Lasix (Furosemide) Infusions

Lasix (Furosemide) Infusions
For Interfacility Transfer Only
Usage:
Congestive heart failure and Acute renal failure that is unresponsive to bolus treatments.
Complications:
Digitalis toxicity, hypokalemia, ventricular ectopy, ototoxicity, electrolye imbalance, esp potassium and magnesium.
Adverse Reactions:
Hypotension, vertigo, tinnitus, hearing loss, rash, weakness, muscle spasm, photosensitivity, ventricular ectopy.
Equipment Maintenance:
Lasix infusions must be run through an infusion pump.
Standing orders:
1. Infusion must be started at the transferring hospital.
2. Verify concentration, infusion rate and VS parameters prior to leaving transferring hospital.
3. Assess serum potassium levels prior to transfer if available. *
4. Monitor and document VS at least every 15 minutes while in transit.
5. Notify Base Command if B/P drops below 15% of initial baseline.
6. Monitor EKG. Notify Base Station of any new onset or increase of ventricular ectopy or tachycardia or signs and symptoms of adverse reaction (see above).
7. Common dosage: 250 mg of Lasix in 250 cc of NS yielding 1 mg/cc.
Maintenance dose: 0.1-0.4 mg/kg/hr not to exceed 4 mg/min.
8. Do not give IV bolus medications through the Lasix infusion.

Class: Loop Diuretic

Dosing (adults)
Edema: initial: 20-40 mg IV/IM over 1-2 min. May repeat in 1 to 2 hours or may be increased by 20 mg until desired response. This individually determined dose may be given once or twice daily.
Edema (oral): initial: 20-80 mg po qd - may repeat in 6-8 hrs. Maximum: 600 mg/day.

HTN: initial: 80 mg po daily (divided twice daily).
CHF: 250 to 4000 mg daily (IV or PO)

Acute pulmonary edema: usual dose - 40 mg IV over 1-2 minutes. If not adequate, may increase dose to 80 mg.

Continuous I.V. infusion: Initial IV bolus dose of 0.1 mg/kg followed by continuous I.V. infusion doses of 0.1 mg/kg/hour doubled q2h to a maximum of 0.4 mg/kg/hour if urine output is <1 ml/kg/hour. Other studies have used a rate of 4 mg/minute as a continuous IV infusion.

Elderly: Oral, IM, IV: Initial: 20 mg/day; increase slowly to desired response.
Refractory heart failure: Oral, IV: Doses up to 8 g/day have been used.
Acute renal failure: High doses (up to 1-3 g/day - oral/IV) have been used to initiate desired response. Avoid use in oliguric states.

Administration: IV injections should be given slowly over 1-2 minutes. Maximum rate of administration for IVPB or infusion: 4 mg/minute. Replace parenteral therapy with oral therapy as soon as possible.
[Supplied 10 mg/ml, 40 mg/5 ml oral soln. 10 mg/ml soln for inj. 20,40, 50, 80mg tablet]