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Lasix (Furosemide)
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Lasix

Lasix is a highly effective FDA approved medication for the treatment of excessive edema (fluid retention) due to kidney disorder (nephrotic syndrome), heart failure, cirrhosis and liver disease. It is also used to treat high blood pressure (hypertension). Lasix works by regulating the way in which the body absorbs salts.

Other names for this medication:

Similar Products:
Bumex, Edecrin, Demadex, Sodium Edecrin, Fluss 40

 

Also known as:  Furosemide.

Description

Lasix prevents excessive edema (fluid retention) in people with kidney disorder (nephrotic syndrome), heart failure, cirrhosis and liver disease. It is also used for the treatment of high blood pressure (hypertension), high levels of potassium (hyperkalemia), calcium (hypercalcemia), and magnesium (hypermagnesemia).

The active component, Furosemide, is a potent loop diuretic (water pill) that eliminates water and salt from the body. Furosemide works by blocking the absorption of sodium, chloride, and water from the filtered fluid in the kidney tubules, causing a profound increase in the output of urine (diuresis).

Lasix starts to act within one hour after oral administration, and the effect lasts for about 6-8 hours.

Dosage

Lasix is available in tablets which should be taken orally with a full glass of water.

The dosage of Lasix depends on the body weight and on the health status of the recipient.

Take Lasix at the same time once a day.

Do not take more than your recommended dose, as high doses of furosemide may cause irreversible hearing loss.

Do not crush or chew the tablet.

To achieve the most effective results, do not stop taking Lasix suddenly.

Overdose

In case of a Lasix overdose visit your doctor or health care provider immediately. Symptoms of a Lasix overdose include fainting, tinnitus, confusion, weakness, lightheadedness, lack of appetite.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Lasix are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Lasix if you are allergic to any of its components or if you are unable to urinate.

Do not take Lasix if you are pregnant, plan to have a baby, or you are breastfeeding.

Do not take Lasix if you suffer from or have a history of kidney disease, cirrhosis or other liver disease, gout, lupus or diabetes.

Do not take Lasix if you suffer from enlarged prostate, bladder obstruction or other urination problems, or an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

Do not take Lasix if you suffer from high cholesterol or triglycerides (a type of fat in the blood).

Use Lasix with care if you are taking indomethacin (such as Indocin); steroids (such as prednisone); diabetes medicines; diet pills; sucralfate (such as Carafate); netilmicin (such as Netromycin); amikacin (such as Amikin); streptomycin; tobramycin (such as Nebcin, Tobi); gentamicin (such as Garamycin); digoxin (such as Lanoxin); blood pressure medicines; salicylates (such as aspirin, Tricosal, Disalcid, Dolobid, Salflex, Doan's Pills); cold medicines; lithium (such as Lithobid, Eskalith), ethacrynic acid (such as Edecrin); probenecid (such as Benemid).

This medicine can make your skin more sensitive to the sunlight. Try to protect your skin where possible.

Avoid becoming dehydrated.

If you are going to have surgery, inform your doctor that you are taking Lasix.

Do not stop taking Lasix suddenly.

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The Mongolian gerbil, Meriones unguiculatus, has been widely employed as a model for studies of the inner ear. In spite of its established use for auditory research, no robust protocols to induce ototoxic hair cell damage have been developed for this species. In this paper, we demonstrate the development of an aminoglycoside-induced model of hair cell loss, using kanamycin potentiated by the loop diuretic furosemide. Interestingly, we show that the gerbil is relatively insensitive to gentamicin compared to kanamycin, and that bumetanide is ineffective in potentiating the ototoxicity of the drug. We also examine the pathology of the spiral ganglion after chronic, long-term hair cell damage. Remarkably, there is little or no neuronal loss following the ototoxic insult, even at 8 months post-damage. This is similar to the situation often seen in the human, where functioning neurons can persist even decades after hair cell loss, contrasting with the rapid, secondary degeneration found in rats, mice and other small mammals. We propose that the combination of these factors makes the gerbil a good model for ototoxic damage by induced hair cell loss.

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To evaluate independent etiologic factors associated with auditory neuropathy spectrum disorder (ANSD) in infants who have been admitted to the neonatal intensive care unit (NICU) compared to normal-hearing controls.

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Results indicated that prerace administration of furosemide decreased the incidence and severity of EIPH in Thoroughbreds racing under typical conditions in South Africa.

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Included in this analysis are trials in which preterm infants with or developing CLD and at least five days of age were randomly allocated to receive a diuretic acting on the distal renal tubule. Eligible studies needed to assess at least one of the outcome variables defined a priori for this systematic review.

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1. Membrane transport of K ions was investigated in red blood cells of bears by methods of measurement of unidirectional isotopic fluxes. 2. Unlike red cells of dogs, red cells of bears exhibited a significant, though small, component of ouabain-sensitive K influx. 3. Ouabain-insensitive K influx, as in other carnivore cells, was activated by swelling and inhibited by shrinkage. Swelling-induced K influx was dependent upon presence of chloride ions but was not inhibited by furosemide or bumetanide. 4. Ouabain-sensitive K influx was largest with ATP and with high concentration of Na in the cell, but it persisted in the absence of cytoplasmic Na or ATP. It was also resistant to the drug, harmaline, at a concentration that in other cells fully inhibits ouabain-sensitive K influx. 5. It was concluded that under such adverse conditions ouabain-sensitive K influx represents another mode of the Na/K pump not fully described elsewhere. 6. Also, as in low K red cells of sheep and goat, apparent absence of Na/K pump activity in carnivore red cells may represent suppression rather than elimination of activity. 7. Ouabain-insensitive K influx showed a seasonal pattern with minima occurring in early winter, earlier than for the minimum observed in Na influx. 8. Ouabain-sensitive K influx tended to be lower in the hibernation season of the bear, but the seasonal pattern was not consistent.

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Eight pigs underwent total hepatectomy after Y-graft interposition between the infrahepatic vena cava and the portal vein to the suprahepatic vena cava. An intracranial probe was inserted for intracranial pressure (ICP) monitoring. Animals received pressure-controlled ventilation under deep narcosis. Vital parameters were continuously recorded. Urinary output, blood gas analysis, haemoglobin, hematocrit, serum electrolytes, lactate, and glucose were monitored hourly, and creatinine, prothrombin time, international normalised ratio, and serum albumin were monitored every 8 hours. Sodium chloride solution 0.9%, hydroxyethyl starch 6%, fresh frozen plasma, and erythrocyte units were used for volume substitution, and norepinephrine was used to prevent severe hypotension. Serum electrolytes and acid-base balance were corrected as required. Antibiotic prophylaxis with ceftriaxon was given daily, as well as furosemide, to maintain diuresis.

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A 20-year old, otherwise healthy, female college student presented in an unresponsive state with respiratory distress after ingesting ecstasy (3,4-methylenedioxymethamphetamine). She had initial plasma sodium concentration of 117 mmol/l.

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Furosemide is a diuretic agent which is often given in high concentration intravenously. Since erythrocytes have a furosemide-sensitive transport system and oral application of furosemide was found to induce an echinocytic shape transformation in horses, we have analysed the influence of furosemide on erythrocyte shape, volume and blood viscosity in vitro. Increasing plasma furosemide concentrations of 0, 1, 10, 100 and 1000 micrograms/ml did not affect the erythrocyte volume or shape and left blood viscosity unaffected. We conclude that furosemide has no influence on blood rheology in humans.

