THERAPEUTIC INDICATIONS
- Hypertension associated with short-term forecasting of life-threatening visceral involvement (hypertensive emergency) particularly during hypertensive encephalopathy or left ventricular depression with pulmonary oedema.
- Cardiologic emergencies : acute lung oedema, asystolic cardiac arrest.
- Severe sodium retention of cardiac, renal origin or in cirrhosis.
- X-rays of lower urinary tract and “wash out” test with Furosemide.
- Can be used in paediatric resuscitation.
PHARMACEUTICAL FORM
Furosemide is available in glass ampoule with an OPC (one point cut) opening system.
PHARMACO-THERAPEUTIC CLASS
Loop diuretic, Code ATC: C03CA01
PHARMACODYNAMICS
Saliuretic action :
With the usual therapeutic doses, Furosemide has an action primarily on the upper limb of Henle’s Loop, inhibiting first the reabsorption of chlorine, then of sodium. Furosemide exerts a minor action on diluting segments of the distal tubule.
Furosemide potentiates renal blood flow to the benefit of the cortical zone. This propriety is of particular interest in association with beta-blockers which may produce the reverse effect.
Furosemide does not modify glomerular filtration (this latter was shown to be higher in certain conditions). Saliuretic action raises accordingly with the doses administered and persists in patients with renal insufficiency.
Antihypertensive action and other actions :
Hemodynamic action is characterized by the decrease of the pulmonary capillary pressure even prior to onset of diuresis, and the increase of the capacity storage of venous vascular bed shown by plethysmography (Studies of these properties were mainly focused on IV administration).
Furosemide treats all forms of sodium retention with response proportional to dosage.
Furosemide exerts antihypertensive action, resulting both from sodium depletion and hemodynamic action.
PHARMACOKINETICS
- After parenteral infusion, the major excretion path is in urine. Saliuretic action is observed within the first 5 minutes after intravenous injection.
- Average elimination half-life is about one hour. This half-life is increased in premature infants.
- Increased digestive elimination (biliary) in patients with renal insufficiency. There is then no accumulation of the product.
- Furosemide passes into the breast milk.
