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Drug Name Dosages Therapeutic Indications Adverse effects Contraindicati Nursing considerations
Actions ons
bumetanide Oral • Bumetanide • Edema • Muscle cramps, Hypersensitivi Assessment
(byoo met' a induces diuresis associated with dizziness, ty,
nide) • edema by inhibiting CHF, cirrhosis, hypotension, progressive • History: Allergy to bumetanide,
Bumex, o Adult: 1 mg reabsorption of renal disease headache, renal failure electrolyte depletion, anuria,
Burinex (CAN) once daily. water and • IV: Acute nausea, and anuria, severe renal failure, hepatic
Give 2nd dose electrolytes pulmonary impaired hepatic coma, coma, SLE, gout, diabetes
Pregnancy 6-8 hr later if (sodium and edema hearing, severe mellitus, lactation
Category C necessary. chloride) in the • Unlabeled use: pruritus, ECG electrolyte • Physical: Skin color, lesions;
o Elderly: 0.5 mg ascending loop Treatment of changes, depletion. edema; orientation, reflexes,
Drug class of Henle and adult nocturia musculoskeletal hearing; pulses, baseline ECG,
daily.
proximal renal (not effective in pain, rash, BP, orthostatic BP, perfusion;
• Refractory
• Loop (high- tubule. men with BPH) chest R, pattern, adventitious
edema
ceiling) discomfort, sounds; liver evaluation, bowel
o Adult: Initially,
diuretic Absorption: renal failure, sounds; urinary output
5 mg daily
Almost completely premature patterns; CBC, serum
increased by 5
and rapidly ejaculation, electrolytes (including calcium),
mg every 12-24
absorbed from the thrombocytope blood glucose, LFTs, renal
hr as required.
GIT. nia, function tests, uric acid,
High doses
Distribution: 95% hypokalaemia, urinalysis
may be divided
bound to plasma hypomagnesae
in 2-3 doses.
proteins. mia,
Max: 10 Interventions
Excretion: hyponatraemia,
mg/day.
Elimination half-life: hyperuricaemia,
• hypertensio hyperglycaemia • Give with food or milk to
n about 1-2 hr. About
80% excreted in , prevent GI upset.
o Adult: 0.5-1 hypocalcaemia. • Mark calendars or use
the urine; 50% as
mg daily. Max: reminders if intermittent
unchanged drug. • Potentially
5 mg/day. therapy is best for treating
Fatal:
Encephalopath edema.
Intravenous y (in patients • Give single dose early in day
with preexisting so increased urination will not
• pulmonary liver disease). disturb sleep.
edema • Avoid IV use if oral use is
• Adult: 1-2 mg IV possible.
repeated 20 min • BLACK BOX WARNING:
later if necessary, Arrange to monitor serum
or 2-5 mg in 500 electrolytes, hydration, liver
ml of a suitable function during long-term
infusion fluid therapy, water and electrolyte
given over 30-60 depletion can occur.
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min. • Provide diet rich in potassium
or supplemental potassium.
Parenteral
Teaching points
• Emergency cases
of edema • Record alternate day or
• Adult: 0.5-1 mg intermittent therapy on a
via slow IV/IM inj, calendar or dated envelopes.
subsequently • Take the drug early in day so
adjust dose increased urination will not
according to disturb sleep; take with food or
response. meals to prevent GI upset.
• Weigh yourself on a regular
basis, at the same time and in
the same clothing; record the
weight on your calendar.
• You may experience these side
effects: Increased volume and
frequency of urination;
dizziness, feeling faint on
arising, drowsiness (avoid rapid
position changes; hazardous
activities, such as driving; and
alcohol consumption);
sensitivity to sunlight (use
sunglasses, sunscreen, wear
protective clothing); increased
thirst (suck sugarless lozenges;
use frequent mouth care); loss
of body potassium (a
potassium-rich diet, or
supplement will be needed).
• Report weight change of more
than 3 pounds in 1 day;
swelling in ankles or fingers;
unusual bleeding or bruising;
nausea, dizziness, trembling,
numbness, fatigue; muscle
weakness or cramps.

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