssignment_STUDENTNAME (2).doc - Advanced Diuretics Table Components of Drug Therapy Drug Dosage Diuretic LOOP DIURETICS Bumetanide

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Advanced Pharmacotherapeutics Diuretics Table Components of Drug Therapy Diuretic: LOOP DIURETICS Bumetanide Furosemide Drug Dosage Bumetanide – starting dose is 0.5mg daily and maintainence dose is 2mg/d MAX dose is 20mg/d Children dosing: 0.015 – 0.1mg/kg/d every 6-24 hours Max dose is 10mg Furosemide – (refractory edema of CHF, hepatic disease) 20-80 mg daily or 2 doses daily Maintainence – titrate in increments of 20-40 mg q6-8h until desired diuresisMax 600mg/d in divided doses (HTN)- 40mg – 2 doses daily Children – 2mg/kg/d MAX 6mg/kg/d Action Inhibit sodium reabsorption in the ascending loop of Henle. Short – acting and cause a large natiuresis Onset of Action Bumetanide – 0.5 – 1 hour Furosemide – 1 hour Peak of Action Bumetanide – 1 – 2 hours Furosemide – 1- 2 hours Duration of Action Bumetanide – 4 -6 hours Furosemide – 6 – 8 hours Serum Half-life Bumetanide – 1 – 1.5 hours Furosemide – 0.5 – 1 hour Absorption Loop diuretics are well absorbed orally Metabolism Furosemide has nonhepatic and hepatic metabolism Excretion Bumetanide – 50 % eliminated in urine and 20% eliminated in feces Furosemide – unchanged in urine Contraindications Use caution with patients: Preexisting electrolyte abnormalities Hepatic dysfunction
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Creatinine clearance less than 25 – 30 mL/min History of gout or renal calculi Diabetics older adults at risk of hypotension Adverse Effects Hypotensive reaction, abnormal potassium level
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