Medication Description: Furosemide (Furosemidum)
FUROSEMID (Furosemidum). 4-Chloro-M- (2-furylmethyl) -5-sulfamoyl anthranilic acid.
Synonyms: Lasix, Furantril, Afsamid, Arasemide, Diusemide, Diuzol , Dryptal, Edefrusex, Errolon, Franyl, Frugex, Frusemide, Frusolon, Furanthril, Furantral, Furfan, Furomex, Furosan, Furosemide, Fusid, Katlex, Kinex, Lasilix, Lasix, Nicorol, Profemin, Protargen, Rasisemid, Renex, Salix, Seguril, Trofurit, Uritol, Urosemid, etc.
White crystalline powder. Insoluble in water.
By chemical structure (the presence of a chlorine atom and a sulfanamide group in the phenyl core) has elements of similarity with dichlothiazide and compounds close to it.
Furosemide is a strong diuretic (saluretic) agent. Effective in oral and parenteral administration. The diuretic effect is associated with inhibition of the reabsorption of N and Cl ions, and this inhibition is observed not only in the proximal, but also in the distal convoluted tubule, and in the region of the ascending part of the loop of Henle. Potassium reabsorption is also inhibited, but to a much lesser extent. Not noticeable inhibition of carbonic anhydrase. The drug is equally effective in conditions of acidosis and alkalosis. The diuretic effect is most pronounced during the first 2 days of taking the drug, but does not disappear even with long-term treatment.
The drug acts quickly. After intravenous administration, the diuretic effect begins within a few minutes, after ingestion - within the first hour. The duration of action after a single intravenous injection of 1, 5 - 3 hours, after ingestion - 4 hours or more. The rapid effect of intravenous administration makes it possible to use furosemide in emergency cases (pulmonary edema, brain, etc.).
Furosemide is used as a diuretic for stagnation in the small and large circulation, caused by heart failure, for liver cirrhosis with symptoms of portal hypertension, chronic and acute renal failure, pulmonary and brain edema, barbiturate poisoning, eclampsia.
Unlike thiazides, furosemide does not reduce glomerular filtration, and it is used in connection with this in chronic renal failure (if indicated by the use of diuretics).
In some cases, furosemide has a diuretic effect with a lack of effectiveness of other drugs.
The effectiveness of furosemide in the treatment of patients with circulatory failure is associated not only with the diuretic effect, but also with a direct expansion effect on peripheral vessels. The first (early) phase, which develops during the first 30 minutes after the injection of the drug, depends on its effect on the peripheral vessels, and the second (late) phase, which develops 1 to 2 hours after the injection, is associated with diuretic action.
Furosemide also has an antihypertensive effect.
The drug is effective in various forms of hypertension, including in severe forms in which other saluretics are ineffective. The mechanism of antihypertensive action is basically the same as when using thiazide diuretics.
Furosemide is also used for the relief of severe hypertensive crises.