Vinzix 20mg vinphaco medicine for pulmonary edema, heart edema, brain edema (2 blisters x 5 tubes x 2ml)

Dosage form Box of 2 blisters x 5 tubes
Specifications Furosemid

Ingredient

Composition information	Content
Furosemid	20mg

Uses

indicated

edema in congestive heart failure, kidney disease and cirrhosis. Blood. Therefore, it is not used to treat hypertension for the elderly.

Furosemid is a diuretics that conducts sulfonamid diuretic belonging to a strong, fast, dosage -dependent effect group. The drug acts on the upward branch of the Henle straps, so it is classified as a group of diuretics. The main mechanism of action of Furosemid is to inhibit the co-transport system Na+-K+-2Cl- at the thick section of the branch on the Henle straps, increasing the excretion of these electrolytes, accompanied by increased water export exercises.

The drug also reduces Na, CL reabsorption and 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 even the kidney phosphate. Losing a lot of potassium, hydrogen and chlorine can cause metabolic alkali. Due to reducing plasma volume, it can cause hypotension but usually only mitigate.

Furosemid has the effect of renal vasodilation, reduces the impact in the kidney and blood flow through the hyperchineated kidney after bravely drugs in patients with congestion heart failure with acute myocardial blood, after furosemid intravenous injection, glomerular filtration power temporarily but significantly, while reducing peripheral vascular resistance and increased peripheral blood vessels. When taking high doses in patients with chronic renal impairment, the filtration rate of the glomeruli may increase temporarily. If the urinary tract is excessive due to a decrease in plasma volume, the blood flow may occur through the kidneys and the speed of glomerular filtration.

Furosemid has less impact on blood glucose levels than thiazid, but can cause hyperglycemia, urinary glucose and glucose tolerance, which can be the result of hypotension.

Dynamic pharmacokinetics

When intravenous injection, the effect of the drug appears after about 5 minutes, reaching the maximum within 20 - 60 minutes and lasts about 2 hours. It is unknown the drug concentration needed in the serum to achieve maximum diuretic effects, but the level of response is not correlated with the peak concentration or the average concentration of the drug in the wall. In people with severe kidney failure, the diuretic benefits may be extended.

up to 99% of blood furosemids attached to plasma albumin. The free (non -mounted) Furosemid part is higher in people with heart disease, deity and cirrhosis. Furosemid is excreted mainly through urine, largely in the form of non -metabolic. Selling time from 30 minutes to 120 minutes in normal people, prolonged in newborns and patients with liver and kidney failure.

Furosemid passes through the placenta and distributed into breast milk. The clearance of Furosemid does not increase when hemolysis.

Before taking Vinzix 20mg vinphaco medicine for pulmonary edema, heart edema, brain edema (2 blisters x 5 tubes x 2ml)

How to use

intravenously or intravenous injection when it is necessary to start diuretic effect quickly or when the patient cannot drink.

When intravenous injection, must be injected slowly for 1-2 minutes. Use oral by oral as soon as possible. When intravenous intravenous injection or intravenous infusion, the speed does not exceed 4mg/minute in adults. For intravenous transmission, dilute Furosemid in 0.9%sodium chloride solutions, Ringer Lactac or 5%Dexerrose, adjust the pH greater than 5.5 when needed.

Dosage

Supporting treatment

Adults: conventional dose of intramuscular or intravenous intravenous 20 - 40 mg, a single dose. If not responded to the first dose, the second dose and each next dose may increase by 20 mg, but not for 2 hours earlier, until the desired diuretic meets. After that, the single dose is effective for 1-2 times daily.

To treat acute pulmonary edema in adults, it is possible to have an intravenous injection of 1 -2 minutes by 40 mg. If within 1 hour does not see the effect, the dose can be increased to 80 mg intravenously for 1-2 minutes. In adults with hypertension, normal renal function, can be intravenous in 1-2 minutes of 40 - 80 mg of Furosemid (along with other blood pressure loss drugs); If the renal function decreases, it may be taken higher.

For children, to treat acute pulmonary edema or covered by congestion or kidney failure, the normal starting dose is 1 mg/kg intramuscularly or intravenously. If necessary, for edema does not respond, the dose may increase by 1 mg/kg but not for 2 hours earlier, until the desired effect is achieved. Usually the dose of 1mg/kg has been satisfactorily responded, rarely have to use 2 mg/kg. The maximum injection dose for children is 6 mg/kg/day. However, such high doses have many potential risks.