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Rhabdomyolysis, a term used to describe the rapid breakdown of striated muscle, is characterized by rupture and necrosis of muscle fibers. This process results in the release of cell breakdown products into the bloodstream and extracellular space. Although direct muscle injury remains the most common cause of muscle injury, additional causes include hereditary enzyme disorders, drugs, toxins, endocrinopathies, malignant hyperthermia, neuroleptic malignant syndrome, heatstroke, hypothermia, electrolyte alterations, diabetic ketoacidosis and non-ketotic hyperosmolar coma, severe hypo- or hyperthyroidism and bacterial or viral infections. The classic triad of symptoms includes muscle pain, weakness and dark urine, although more than 50% of the patients do not complain of muscle pain or weakness. Additional systemic symptoms include fever, general malaise, tachycardia, nausea and vomiting. The laboratory diagnosis is based essentially on the measurement of creatine kinase in serum or plasma. Plasma and urine myoglobin measurement might be useful in the early stages of the syndrome and for identifying a subset of patients with minor skeletal muscle injury. Patient monitoring is pivotal (the mortality rate is as high as 8%), and should be focused on preventing the detrimental consequences, that often include renal disease and coagulopathy. In the pre-hospital setting, forced hydration with 1.5-2 L of sterile saline solution should be started immediately, followed by 1.5-2 L/h. Following hospital admission, continuous hydration should be ensured, alternating the saline solution with a 5% glucose solution. In the presence of myoglobinuria, urine should be alkalinized by use of sodium bicarbonate solution. Clin Chem Lab Med 2010;48:749-56.

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A possible interaction between furosemide and the non-steroidal antiinflammatory drug (NSAID) tenoxicam was investigated in 12 patients (6 males, 6 females) with mild heart insufficiency and with a need for antiinflammatory treatment. The patients received once daily doses of 40 mg furosemide over 15 days. From day 6 onwards until day 13 tenoxicam was concurrently administered: 20 mg b.i.d. on days 6 and 7 and 20 mg once a day on days 8 through 13. On days 0 (pre-check), 1, 3, 5, 9, 12 and 15 vital parameters were measured and urine quantitatively collected to assess the elimination of a series of biochemical determinants. The urinary excretion profiles of furosemide and trough plasma levels of tenoxicam were measured on days 5, 9, 12 and 15. Vital parameters (blood pressure, heart rate, ECG and body weight) were not affected by tenoxicam. The urinary excretion of sodium and chloride tended to decrease during treatment with tenoxicam, but this effect was not significant. Tenoxicam caused a significant drop of prostaglandin E2 (PGE2) in 12-h urine of both gender: from 601 +/- 397 ng on day 5 to 264 +/- 117 ng on day 9 for men and from 128 +/- 78 ng on day 5 to 67 +/- 55 ng on day 9 for women. Creatinine clearance, beta 2-microglobulin clearance and urinary excretion of N-acetyl-glucosaminidase did not reveal evidence for acute renal impairment. The urinary excretion profile of furosemide was not significantly changed by concurrent dosing of tenoxicam. The drop in PGE2 excretion was likely a direct effect of tenoxicam on the synthesis of renal prostaglandins.

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Within-subject variability in MFBIA at 1, 5, 50, and 100 kHz expressed as standard deviations was 21, 19, 14, and 14 Ohm (omega), respectively. Furosemide caused a mean weight loss of 1.8 +/- 0.6 kg, which resulted in significant increases in impedance of 57 +/- 24 omega at 1 kHz and 37 +/- 12 omega at 100 kHz (p < .001). The responsiveness of MFBIA for the diuretic intervention was best at 5 kHz (responsiveness index = 1.98).

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This study investigated the pharmacokinetics, safety, and tolerability of aliskiren administered alone or in combination with either the loop diuretic furosemide or an oral extended-release formulation of isosorbide-5-mononitrate (ISMN). In separate studies, 22 healthy subjects (ages 18-45 years) received either ISMN 40 mg or furosemide 20 mg once-daily for 3 days followed by a 3-day washout. Subjects then received aliskiren 300 mg once-daily for 7 days followed by combination therapy for 3 days. Pharmacokinetic assessments were taken at regular intervals over 24 h after dosing on the last day of each treatment period. At steady state, aliskiren AUC(tau) was decreased by 7% (geometric mean ratio [90% CI], 0.93 [0.84, 1.04]), and C(max) by 20% (0.80 [0.65, 0.97]) with furosemide coadministration compared with aliskiren administration alone. Aliskiren coadministration reduced furosemide AUC(tau) by 28% (0.72 [0.64, 0.81]) and C(max) by 49% (0.51 [0.39, 0.66]) compared with furosemide alone. Coadministration of aliskiren and ISMN was associated with only minor changes in the pharmacokinetic parameters of aliskiren (AUC(tau) 1.03 [0.90, 1.18]; C(max) 0.94 [0.69, 1.29]) and ISMN (AUC(tau) 0.88 [0.71, 1.10]; C(max) 0.94 [0.79, 1.13]). Headache and dizziness were the most common adverse events in both studies; dizziness and BP values below normal (SBP < 90 and/or DBP < 50 mmHg) were more frequent with aliskiren and ISMN coadministration than with either agent alone. Coadministration of aliskiren and ISMN had no clinically relevant effect on either aliskiren or ISMN pharmacokinetics. In conclusion, coadministration of aliskiren and furosemide reduced furosemide exposure and had a minor effect on aliskiren pharmacokinetics. The clinical significance of reduced systemic exposure to furosemide during coadministration of aliskiren is uncertain.

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Differential interference contrast microscopy was used in combination with standard electrophysiological techniques in the in vitro perfused mouse medullary (mTALH) and cortical (cTALH) thick ascending limbs of Henle to evaluate the cell volume responses of these nephron segments to sudden increases in peritubular osmolality and to assess the role of antidiuretic hormone (ADH) and net NaCl absorption on hypertonic volume regulation. In the absence of CO2/HCO3- in external media, the cells of the mTALH behaved in a simple osmometric fashion, with an osmotic space equivalent to 70-80% of the total cell volume. However, in CO2/HCO3- -containing media, the cells of the mTALH, but not the cTALH, were able to increase their cell volume to the original volume after shrinkage in peritubular media made hypertonic with either NaCl or mannitol. This volume-regulatory increase response (VRI) in the mTALH was mediated by an increase in intracellular osmoles, and required peritubular ADH, at concentrations that stimulate maximally the rate of net NaCl absorption. This ADH effect on VRI could be mimicked by addition of dibutyryladenosine 3',5'-cyclic monophosphate to the bath in the absence of hormone. However, 10(-4) M luminal furosemide, a concentration that abolishes ADH-dependent NaCl absorption in the mTALH, had no effect on the VRI response. These results indicate that the cells of the mTALH, but not the cTALH, are capable of hypertonic volume regulation, that ADH (via adenosine 3',5'-cyclic monophosphate) is required for expression of the VRI response in the mTALH, and that the effects of ADH on net NaCl absorption and the VRI response in the mTALH are completely dissociable. Thus these results are consistent with a role for ADH in hypertonic VRI in the mammalian mTALH, which may operate to maintain constant cell volume in this nephron segment during antidiuresis.

