Furosan 40mg Hasan Medicines treat edema, mild or medium hypertension (10 blisters x 10 tablets)

Pharmacology

Furosemid is a diuretics that conducts sulfonamid diuretic in a strong, fast, dosage -dependent effect group. The drug acting in the branch of Henle straps should be classified as a diuretic group.

Mechanism of action

Mainly inhibit the Na+/K+/2Cl transport system in the thick segment of the branch on the Henle straps, increasing the excretion of these electrolytes, accompanied by increased water export exercises. The drug also reduces the reabsorption of Na+, Cl-, increases the excretion of K+ in the distance and can work directly on the nearby tube. Furosemid does not inhibit the anhydrase carbon dioxide and non -antagonistic with aldosteron. Furosemid increases the elimination of Ca2+, Mg2+, hydrogen, ammonium, bicarbonate and maybe both phosphate through the kidneys. Losing a lot of potassium, hydrogen and chlorine can cause alkaline metabolism. Due to reducing plasma volume, it can cause hypotension but usually only mitigate.

Furosemid has the effect of renal vasodilation, reducing the impact of the kidney and blood flow through the kidney after taking the drug. In patients with congested heart failure with acute myocardial infarction, after furosemid intravenous injection, glomerular filtration power increases temporarily but significantly, while reducing peripheral veins and increasing peripheral venous blood. When using high doses in patients with chronic renal failure, the filtration rate of the glomeruli can temporarily increase. If the urinary tract is excessive due to the drug that reduces plasma volume, the blood flow may occur and reduces the rate of glomerular filtration.

Furosemid has less impact on blood glucose levels than thiazid, but can cause hyperglycemia, ureter glucose and glucose tolerance, which can be caused by hypokalemia.

Pharmacokinetics

absorption

Furosemid absorbs rapidly through the digestive tract, bioavailability is about 60 - 70%, but the absorption changes due to the effects of drugs, background diseases and the presence of food. However, whether you are hungry or full of diuretic benefits are similar.

In patients with heart failure, Furosemid absorption is even more erratic. Born can be reduced to 10% in kidney disease, increasing slightly in liver disease. When taken, the effect appears quickly after 1/2 hours, reaching the maximum effect after 1-2 hours and maintaining the effect from 6 - 8 hours. The maximum reduction of blood pressure may not be clear until a few days after starting the medication.

Distribution

Furosemid is linked to plasma albumin (about 99%). The higher free Furosemid part of heart disease, kidney failure and cirrhosis.

The drug can pass the placenta and into the breast milk.

Metabolism

Furosemid metabolizes partially through the liver.

Elimination

Furosemid is excreted mainly in urine, mostly in the form of non -metabolic. The sale time is from 30 to 120 minutes in normal people, prolonged in infants and patients with liver and kidney failure. The clearance of Furosemid does not increase when hemolysis.

Be cautious when used

should treat hypotension, reduce blood volume and any acid -base disorders before using Furosemid. Symptomic hypotension leads to dizziness, fainting or loss of consciousness that may occur in patients treated with Furosemid, especially in the elderly, patients use drugs or suffer from accompanying diseases that increase the risk of lowering blood pressure.

Need to adjust the dose carefully (to reduce the risk of hearing nerve) in patients with reduced blood protein concentration (kidney syndrome ...) and patients with average liver congestion.

Be cautious in cases of liver failure, kidney failure and liver syndrome, diabetes (using Furosemids can develop potential diabetes, need insulin dose in some patients), elderly people, difficult urine patients or risk of urinary obstruction such as prostate hypertrophy (increased risk of urinary urination), gout (risk pressure.

Need to regularly monitor clinical monitoring in patients with hematopathy (stop immediately if occurred), liver damage. Increased risk of formation of calcium stones, kidney lithium stones in premature babies, need to regularly monitor kidney function and kidney ultrasound.

During treatment, it is necessary to monitor the regular Bun index in the first few months of treatment and periodic treatment; Monitoring the electrolyte concentration in serum and taking measures to adjust or supplement accordingly.

may increase the level of creatinine and urea in serum during treatment. Serum cholesterol and triglyceride levels may increase but often return to normal within 6 months of using Furosemid. Should temporarily stop using the drug before performing glucose tolerance test.

The ability to drive and operate machinery

The drug can cause headaches, dizziness, fainting, hypotension, mental reduction ... Even not all patients have encountered. It is necessary to warn the patient in the event of the above unwanted effects, not to drive, operate machinery, work on high or other dangerous jobs that require alertness and concentration.

