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DRUG STUDY

GENERIC NAME: Bumetanide


Brand name: Bumex
Drug Classification: Loop (high-ceiling diuretic)

DOSAGE, ROUTE, SIDE EFFECTS and


INDICATIO MECHANISM
FREQUENCY (prescribed and ADVERSE
N OF ACTION
recommended) REACTIONS (by
Oral •Edema associated •Bumetanide induces •Muscle cramps,
system)dizziness,
•edema with CHF, cirrhosis, diuresis by inhibiting hypotension,headache,
oAdult: renal disease reabsorption of water and nausea,impaired hearing,
1 mgonce daily.Give 2nd dose6-8 hr • IV: electrolytes (sodium pruritus, ECG changes,
later if necessary. Acutepulmonary andchloride) in the musculoskeletal pain,
oElderly: edema ascending loop of Henle rash,chest discomfort,renal
0.5 mgdaily. •Unlabeled use: andproximal renaltubule. failure,prematureejaculatio
•Refractoryedema Treatment of adult Absorption: n,thrombocytopenia,hypoka
oAdult: nocturia(not Almost completely and laemia,hypomagnesaemia,h
Initially,5 mg dailyincreased by effective in men rapidly absorbed from yponatraemia,hyperuricaem
5mg every 12-24hr as required.High with BPH. th e GIT. ia,hyperglycaemia,hypocal
dosesmay be dividedin 2-3 Distribution: caemia.
doses.Max: 10mg/day. 95%bound to •PotentiallyFatal:
•hypertension plasmaproteins. Encephalopathy (in
oAdult: Excretion: patientswith
0.5-1mg daily. Max:5 mg/day. Elimination half- preexistingliver disease)
Intravenous life:about 1-2 hr.
•pulmonaryedema About80% excreted inthe
•Adult: urine; 50% as unchanged
1-2 mg IVrepeated 20 minlater if drug
necessary,or 2-5 mg in 500ml of a
suitableinfusion fluidgiven over 30-
60

Bumetanideinduces diuresisby NURSING
CONTRAINDICATION/S
inhibitingreabsorption of water RESPONSIBILITIES (at
andelectrolytes(sodium andchloride) least 10)
Hypersensitivity,progressive
in theascending loopof Henle renal Assessment
andproximal renaltubule.
failure and anuria,hepatic •History:Allergy to bumetanide,electrolyte depletion, anuria,severe renal
Absorption:
coma,severe electrolyte depletion. failure, hepaticcoma, SLE, gout, diabetesmellitus, lactation
Almost completelyand • Physical:
rapidlyabsorbed from theGIT. Skin color, lesions;edema; orientation, reflexes,hearing; pulses, baseline
Distribution: ECG,BP, orthostatic BP, perfusion;R, pattern, adventitioussounds; liver
95%bound to plasmaproteins. evaluation, bowelsounds; urinary outputpatterns; CBC, serumelectrolytes
Excretion: (including calcium),blood glucose, LFTs, renalfunction tests, uric
Elimination half-life:about 1-2 hr. acid,urinalysis
About80% excreted inthe urine;
50% asunchanged drug. Interventions
• •Give with food or milk toprevent GI upset.
Edemaassociated withCHF, •Mark calendars or usereminders if intermittenttherapy is best for
cirrhosis,renal disease treatingedema.
• •Give single dose early in dayso increased urination will notdisturb sleep.
IV: Acutepulmonaryedema •Avoid IV use if oral use ispossible.
• •BLACK BOX WARNING: Arrange to monitor serumelectrolytes,
Unlabeled use:Treatment of adult hydration, liver function during long-termtherapy, water and
nocturia(not effective inmen with electrolytedepletion can occur.
BPH)

•Provide diet rich in potassiumor supplemental potassium
Muscle
cramps,dizziness,hypotension,heada Patient’s Name / Room No.
che,nausea,impairedhearing,pruritus
, ECGchanges,musculoskeletalpain,
rash,chestdiscomfort,renal
failure,prematureejaculation,thromb
ocytopenia,hypokalaemia,hypomagn