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This study was conducted to determine whether a chronic increase in sodium delivery to, and sodium uptake by, the distal tubule stimulates the transport capacity of this tubular segment. To increase the rate of sodium delivery to the distal tubule, furosemide (12 mg/day) was administered continuously to rats by osmotic minipump for 6 days. Volume depletion was prevented by giving the animals a drinking solution containing 0.8% NaCl and 0.1% KCl. Control animals were given vehicle (0.9% NaCl) by osmotic minipump and tap water to drink. All animals were adrenalectomized and given replacement doses of aldosterone (0.5 microgram.100 g-1.day-1) and dexamethasone (1.2 microgram.100 g-1.day-1) to eliminate changes in adrenal corticosteroid levels. Furosemide was withdrawn 12 h before sodium and potassium transport rates were measured in distal tubules by in vivo microperfusion. We found that increased sodium uptake dramatically enhanced the transport capacity of the distal tubule. Sodium absorption rose from 71.7 to 316.7 pmol.min-1.mm-1, and potassium secretion increased from 30.7 to 73.7 pmol.min-1.mm-1. This response was accompanied by an increase in cell and mitochondrial volume and by proliferation of the basolateral membrane of distal convoluted cells, connecting tubule cells, and principal cells in the distal tubule. We conclude that a chronic increase in sodium uptake by the distal tubule, independent of alterations in extracellular fluid volume and aldosterone levels, stimulates the transport capacity of this nephron segment in part by inducing specific alterations in cell ultrastructure.

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Nitrate therapy improves hemodynamics in patients with heart failure, but the chronic effects of oral nitrates on exercise performance and clinical status have not been well studied.

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Torasemide is a loop diuretic used for the treatment of hypertension and for oedema in chronic heart failure (CHF), renal failure and cirrhosis. The efficacy of torasemide in reducing salt and water retention in CHF has been established in double-blind comparative studies against furosemide. Torasemide has been shown to be at least as effective as furosemide in terms of total volume of urine excreted and also has a longer duration of action. The efficacy of torasemide (in terms of improved CHF symptoms and reduced pulmonary congestion, oedema and bodyweight) has been shown in randomised controlled trials and confirmed in large postmarketing studies. In addition, data from postmarketing studies have shown that patients receiving torasemide had significantly reduced hospital admission rates compared with patients receiving furosemide. Pharmacoeconomic assessments of torasemide have focused on its effect in reducing hospitalisation. Hospitalisation costs due to CHF decreased by 86% during the 11.2-month period of torasemide treatment, compared with the 6-month period prior to treatment, in a US retrospective study assessing medical and pharmacy claims data. Overall, average monthly costs for patients decreased by 56.6% after 5.1 months (from $US1,897.28 to $US823.70 per patient per month; PPPM), and by 76% after 11.2 months (from $US1,944.76 to $US470.76 PPPM) of torasemide treatment. In the furosemide group, average monthly costs for patients increased moderately from $US227.28 to $US261.18 PPPM after 12 months. Direct comparison of the torasemide and furosemide study groups was not possible because the group receiving torasemide had much higher healthcare resource use at baseline. Compared with furosemide, torasemide was associated with reduced rates of hospital admissions for CHF and/or cardiovascular causes in 3 studies, a retrospective analysis conducted in Germany, a prospective US study of patients enrolled from hospital admissions and a decision-analysis model. As a result, the direct costs of treatment for CHF or cardiovascular diseases for patients treated with torasemide were less than those with furosemide. However, in the US study, there was no statistically significant difference in hospital admissions for all causes and/or in overall direct medical costs, although the study was not powered to show this. In another US study of managed care patients with New York Heart Association (NYHA) class II or III CHF, no difference in clinical or economic outcomes was observed between patients taking torasemide or furosemide; despite the higher acquisition costs for torasemide, total costs were similar for both groups. Torasemide was found to be more cost effective than furosemide in terms of cost per patient with improved functional (NYHA) class of CHF severity in a retrospective German analysis, although this measure is not ideal. This study also evaluated indirect costs (for loss of productivity of employed patients) and resultssuggest torasemide has a favourable effect in reducing days off work compared with furosemide, although the population of employed patients in the study was very small. Torasemide has been shown to improve some measures of quality of life in 2 studies. It was associated with higher quality-of-life scores than furosemide in a 6-month study, but the differences were only significant at month 4. In another study, torasemide significantly improved fatigue, but full study details are yet to be published.

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Each infant had pulmonary function tests at study entry, 4 weeks after study entry, 1 week and 8 weeks after being weaned to room air and off study drugs, and at 1 year of corrected age. Pulmonary function tests include dynamic pulmonary compliance, airway resistance, thoracic gas volume, and maximal expiratory flow at functional residual capacity; most of the infants had functional residual capacity measured. Between the first and second pulmonary function tests (while the infants were receiving diuretic or placebo), the infants in the diuretic group had a significant improvement in dynamic pulmonary compliance (46%; p < 0.001) and airway resistance (31%; p < 0.05); there were no changes in compliance or resistance in the placebo group. Although patients in both the diuretic and the placebo groups required progressively less supplemental oxygen, by 4 weeks after study entry the patients in the diuretic group needed less supplemental oxygen than did those in the placebo group (p < 0.01). There were no significant differences in results of serial pulmonary function tests in either group after discontinuation of diuretic therapy. Despite the significant differences in pulmonary function between the two groups, there was no significant difference between them in the total number of days that supplemental oxygen was required. Significantly more infantsin the placebo group received more than 10 doses of furosemide on an as-needed basis.

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To investigate whether electrocochleography (ECochG) and glycerol and furosemide tests could predict progression from atypical to definite Ménière's disease (MD).

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The radioimmunologic assays appeared to be the most convenient methods for determination of atrial natriuretic peptide (ANP) concentration in blood plasma. The purpose of this work was to compare the control quality parameters of two radioimmunologic methods for the ANP determination in human plasma: the methods described by Pruszczyński et al. and the method with the use of Amersham ready-made set (kit). The comparison of the two methods was performed by analyzing 10 series of ANP determinations carried out by Pruszczyński method, and 15 series by means of the kit. Both methods appeared to fulfil the criteria of satisfactory quality for RIA determinations. The second purpose of this study was to define the utility of the RIA method for the determination of ANP in clinical practice, taking into the consideration some factors influencing or modifying plasma ANP levels. Three groups of persons of were studied: 15 healthy subjects, 16 patients with acromegaly and 47 patients with the impairment of renal function. The ANP level in plasma was determined in these 3 groups of persons. It has been demonstrated that the change of body position from upright to supine caused the increase of the ANP concentration in plasma. It has also been found that the decrease in the intravascular fluid volume induced by furosemide administration resulted in the reduction of ANP concentration in plasma. The enlarged intravascular fluid volume, accompanying acromegaly and probably present in persons with the impairment of kidneys, was associated with the increased ANP concentrations in plasma.

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Each patient underwent a successful procedure without open conversion or transfusion. The average estimated blood loss was 40 mL. The operative time averaged 122 minutes (range 60 to 330) overall. Crossing vessels were present in 30% of the patients and were preserved in all cases. The time for the anastomosis averaged 20 minutes (range 10 to 100). Intraoperatively, no complications occurred. Postoperatively, the average hospital stay was 1.1 days. The stents were removed at an average of 20 days (range 14 to 28) postoperatively. The average follow-up was 11.7 months; at the last follow-up visit, each patient was doing well. Of the 50 patients, 48 underwent one or more renograms, demonstrating stable renal function, improved drainage, and no evidence of recurrent obstruction.

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Despite the development of AKI requiring dialysis after surgical correction of congenital cardiac anomalies, the long-term renal prognosis in survivors is good.