Pregnancy

Classification of pregnancy by FDA

toxicity that causes teratogenicity and on embryo development has not been clearly defined in humans. There is very little evidence of safety when using high doses of Furosemid in pregnant women, although there is no harmful effects in animals. Do not use drugs in pregnant women unless the benefits exceed the risks of the fetus (including the risk of a home vascular existence).

breastfeeding period

using Furosemid during breastfeeding is at risk of inhibiting milk secretion. Should stop breastfeeding if taking the drug is necessary. Furosemid may be distributed into milk or inhibit milk. Use carefully in breastfeeding women. Stop medication or stop breastfeeding depending on the need for the drug for the mother.

Interactive drug

simultaneously used with antihypertensive drugs increases hypotension. Furosemid should be stopped or reduced the dose before starting the angiotensin transfer inhibitor. The risk of the first dose when combined with alpha receptor blockers (prazosin). Furosemid may interact with Angiotensin transferring enzyme inhibitors that cause kidney damage.

Sedative: Furicemia caused by Furosemid increases the risk of heart toxicity. Avoid using simultaneously with primozid. Increased risk of ventricular arrhythmia with Amisulprid or Serindol. Increase hypotension with phenothiazine.

Anti -arrhythmia (amiodaron, disopyramid, sotalol ...): increases the risk of heart poisoning (due to decreased potassium blood). The impact of lidocaine, tocainid, mexilentin may be antagonistic by Furosemid.

The drug extends the QT interval: Hypotoxicity caused by decreased potassium or decreased blood magnesium.

cardiac glycosides: Hypotension and electrolyte disorders (including blood magnesi) increases the risk of cardiac poisoning.

Increased hypotension with thymxamine or hydralazin.

Renin inhibitors: Aliskiren reduces the plasma concentration of Furosemid.

Nitrate: Increased hypotension.

Furosemid reduces lithium elimination, increasing lithium concentration in plasma (increasing the risk of toxicity). Avoid using simultaneously unless the plasma concentration is controlled.

Chelate complex artificial agent: Sucralfat can reduce the gastrointestinal absorption of Furosemid, should use two drugs on each other 2 hours apart.

Lipid regulating drugs - reducing bile acid: reducing the absorption of Furosemid, which should be used 2-3 hours apart.

Non -steroid anti -inflammatory drugs (NSAID): Increased risk of kidney toxicity (especially in case of hypoglycemia). Indomethacin and Ketorolac may oppose the effect of Furosemid. In patients dehydration or decreased volume, NSAIDs can cause acute renal failure.

Increase the impact of salicylate when combining Furosemid.

Increased risk of hearing nerve toxic by aminoglycosides, polymyxin or vancomycin. Increased risk of kidney toxicity by aminoglycosides or cefaloridin. Furosemid can reduce plasma vancomycin levels after heart surgery.

Increased hypotension effect with monoamine inhibitors of oxidase. Increased risk of hypotension standing with three -round antidepressants. Increasing risk of hypokalemia with reboxetin.

The hypoglycemia of blood glucose of diabetes is antagonistic by Furosemid. The insulin dose may be increased.

Anti -epileptic drugs: Increased risk of hypoglycine (carbamazepine), decreased diuretic effect (phenytoin).

Antihistamine drugs: Hypotension increases the risk of heart toxicity.

Increased risk of hypokalemia with amphotericin.

sedative and sleep: increase the impact of hypotension. Chlorine hydrate or triclofos can replace thyroid hormones in a complex with plasma protein.

Central nervous stimulants (used in attention hyperactive hyperactivity syndrome): Hypotension increases the risk of ventricular arrhyths.

Central neurological inhibitors (Clopromazin, Diazepam, Clonazepam, Halothan, Ketamin): Increases the effect of lowering blood pressure.

corticosteroid: Antibiotic impact of diuretics (holding sodium) and increases the risk of hypokalemia.

Increased risk of kidney toxicity and hearing nerve for platinum -containing compounds.

The diuretic effect is strong when using Furosemid and Metolazon simultaneously. Increased risk of hypokalemia with thiazid.

Dopaminergic drugs: Increasing Levodopa's hypotension.

Immunodefighting drugs: Increasing hypotension effect with Aldesleukin.

Mechanical dilatation: Increases the hypotension effect of Baclofen and Tizanidine.

estrogen and progesterone: antagonistic diuretic effects.

Prostaglandin: Increasing the effect of hypotension with alprostadil.

Sympathetic nerve stimulants: Increasing hypotension effects when using high doses of agonized drugs β2 (Bambuterol, Fenoterol, Salbutamol, Salmeterol, Terbutalin).

Theophylline: Increasing hypotension.

Probenecid: Reducing Furosemid's glomerular filtration and reduces diuretic effects.

General anesthetic: may increase the hypotension effect of Furosemid. Furosemid increases the anesthesia of Cura plastic.

Alcohol: Increasing hypotension effect.

Laxative abuse: Increased risk of potassium loss

Licorice: Using a lot can increase the risk of hypokalemia.