Hypercalcemia treatment

Adults: Severe cases, intravenous injection 80 - 100 mg, repeat if necessary after every 1-2 hours. If the level is lighter, the dose may be smaller, 2-4 hours away.

Children: Intramuscularly or intravenously 25 - 50 mg, if needed can be reminded, 4 hours apart until satisfactory.

Elderly people may be more sensitive to the effects of the drug.

High -dose therapy

high -dose Furosemid used for supplementary treatment for other therapy to treat acute or chronic renal failure, including peritoneal or artificial kidney. In some patients, Furosemid may delay the demand for fertilizer, increase the distance to make fertilizer, shorten the time of hospitalization or allow the water to put the water into a slightly more free body.

Treatment of urinary - anuria in acute or chronic renal failure, when the glomerular filtration level is less than 20 ml/min, take 250 mg of diluted Furosemid in 250 ml of appropriate infusion such as 0.9%sodium chloride, ringer lactate, dextrose ... transmitted for an hour.

If the diuretic effect has not met an hour after the transmission, the dose can increase to 500mg phase with the appropriate number of transmission and the transmission time about 2 hours.

If the diuretic effect is not satisfactory 1 hour after the end of the second end, then the third dose: 1 gram of Furosemid is continued in 4 hours, the transmission speed does not exceed 4mg/min. If the maximum dose of 1 gram of intravenous infusion does not work, patients need artificial dialysis.

Can be used to remind the dose effectively after 24 hours, after which the dose must be adjusted depending on the response of the patient.

Treatment of chronic renal failure, the initial dose is 250 mg. When necessary, you can add 250 mg, maximum of 1.5 g/24 hours, special cases can be up to 2 g/24 hours.

Adjust the dose depending on the response of the patient. However, not long -lasting.

While using high -dose Furosemid therapy, it is necessary to check for water -electrolyte monitoring. Especially in shocked people, blood pressure and blood volume must be measured to adjust before starting this therapy. This high -dose therapy is contraindicated in renal failure due to toxic drugs for kidney or liver and in renal failure in combination with liver coma.

What to do when overdose?

Management: In return, the amount of water and electrolytes has been lost. Check regularly in serum, carbon dioxid and blood pressure. Must ensure adequate drainage in patients with congestion of urine from the bladder (such as prostate hypertrophy). Sample mitosis does not increase Furosemid excretion.

What to do when forgetting a dose?

Side Effects

The unwanted effect mainly occurs during high doses, the most common is water and electrolyte imbalance, especially in people with liver failure, kidney failure, after high doses and prolonged doses. The signs of electrolyte imbalance include headache, hypotension, dizziness, dizziness, visual disorders, cramps, dry mouth, thirst, weak, tired, sleepy, sleepy, sleep, low piss, arrhythmia and digestive disorders. Reducing blood volume and dehydration may occur, especially in the elderly. Because of the shorter acting time, the risk of hypokalemia of Furosemid may be less than the diuretic benefits. Unlike thiazid, Furosemid increases excretion of calcium in urine and renal calcium infection that has been notified in children.

Common, ADR> 1/100

Circulation: Reduce blood volume in case of high doses. Lower blood pressure.

Metabolism: Water and electrolyte imbalance include hypokalemia, hypoglycet hypoglycemia, hypoxemia, blood calcium, alkaline contamination of blood chlorine.

Uncommon, 1/1000

Gastrointestinal: Nausea, vomiting, digestive disorders.

Metabolism: Hypertension of uric acid and gout

Rare, ADR

Skin: skin rash, paresthesia, urticaria, itching, hemorrhage, peeling dermatitis, sensitive reaction to light (possibly serious).

Hypersensitivity reactions: vasculitis, interstitial nephritis, fever.

Blood: Inhibiting bone marrow, leukopenia, platelets, granulocytes, anemia.

Metabolism: increased blood glucose, urinary glucose (may be less than the durian benefits).

Pancreatitis and jaundice (more than thiazid).

ears: tinnitus, hearing loss, deafness (especially when high doses, fast speed). Deafness may not recover, especially in patients taking the same drugs that are also toxic to ears.

Instructions on how to handle ADR

Check regularly electrolytes. Supplement potassium or use with diuretics to keep potassium when the patient is at higher risk of hypokalemia. Avoid intramuscular injection or intravenous injection and exceeding the usual dose of 20 - 40 mg treatment to reduce the risk of tinnitus, hearing loss, deafness.