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We studied 124 patients retrospectively in whom incomplete dRTA was suspected: 71 had kidney stones only, 9 had nephrocalcinosis only and 44 had both. A total of 158 UA tests were performed: 124 F+F and 34 NH4Cl; both tests were completed in 34 patients.

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Renographic studies under standardised conditions of maximal diuresis provoked by infusion of hypotonic saline and frusemide were made on 51 patients with 54 dilated upper urinary tract systems in order to distinguish obstructed from non-obstructed systems. Of the 23 systems judged on clinical and radiological grounds to be obstructed only 12 were in fact obstructed following infusion of hypotonic saline and frusemide. In 10 of these systems (10 patients) an Anderson-Hynes pyeloplasty was carried out. All systems showed improved renal function after operation and the renographic pattern became non-obstructed.

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A 21-month-old boy came to our attention because of pneumonia. His weight increased before presentation, and his blood test results showed hyponatremia (116 mEq/L), low plasma osmolarity (241 mOsm/L), and high urine osmolarity (435 mOsm/L). He was treated with 0.9% sodium chloride solution and intravenous furosemide, and sodium levels rose up to 135 mEq/L in 36 hours. No standard treatment is available for severe hyponatremia in children. The use of vaptans in pediatric patients is described in literature, but it lacks evidence about safety and effectiveness. We suggest that furosemide administration plus salt replacement is effective in restoring normal values of plasma sodium concentration in severe euvolemic and hypervolemic hyponatremia.

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The aqueous calyx extract of Hibiscus sabdariffa (HS) has a folk reputation as an antihypertensive agent. On account of its antioxidant properties and probably high K+ concentration, we hypothesized that HS may attenuate the development of salt-induced hypertension. Sprague-Dawley rats (n=8 each) were treated for 12 weeks as follows: control (normal diet + water), salt-loaded (8% salt diet + water), HS (normal diet + 6 mg/ml HS), salt+HS (8% salt diet + 6 mg/ml HS) and furosemide (normal diet+ 0.25mg/Kg furosemide). Their blood pressure and heart rates were measured and responses to noradrenalin and acetylcholine (0.01 mg/kg respectively) were estimated. The cationic concentration of 6 mg/ml HS was determined. The Na+ and K+ concentrations of 6 mg/ml HS were 3.6 and 840 mmol/l respectively. The mean arterial pressure (MAP±SEM; mmHg) of salt loaded rats (184.6±29.8) was significantly higher than control (113.2±3.0; P<0.05), HS (90.0±7.4; P<0.001) salt+HS (119.4±8.9; P<0.05) and furosemide (94.9±11.5; P<0.01). The MAP of salt+HS and control rats did not differ significantly and the effect of HS was comparable to furosemide. The pressor response to noradrenalin or vasodilator response to acetylcholine remained similar in all groups. These results suggest that HS attenuated the development of salt-induced hypertension and this attenuation may be associated with its high K+ content or high potassium: sodium ratio and not with altered pressor/depressor response to noradrenalin or acetylcholine. Also the effects of HS and furosemide on blood pressure are comparable.

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Furosemide alone produced natriuresis/diuresis and a prompt rise in plasma aldosterone values. Nesiritide alone produced no significant natriuresis/diuresis, but decreased plasma aldosterone values. When furosemide was administered on a background of nesiritide infusion, the observed natriuresis/diuresis was similar to that seen with furosemide alone, without the anticipated increase in plasma aldosterone observed with furosemide alone.

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The study was conducted on normal hearing albino mice of the Sabra strain. They were injected with either salicylic acid alone (N = 11), or furosemide alone (N = 14), or both together (N = 14), or with saline control (N = 11) and exposed to broad band noise for 3.5 hours. An additional group of 9 mice was injected with both salicylic acid and furosemide, but not exposed to noise. The degree of the resulting hearing loss was assessed by recording thresholds of the auditory nerve brainstem evoked responses to broad band clicks before the injections and noise, and 7, 14 and 21 days after.

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In order to determine how both diuretics affect water metabolism, we here compare the effects of a rechallenge with either amiloride-hydrochlorothiazide fixed association (AmHTZ; amiloride chlorhydrate 5 mg+hydrochlorothiazide 50 mg; Moduretic) or furosemide (F; 40 mg; Lasix) on water excretion in a 79 year old woman who was previously admitted for severe symptomatic hyponatremia secondary to a 5 days course of AmHTZ for systolic hypertension. After correction of initial hydromineral disturbances, a standard oral water load (WL; 20 mL per kg body weight) was administered before, during and after AmHTZ or F challenges.

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lasix dose 2017-07-10

Factors that influence intersubject variability in response to furosemide have been investigated in normal subjects and patients with cirrhosis. Furosemide pharmacokinetics and pharmacodynamics were measured in eight normal subjects and 14 patients with cirrhosis, eight of whom were resistant to diuretic therapy. Furosemide renal clearance decreased in proportion to creatinine clearance, whereas nonrenal clearance and volume of distribution were unchanged. These pharmacokinetic changes were, however, minimal and resulted in an only marginal alteration in the plasma concentration-time curve. The maximal rate of urinary sodium excretion decreased with reductions in creatinine clearance (r = 0.77). However, the extent of reduction in urinary excretion of sodium was proportionally greater than the reduction in creatinine clearance, whereas the rate of urinary furosemide excretion required to achieve 50% of maximal response did not change buy lasix . Furosemide's pharmacokinetics were not, therefore, appreciably altered by cirrhosis. However, cirrhosis was associated with a reduction in pharmacodynamic response to this diuretic.

lasix 20mg tab 2015-06-07

Prospective study. buy lasix

lasix drug class 2015-02-19

Testing hepatotoxicity is a crucial step in the development and toxicological assessment of drugs and chemicals. Bio-activation can lead to the formation of metabolites which may present toxicity for the organism. Classical cytotoxic tests are not always appropriate and are often insufficient, particularly when non metabolically-competent cells are used as the model system, leading to false-positive or false-negative results. We tested over 24 h the effects of eight reference compounds on two different cell models: primary cultures of rat hepatocytes and FAO hepatoma cells that lack buy lasix metabolic properties. We performed inter-assay validation between three classical cytotoxicity assays and real-time cell impedance data. We then complemented these experiments with high-content screening (HCS) to determine the cell function disorders responsible for the observed effects. Among the different assays used, the neutral red test seemed to be well suited to our two cell models, coupled with real-time cellular impedance which proved useful in the detection of bio-activation. Indeed, impedance monitoring showed a high sensitivity with interesting curve profiles yet seemed unsuitable for evaluation of viability on primary culture. Finally, HCS in the evaluation of hepatotoxicity is likely to become an essential tool for use in parallel to a classical cytotoxic assay in the assessment of drugs and environmental chemicals.

lasix medicine 2016-03-29

Thirty six infants were included in the present study. Fourteen had abnormal ultrasound buy lasix scans compatible with nephrocalcinosis giving an overall incidence of 38.9%. Factors associated with nephrocalcinosis included severity of respiratory illness, PDA, oxygen dependency, furosemide therapy, and fluid restriction. Urinary tract infection was the renal morbidity found in 3 infants (21.4%). Nephrocalcinosis was resolved in one out of 7 infants who had repeated renal ultrasound scan at about 2 months after the first scan.

lasix 40mg tab 2015-07-08

The efficacy and side effects of the combination therapy of thiazide and furosemide administered to patients with refractory heart failure, for a prolonged period of time, were assessed. Thirty-two patients were hospitalized during the years 1985-1991. Left heart failure (left ventricular ejection fraction (LVEF = 22.4% +/- 6.6%) was present in 26 patients, right heart failure in 3 patients, chronic renal failure, cirrhosis and bilateral pleural effusion were present each in one patient. Chlorothiazide 0.5 g daily was added to conventional therapy. Patients were monitored closely during hospitalization and later as outpatients. During hospitalization, addition of chlorothiazide caused a reduction of 4.8 +/- 4.0 kg in patients' weight, serum potassium decreased from 4.4 +/- 0.6 to 4.0 +/- 0.5 mmol/l (P < 0.005) and serum sodium from 139.0 +/- 4.7 to 136.8 +/- 5.5 mmol/l (P < 0.05). The duration of the combined therapy was 17.2 +/- 19.1 months. Thirteen patients had short treatment (1.6 +/- 0.8 months) and 19 patients had buy lasix prolonged treatment (26.5 +/- 19.0 months). No specific characteristics distinguished patients in both groups. Thiazides were discontinued in 19 patients, 10 of which had side effects. In only 5 of the 19 patients treated for the prolonged period had thiazides to be discontinued because of side effects. Addition of thiazides to furosemide is efficacious in severe heart failure. The combination should be started during hospitalization. Many patients can be maintained on this combination for a prolonged period of time on an ambulatory basis.

lasix 500mg tablet 2016-02-24

Basolateral membrane vesicles (BLMV) isolated from both red outer medulla or from thick ascending limb segments isolated from the dog kidney were used to examine the process of lactate transport in this nephron segment. The BLMV preparation was enriched in Na(+)-K(+)-adenosinetriphosphatase (Na(+)-K(+)-ATPase) that represented 96% of the total ATPase activity of this preparation and the vesicles were largely under the right side-out orientation. On application of a OH- or HCO3- gradient (inside greater than outside), a secondary active lactate accumulation was observed, with characteristic transient overshoot. This phenomenon was shown to occur irrespective of the presence or absence of Na+, K+, or Cl-. The pH, but not the bicarbonate-driven, overshoot was abolished by nigericin (in presence of K+). Studies with valinomycin and K+ demonstrated that the generation of a membrane potential was not responsible for the acceleration of lactate transport, even if the amplitude of lactate accumulation was reduced in the presence of a bicarbonate gradient buy lasix and valinomycin. A significant trans-stimulation of [14C]lactate transport by cold lactate was observed (under voltage-clamp condition). The transport was 4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonic acid insensitive but sensitive to furosemide (IC50 = 0.1 mM) and alpha-hydroxycyanocinnamate (IC50 = 1 mM). The kinetic parameters of the transporter revealed a single carrier with an apparent Michaelis constant of 1.7 mM and an apparent Vmax of 9.7 nmol.mg protein-1.30 s-1. The transporter was shown to be distinct from that of proximal tubule brush-border membrane or mitochondria (pyruvate). Thus thick ascending limbs possess a carrier-mediated lactate transport that can be used for lactate uptake (aerobic condition) or for lactate release (anaerobic glycolysis) according to metabolic processes imposed by the local oxygenation condition.

3 mg lasix 2015-01-21

1. The inhibitory neurotransmitter glycine can elicit depolarizing responses in immature neurones. We investigated the changes in glycine responses and their ionic mechanism in developing neurones of the rat lateral superior olive (LSO), an auditory brainstem nucleus involved in sound localization. 2. Whole-cell and gramicidin perforated-patch recordings were performed from visually identified LSO neurones in brain slices and glycine was pressure applied for 3-100 ms to the soma. Glycine-evoked currents were reversibly blocked by strychnine. They were mostly monophasic, but biphasic responses occurred in approximately 30 % of P8-11 neurones in perforated-patch recordings. 3. In whole-cell recordings from P2-11 neurones, the reversal potential of glycine-evoked currents (EGly) was determined by the transmembranous Cl- gradient and corresponded closely to the Nernst potential for Cl-, regardless of age. This indicates that Cl- is the principle ion permeating glycine receptors, but is also consistent with a low relative (10-20 %) permeability for HCO3-. The Cl- gradient also determined the polarity and amplitude of glycine-evoked membrane potential changes. 4. Leaving the native intracellular [Cl-] undisturbed with gramicidin perforated-patch recordings, we found a highly significant, age-dependent change of EGly from -46.8 +/- 1.8 mV (P1-4, n = 28) to -67.6 +/- 3.3 mV (P5-8, n = 10) to -82.2 +/- 4.1 mV (P9 buy lasix -11, n = 18). The majority of P1-4 neurones were depolarized by glycine ( approximately 80 %) and spikes were evoked in approximately 30 %. In contrast, P9-11 neurones were hyperpolarized. 5. In perforated-patch recordings, EGly was influenced by the voltage protocol and the glycine application interval; it could be shifted in the positive and negative direction. For a given application interval, these shifts were always larger in P1-4 than in P8-11 neurones, pointing to less effective Cl- regulation mechanisms in younger neurones. 6. Furosemide (frusemide), a blocker of cation-Cl- cotransporters, reversibly shifted EGly in the negative direction in P2-4 neurones, yet in the positive direction in P8-10 neurones, suggesting the blockade of net inward and net outward Cl- transporters, respectively. 7. Taken together, age-dependent changes in active Cl- regulation are likely to cause the developmental shift from depolarizing to hyperpolarizing glycine responses. A high intracellular [Cl-] is generated in neonatal LSO neurones which decreases during maturation.

lasix 20 mg 2017-04-07

The effect on renal function of long-term treatment with either enalapril (n = 123) or placebo (n = 120) in addition to conventional therapy was studied in a randomized trial in patients with severe congestive heart failure (New York Heart Association functional class IV; the Cooperative North Scandinavian Enalapril Survival Study). Enalapril was administered in a dose of 2.5 to 40 mg/day. The analysis was restricted to the first 6 months of treatment. There was an average initial increase of 10 to 15% (10 to 20 mumol/liter) irrespective of baseline serum creatinine within the first 3 buy lasix weeks of enalapril treatment, whereafter mean serum creatinine remained on a similar level during the first 6 months. Enalapril was well-tolerated by most patients, and serum creatinine was reduced in 24%. Serum creatinine increased by greater than 100% in 13 patients (11%) in the enalapril group (mainly as a consequence of intercurrent disease or severe hypotension, and usually transiently) and in 4 (3%) in the placebo group. The maximal increase in serum creatinine in the enalapril group was inversely correlated to the diastolic blood pressure (p = 0.008) at baseline and to the mean diastolic and systolic blood pressures measured at the time of the maximal increase in serum creatinine (p = 0.0001). According to multivariate regression analysis, the maximal increase in serum creatinine was also slightly influenced by the dose of furosemide taken. The development of hypotension emerged as the strongest factor explaining an abnormal increase in serum creatinine.(ABSTRACT TRUNCATED AT 250 WORDS)

lasix tablets 2015-11-05

Furosemide increased U-AQP2 (140 %), urine volume (280 %), C(H2O) (95 %) and buy lasix FE(Na) by a factor of 15 (p<0.008 for all), and also AVP (51 %), PRC, Ang II (86 %) and Aldo (59 %) (p<0.021 for all). ANP and BNP did not change.