Dose reduction or stop treatment if ADR is medium or severe.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

sensitive to any ingredients of the drug.

Hypersensitivity to Furosemid and sulfonamid derivatives, such as sulfamid cure diabetes.

Reducing blood volume, dehydration, severe hypotension, severe hypoglycemia.

Condition of liver coma, liver coma with cirrhosis.

Anaturia or kidney failure due to toxic drugs with kidney or liver.

Caution when using

Cases of caution when taking the drug:

Monitor electrolytes, especially potassium and sodium, hypotension, gout, diabetes, kidney failure, liver failure. Avoid use in patients with severe liver failure. Reduce the dose in the elderly to reduce the risk of toxicity with hearing. When the urine is small, it is necessary to compensate for the blood volume before taking the drug.

Be cautious when using Furosemid in children, especially when used for prolonged use. Careful monitoring of water and electrolytes must be monitored. Babies lacking monthly when using Furosemid may be at risk of getting diseases and arterioscleros. Furosemid occupies the place of bilirubin at the albumin -mounted position, must be used cautiously in children with jaundice. Furosemid's clearance in infants is much slower than adults, the half -life of plasma is 8 times longer, calculating when using the dose repeated.

Intravenous speed does not exceed 4 mg/ min, slower in patients with renal impairment, liver syndrome or liver failure.

Be cautious for patients with prostate hypertrophy or urination because it can promote urinary retention. Using Furosemid is considered unsafe in patients with porphyrin metabolism disorders because it is often accompanied by an exacerbation.

In patients with parathyroid hygiene, using Furosemid may cause muscle spasms (tetani) due to hypocalcemia.

The effect of the drug on the ability to drive and operate machinery

The drug can cause unwanted effects such as headache, hypotension, dizziness, dizziness. So do not drive, operate machinery or work on high when encountered unwanted effects of the drug.

Use drugs for women during pregnancy and lactation

Pregnant women:

Furosemid may affect the fetus due to a decrease in the mother's blood volume.

Animal studies found that Furosemid could cause miscarriage, fetal death and mother without explaining. There is evidence of water stasis that occurs in pregnancy when the mother is treated with Furosemid. There are not enough well -controlled and complete studies in pregnant women, so only use Furosemid during pregnancy when the benefits are greater than the risk of pregnancy.

breastfeeding women:

using Furosemid during breastfeeding is at risk of inhibiting milk secretion. Should stop breastfeeding if taking the drug is necessary.

Interactive drug

Other diuretic drugs: increase the effect of Furosemid. Potassium -keeping pills can reduce potassium loss when using Furosemid (beneficial).

Antibiotics: Cephalosporin increases the toxicity of the kidneys, aminoglycosides increase toxicity to the ears and kidneys, Vancomycin increases the toxicity of the ear.

Lithi salt: increases the level of lithium in the blood, can be toxic. Should avoid using if you cannot monitor the concentration of blood lithium.

cardiac glycosides: increases the toxicity of glycosides on the heart due to furosemids that lower blood potassium. Need to monitor blood potassium and electrocardiograms.

Non -steroid anti -inflammatory drugs: increases the risk of toxicity to the kidneys, reduces diuretic effects.

corticosteroid: Increased risk of reducing potassium, antagonism with diuretic effects.

Anti -diabetic drugs: reduce the effect of lowering blood glucose of anti -diabetic drugs. Need to monitor and adjust the dose.

Non -reducing muscle relaxants: increase muscle relaxation effect.

Anticoagulants: Increasing anticoagulant effects.

cisplatin: Increases toxicity with ears and kidneys.

Hemotrogate medications: increase the effect of lowering blood pressure. If coordinated, the dose should be adjusted. Especially when combined with enzyme inhibitors Angiotensin, blood pressure may be severe.

Anti -epileptic drugs: Phenytoin reduces the effect of Furosemid, carbamazepine reduces sodium blood.

Chloral Hydrate: causes blushing syndrome, tachycardia, hypertension, sweating.

Probenecid: reduces the kidney clearance of Furosemid and reduces the diuretic effect.

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

taboo

"Notice immediately to the doctor or pharmacist the unwanted effects when using the drug"

Injecting Furosemid solution is a mild alkaline solution, not mixed or diluted in glucose solution or acid solution, not combined with any drug in infusion or syringe containing Furosemid.

Storage

Leave a cool place, avoid light, temperatures below 30⁰C.

To be out of reach of children, read the instructions carefully before use.

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