lasix generic name 2017-12-11

Each GABA(A) receptor consists of two alpha and three other subunits. The spatial and temporal distribution of different alpha subunit isomeres expressed by the CNS is highly regulated. Here we study changes in functional contribution of different alpha subunits during neonatal development in rat visual cortex. First, we characterized postsynaptic alpha subunit expression in layer II-III neurons, using subunit-specific pharmacology combined with electrophysiological recordings in acutely prepared brain slices. This showed clear developmental downregulation of the effects of bretazenil (1 microm) and marked upregulation of the effect of 100 nM of zolpidem on the decay of spontaneous inhibitory postsynaptic currents (sIPSCs). Given the concentrations used we interpret this as downregulation of the synaptic alpha3 and upregulation of alpha1 subunit. Furthermore, the effect of furosemide, being indicative of the functional contribution buy lasix of alpha4, was increased between postnatal days 6 and 21. Our second aim was to study the effects of plasticity in alpha subunit expression on decay properties of GABAergic IPSCs. We found that bretazenil-sensitive IPSCs have the longest decay time constant in juvenile neurons. In mature neurons, zolpidem- and furosemide-sensitive IPSCs have relatively fast decay kinetics, whereas bretazenil-sensitive IPSCs decay relatively slowly. Analysis of alpha1 deficient mice and alpha1 antisense oligonucleotide deletion in rat explants showed similar results to those obtained by zolpidem application. Thus, distinct alpha subunit contributions create heterogeneity in developmental acceleration of IPSC decay in neocortex.

lasix 160 mg 2016-07-06

Three hundred and thirty-five cirrhotic patients (219 males; mean age 65 ± 10.85 years; 196 Child-Pugh class A, 104 class B and 35 class C) buy lasix were consecutively analysed and followed up for 24 months. Electrocardiograms were available for all patients before starting the study, at basaltime and during the follow-up. Echocardiography was performed in individuals with atrial fibrillation and in 100 randomly chosen patients without it.

lasix order 2017-08-26

Compatibility and stability of the polygeline-based blood plasma expander/plasma substitute Haemaccel with different drug products i.e., Profenid, Stemetil, and Lasix were examined in the context of its potential use in surgical, spinal, septic shock and in circulatory insufficiency, because treatment, safety, acceptability and efficacy of drug product may be affected by drug instability or incompatibility buy lasix . Therefore, drug stability and compatibility are critical elements in accurate and appropriate delivery of drug therapy to patients. This study was initiated to specifically and critically assess the compatibility of Haemaccel with different drug products with the aim of delivering safe, suitable, acceptable and efficacious administration of two different drug products simultaneously in emergency conditions. All of these different brands of drug products were physically and chemically compatible with Haemaccel and all of the test results were almost similar before and after mixing different drugs in Haemaccel. This study revealed that Lasix, Profenid and Stemetil can be administered/co-administered with Haemaccel safely. Different drug product must be studies in detail before it's co-administration with Haemaccel.

lasix 240 mg 2016-06-28

Higher magnetic field strength is beneficial for renal BOLD MRI studies. The cortico-medullary contrast on the R2* map was significantly improved at 3.0 T, with no evidence of increased bulk susceptibility artifacts. Baseline R2* and DeltaR2* in the renal medulla at 3.0 T were both significantly higher compared to our previously reported data buy lasix obtained at 1.5 T.

lasix gtt dosage 2017-10-18

The bioavailability, pharmacokinetics, and pharmacodynamics of torsemide (10 mg orally and intravenously) and furosemide (40 mg orally and 20 mg intravenously) were determined in a randomized crossover clinical trial in 16 patients with compensated congestive heart failure. Torsemide (time to reach maximum concentration [tmax], 1.1 +/- 0.9 hour) was more rapidly absorbed than furosemide (tmax, 2.4 +/- 2.5 hours), the absorption of which was delayed compared with that in healthy volunteers. Bioavailability of torsemide was also greater and less variable Lasix 40mg Tab than that of furosemide. All four treatments yielded comparable changes from baseline in 24-hour electrolyte excretion. Based on the relationships between sodium excretion rate and fractional sodium and urinary drug excretion rate, response to both diuretic agents at the level of the nephron was decreased compared with previous studies with healthy subjects. Assessment of the clinical relevance, if any, of the difference in the variability of absorption warrants further study.

lasix and alcohol 2017-11-25

The obstructed mean resistive index before (0.71) and after (0.74) furosemide administration differed significantly from the nonobstructed mean resistive index (0.65, p < 0.02). Postoperative mean resistive index (0.68) was not affected by the diuretic and did not differ from the mean resistive index of nonobstructed kidneys. Resistive index test sensitivity was 76% and specificity Alcohol W Flagyl was 88%. The precision for 3 values per test was +/- 0.11.

lasix reviews 2015-03-04

Research in nephrologic nuclear medicine is presently concentrated in two well-defined areas: interventional procedures and Norvasc Tablet Benefits the use of mercaptoacetyltriglycine. The ongoing evaluation of mercaptoacetyltriglycine continues to be a source of interesting research activity, with the distribution volume and the extent of hepatic excretion remaining points of discussion. This tracer permits quantitative determination of renal function. As an imaging agent, mercaptoacetyltriglycine compares favorably with hippurate and with diethylenetriamine penta-acetic acid, particularly in evaluating renal insufficiency. Renal function studies obtained during pharmacologic or physiologic intervention dominate research in hypertension and obstructive uropathy. Angiotensin-converting enzyme inhibition improved the renographic detection of renovascular lesions. Interventional renography with angiotensin-converting enzyme inhibition or ergometric exercise were both capable of generating useful prognostic data on the posttherapy blood pressure response in patients with renovascular hypertension. Interventional diuretic renography with furosemide permits surgical intervention to be reserved for organs at immediate risk because the degree of obstruction and the extent of renal function compromise are easily recognized.

lasix cost 2016-02-18

The objective of this study was to evaluate the human NCI-N87 cell line as a model for gastric permeability drug studies under pH conditions of the stomach. The optimal conditions that led NCI-N87 cells to form a typical differentiated gastric epithelial barrier were a seeding density of 2.5 × 10⁵ cells/cm² on porous inserts and growth in serum-complemented RPMI-1640 medium until 18-27 days post-confluency. The resulting cell monolayers showed moderately high transepithelial electrical resistance (TEER) values of about 500 Ω cm², cells of polygonal morphology expressing E-cadherin and ZO-1 proteins at their contact surfaces, and production of mucus clusters. The monolayers withstood apical pH of 7.4 down to 3.0 with the basal pH fixed at 7.4. The apparent permeability coefficients (P(app)) of model compounds were evaluated in the apical-to-basolateral and basolateral-to-apical directions under different pH gradients. The monolayers were impermeable to the integrity marker Lucifer Yellow (low P(app) of 0.3-1.1 × 10⁻⁶ cm/s). The furosemide P( Detrol La Generic app) (0.4-1.5 × 10⁻⁵ cm/s) were slightly dependent on pH but remained moderate. The caffeine P(app) (4.2-5.0 × 10⁻⁵ cm/s) were higher and insensitive to pH changes. The NCI-N87 cell line provides a useful in vitro tool to assess gastric drug permeability and absorption under physiologic conditions prevailing in the human stomach.

lasix generic 2016-09-14

The treatment of severe cirrhotic ascites is still a major clinical problem. On the basis of the current recommendations for treatment in the textbooks we have reviewed the randomized clinical trials comparing the existing different options of treatment. It is concluded that paracentesis is marked by several advantages compared to diuretics. Paracentesis has to be followed by an intravenous infusion of a volume expander to avert hypovolaemic complications and can then be performed as total paracentesis. The effect has to be maintained by diuretics. Synthetic products of low cost may substitute albumin. Intravenous reinfusion of ascites fluid constitutes a viable alternative. Under diuretic treatment spironolactone (in doses up to 400 mg daily) should be preferred to furosemide. Combinations of diuretics offer no advantages. The value of sodium restriction although rational is not documented in randomized trials. Sodium restriction is difficult to comply with and is not crucial for the therapeutic effect when diuretics are being administered at the Strattera And Alcohol same time. The advantages of a peritoneovenous shunt are outweighed by the very frequent incidence of shunt occlusion, for which reason the application should be restricted.

lasix dosage racehorses 2016-08-27

The prostaglandin system influences renal sodium and water excretion and appears to be more active in the Dahl salt-resistant (DR) than salt-sensitive (DS) rat. During an investigation of renal papillary prostaglandin E (PGE) biosynthesis in DR and DS rats, it was noted that the PGE response to specific stimuli was dependent on the type of stimulus applied. Rats fed either a 0.3% of 4% NaCl diet from Vasotec Cost 3 weeks of age were killed at 13 to 15 weeks of age. The renal papilla was sectioned and incubated in Krebs-Henseleit buffer. We stimulated PGE biosynthesis by incubation of tissues in hyperosmolal buffer (1500 mOsm NaCl) or in the presence of furosemide (3 mmol/L). PGE production was determined by radioimmunoassay of the incubation buffer. The PGE biosynthesis in response to hyperosmolality was significantly greater in the groups fed the 4% NaCl diet, independent of rat strain. The PGE biosynthesis in response to furosemide was significantly greater in each group of DR rats, independent of dietary NaCl. These results suggest that in the renal papilla of the Dahl rat stimulation-secretion coupled PGE biosynthesis is dependent not only on genetic determinants but also on the type of stimulus applied.

lasix tabs 2015-08-23

The combination of benazepril and robenacoxib was well tolerated and either increased or had a neutral effect on GFR in healthy cats without or with concomitant furosemide. The combination of benazepril and robenacoxib Zithromax Alcohol reduced plasma aldosterone concentrations increased by furosemide. It is recommended to test the efficacy and safety of the combined use of benazepril and robenacoxib in cats with clinical disease, notably proteinuric chronic kidney disease.

lasix 30 mg 2017-04-30

A 5-month-old Holstein heifer had clinical signs of tricuspid valve insufficiency and histopathologic evidence of endocardial fibroelastosis. The calf had a 3-week history of weight loss, abdominal distention, dyspnea, and decreased appetite. Physical examination revealed signs of right-sided heart failure, and a systolic murmur (II/VI) was heard best over the right heart base. Results of cardiac catheterization and echocardiography indicated tricuspid valve insufficiency and right-sided heart failure. The calf was euthanatized after not responding to treatment with penicillin, furosemide, and removal of fluid from the thorax and abdomen. Necropsy findings included multifocal areas of thickening and opacification of the endocardium of the left and right ventricles Cipro Po Mg . Excessive elastic fibers, consistent with fibroelastosis, were seen by use of special stains applied to sections of endocardium.

lasix 80 mg 2017-03-12

Nine chronically catheterized fetal sheep, five with an intact and four with a surgically ligated esophagus, were studied for 7 hours on 2 consecutive days. Day 1 was a control day in which the fetal parameters of arterial, venous, and amniotic fluid pressures; heart rate; and urine flow were measured continuously. Fetal and maternal blood, amniotic fluid, and fetal urine were sampled for osmolality, electrolytes, blood gases, and pH twice during the first hour and hourly thereafter. On day 2, 15 mg of furosemide was injected into the amniotic cavity after 1 hour and fetuses were monitored in the same fashion as on the control day.

lasix dosage 2016-03-04

The renal tubular secretion of thiazides and loop diuretics via the organic anion transport system in renal tubules is required for them to reach their principal sites of action. Similarly, acetazolamide, a diuretic clinically administered for glaucoma, is excreted from the kidney by glomerular filtration and tubular secretion. In this study, we investigated the interaction and transport of these diuretics via the rat renal organic anion transporter rOAT1 by using Xenopus laevis oocyte expression system. p-[(14)C]Aminohippurate (PAH) uptake by rOAT1-expressing oocytes was inhibited in the presence of a thiazide (chlorothiazide, cyclothiazide, hydrochlorothiazide), a loop diuretic (bumetanide, ethacrynic acid, furosemide), or a carbonic anhydrase inhibitor (acetazolamide, ethoxzolamide, methazolamide). Dixon plot analysis demonstrated that the inhibition constant (K(i)) value was 1.1 mM for acetazolamide, 150 microM for hydrochlorothiazide, 9.5 microM for furosemide, and 5. 5 microM for bumetanide. Kinetic analysis revealed that acetazolamide inhibited rOAT1 competitively and that inhibition style of furosemide was a mixture of competitive and noncompetitive. [(14)C]PAH efflux was significantly enhanced when the rOAT1-expressing oocytes were incubated in the presence of unlabeled PAH, alpha-ketoglutarate, acetazolamide, chlorothiazide, or hydrochlorothiazide. rOAT1 stimulated acetazolamide uptake, which was inhibited by probenecid. Although the loop diuretics had little trans-stimulation effect on [(14)C]PAH efflux via rOAT1, the rOAT1-mediated furosemide uptake was observed. These findings suggest that rOAT1 contributes, at least in part, to the renal tubular secretion of acetazolamide, thiazides, and loop diuretics.

lasix oral dosage 2017-12-13

On the basis of the finding of this study, the prescribing practices for antibiotic and injection shows deviation from the standard recommended by WHO. These two commonly overused and costly forms of drug therapy need to be regulated closely. Drug use evaluation should be done for some of the antibiotics to check whether they were appropriately prescribed or not. On the other hand, polypharmacy, generic prescribing and prescribing from EDL were not found to be a problem in this study. Teaching hospitals have a special responsibility to society to promote rational prescribing by their staff and, through them, the future generations of doctors.

lasix 600 mg 2015-07-01

Slow release formulations (SRFs) are developed on the basis that the response elicited by a drug is closely related to changes in its plasma concentrations. As a consequence, the drug in the SRF is considered bioequivalent to the same drug administered in a conventional or immediate release formulation (IRF). The available literature suggest that for drugs eliciting a simple response, i.e. theophylline, the response is not affected by the rate of input of drug into the systemic circulation. Therefore, the pharmacodynamics are closely related to the pharmacokinetics of the drug, which are independent of formulation. In this case, SRFs and IRFs are truly bioequivalent. The pharmacological effect of some drugs, e.g. nifedipine, prazosin, furosemide (frusemide), etc., triggers compensatory homeostatic mechanisms. Therefore, the measured effect may not directly relate to the plasma drug concentration. Furthermore, the characteristics of the response will be modulated by the rate of input of the drug, i.e. drugs in SRF will elicit a greater response because a slow input triggers fewer homeostatic reactions. As a consequence, for drugs that trigger homeostatic reactions, a drug released from an SRF may not be bioequivalent to the same drug released from an IRF. Finally, when tolerance to an effect develops, a drug administered as an SRF will elicit a smaller effect than when administered as an IRF. Therefore, even if the different formulations of a drug were bioequivalent on the basis of pharmacokinetic parameters, they would not be equivalent on the basis of pharmacodynamic factors.(ABSTRACT TRUNCATED AT 250 WORDS)

lasix 10mg tablet 2015-01-03

The pharmacokinetics of dipyrone are characterised by rapid hydrolysis to the active moiety 4-methyl-amino-antipyrine (MAA), which has 85% bioavailability after oral administration in tablet form, and takes a short time to achieve maximal systemic concentrations (tmax of 1.2 to 2.0 hours). Absolute bioavailability after intramuscular and rectal administration is 87 and 54%, respectively. MAA is further metabolised with a mean elimination half-life (t1/2) of 2.6 to 3.5 hours to 4-formyl-amino-antipyrine (FAA), which is an end-metabolite, and to 4-amino-antipyrine (AA), which is then acetylated to 4-acetyl-amino-antipyrine (AAA) by the polymorphic N-acetyl-transferase (t1/2 of AA is 3.8 hours in rapid acetylators and 5.5 hours in slow acetylators). Urinary excretion of these 4 metabolites accounts for about 60% of the administered dose of dipyrone. Protein binding of the 4 main metabolites is less than 60%. The volume of distribution of MAA is about 1.15 L/kg of lean body mass. All 4 metabolites are excreted into breast milk. A single-dose study (0.75, 1.5 and 3g) and a multiple-dose study (1g 3 times a day for 7 days) revealed nonlinear pharmacokinetics consistent with a shift of MAA metabolism from FAA to AA. Apparent MAA clearance decreased by 22% during multiple administration. MAA clearance was reduced by 33% in the elderly. In patients with cirrhosis of the liver, the apparent clearance of all metabolites is generally reduced. In patients with renal disease, apparent clearance of MAA remains unchanged, whereas elimination of the renally excreted metabolites AAA and FAA is markedly impaired. No clinically important drug interactions have thus far been recognised. Dipyrone does not affect the pharmacodynamic response to alcohol (ethanol), glibenclamide (glyburide), oral anti-coagulants or furosemide (frusemide). The low toxicity of dipyrone and its efficacy support its use in clinical practice, despite some complex aspects of its disposition.

lasix 40 mg 2015-09-28

Hypokalemia induced by diuretic abuse is a life-threatening emergency.

lasix 50 mg 2017-12-06

We have retrospectively investigated clinical profile, efficacy, and safety in 41 patients who were treated with liposomal amphotericin B (L-AMB) in Aichi Medical University Hospital between January 2008 and June 2009. It turned out that L-AMB was used for severe infectious diseases and 31.7% cases discontinued L-AMB therapy because of death. L-AMB was administered as the second-line therapy in 56.1% (23/41), and was not effective in 48.8% (20/41). L-AMB was administered as the first-line therapy in 43.9% (18/41); (1) 1 for cryptotoccal infection, (2) 7 for severe sepsis or septic shock, (3) 2 for the case which cannot remove medical device and might have biofilm formation, (4) 6 for the induction of step-down therapy concept, (5) 2 for febrile neutropenic patients who have needed aggressive empiric therapy. There was no significant difference in serum potassium level (p = 0.10) and serum creatinine level (p = 0.05) between pretreatment and posttreatment with L-AMB. The serum creatinine level before initial treatment with L-AMB was 1.31 +/- 1.30 mg/dL. The patients for 7.3% (3 cases) had dialyzed before initial treatment with L-AMB, however, there was no case who need dialysis after administration of L-AMB. As for the highest creatinine level in L-AMB administered cases, 29.3% (12/41) and 24.4% (10/41) were normal to abnormal, and abnormal to abnormal, respectively. This is the first investigational report when the serum creatinine level before initial administration of LAMB had been abnormal. The other antimicrobial agents, which might have influenced renal function, were administered to 51.2% cases (21/41). That means the cases administered L-AMB might have other bacterial infections. As for the serum creatinine level, we observed the changing cases and the cases which did not cause the change at all regardless of the administering period of LAMB. The serum potassium level before initial administration of L-AMB was 4.1 +/- 0.8 mEq/L, concomitant use of furosemide etc. was 31.7% (13/41), the lowest serum potassium level was 3.4 +/- 0.9 (1.9-6.2)mEq/L in during using L-AMB, the serum potassium was 34.1% (14/41) in replenish potassium during administration of L-AMB, and the total replenished potassium was 131.25 mEq. We did not observe the case who had died because of the low potassium. Since L-AMB was the only fungicidal drug, when we use L-AMB for the serious infectious diseases to make the best use of the characteristic, we have to pay attention to the concomitant medication, renal function and the serum potassium level.

lasix yellow pill 2016-02-04

Methacholine (MCh)- and isoproterenol (Iso)-stimulated 14CO2 production was compared between freshly dissociated rhesus sweat secretory coil cells (mainly clear cells) and cultured cells (grown on a collagen-coated plastic plate) derived from native cells. 14CO2 production was enhanced by MCh and by Iso in native coil cells (but not in ductal cells) in a pharmacologically specific and dose-dependent manner. 14CO2 production in subcultured coil cells (19-45 days in culture) was only one-third to one-fifth that of native cells. MCh-stimulated 14CO2 production was inhibited by ouabain and furosemide in both native and cultured coil cells. A decrease in 14CO2 production, of about one-half, was already evident in primary cells cultured for less than 1 wk. The decreased pharmacological responsiveness of the cultured coil cells was seen, although the cultured cells showed the typical epithelioid appearance, abundant mitochondria, the occasional presence of intercellular lacunae resembling intercellular canaliculi, and the persistence of immunoreactive keratin. We conclude that 1) a primary culture of sweat gland cells can be initiated from dissociated cells; 2) cultured sweat secretory coil cells qualitatively, but not quantitatively, retain the pharmacological responsiveness and transport activity of the native cells as determined by 14CO2 production; 3) collagenase-dissociated cells represent an excellent in vitro system for the study of glandular function at the cellular level; and 4) the decrease in pharmacological responsiveness is not simply due to trypsin treatment during harvesting of cultured cells, because that of organ-cultured, intact, secretory coils also declines with time of culture.

lasix user reviews 2016-12-30

The measurement of resistive index (RI = [peak systolic velocity--end diastolic velocity]/peak systolic velocity) by Doppler sonography has demonstrated variable reliability as an indicator of pediatric urinary obstruction. By modifying Doppler studies with the addition of furosemide (diuretic Doppler sonography), we previously found significant differences between 10 nonobstructed and 10 obstructed kidneys in children (median age 7 months). The obstructed kidneys have since undergone surgical repair, and postoperative reevaluation has been performed by diuretic Doppler sonography and diuretic renography. Diuretic Doppler sonography was performed on well hydrated catheterized patients, with resistive index measurement of the renal interlobar and arcuate arteries obtained before and 10 minutes after 1 mg./kg. furosemide infusion. Following surgical repair of obstruction all 10 kidneys had stable glomerular filtration rate with improved pelvic emptying times as demonstrated by half-time. Of 6 kidneys evaluated by diuretic Doppler sonography before 3 months 2 had resistive index levels greater than 75. Of the 9 kidneys measured at 3 months or more postoperatively all had resistive index values of less than 75, even after furosemide infusion (5 kidneys underwent repeat evaluation). In our study the previously demonstrated post-diuretic elevation of resistive index in pediatric urinary obstruction was eventually reversed following surgical repair. Diuretic Doppler sonography appears to be a promising noninvasive method for evaluating pediatric hydronephrosis, providing an alternative physiological parameter with which to measure renal obstruction.