FUROSEMYD (Furosemidum; synonym: lasixum, furanthril, Frusemide. Fu-rantral, Furomex, Salix, etc.; joint venture. B) — diuretic. 4-Hlor-K-(2 furylmethyl) - 5-sulfamoilant-ranilovaya to - that; C12H11C1N205S:
White crystal powder, difficult water soluble.
T. is highly active diuretic from group of saluretics. The mechanism of its diuretic action is connected generally with oppression of a reabsorption of ions of chlorine and sodium in the ascending knee of a nephronic loop (see Kidneys, physiology). Assume that at the same time under the influence of F. chloric channels of cellular membranes of a renal tubule are blocked first of all. It is not excluded that a nek-ry role is played by also oppressing influence F. on transport of ions of sodium in proximal department of tubules, especially at administration of drug in high doses. T. the ABP at an idiopathic hypertensia reduces and strengthens action of antihypertensives (see).
At intake F. it is soaked up from went. - kish. a path approximately for 70%. Its action begins in 30 min. after reception and continues near the 6th hour. At intravenous administration the effect occurs the first minutes and proceeds
till 3 o'clock. T. contacts proteins of plasma for 80 — 95% and thereof it is a little filtered in kidneys. Nevertheless it is very quickly allocated with urine of hl. obr. in not changed look by active canalicular secretion. Partial allocation F. happens also to bile. Period of semi-life F. at introduction to blood makes apprx. the 2nd hour. Drug rather easily gets through fabric membranes, including through a placental barrier.
T. apply at developments of stagnation in a small and big circle of blood circulation and hypostases of various genesis — at heart failure (see), portal hypertensia (see), damages of kidneys (see Kidneys, pathology). Due to the high activity and bystry development of effect drug can be used in urgent cases, napr, at a fluid lungs (see) and wet brain (see Hypostasis and swelling of a brain), and also for carrying out an artificial diuresis (see Poisonings). Like a dichlothiazide (see) and to other saluretics F. use in a combination therapy of an idiopathic hypertensia together with Reserpinum (see) and other antihypertensives.
T. appoint inside and parenterally (intravenously or intramusculary). Inside appoint the adult 0,02 — 0,04 g once a day. Too strong diuretic effect is, as a rule, undesirable since it can cause the compensatory reactions directed to restriction of a diuresis (reduction of glomerular filtering, strengthening of secretion of Aldosteronum). Sick, resistant to other diuretics, and also to usual doses F., it is appointed inside on 0,08 — 0,12 g (to 0,16g) in days in 2 — 3 bucketed receptions the 6th hour. Intravenously and intramusculary F. appoint on 2 ml 1% of solution of 1 times in 2 days. If necessary enter on 2 — 4 ml 1% of solution of 1 times a day. At a fluid lungs F. enter intravenously on 2 — 6 ml 1% of solution. In its high doses it is necessary to appoint sometimes the patient with the hypostases caused heavy hron. renal failure. In such cases under the influence of F. increase in a renal blood-groove and glomerular filtering is quite often observed. At acute poisonings with the phenomena of an acute renal failure F. it is possible to combine from a mania volume (see) for strengthening of an osmotic diuresis.
Drug is usually well transferred. However at long appointment it in high doses owing to rather big losses of chlorine the hypo-hloremichesky alkalosis (see), and owing to considerable losses
Leah with urine — a hypopotassemia can develop (see). In this regard for correction and prevention of the specified disturbances it is necessary to use drugs of potassium, to appoint a potassium diet or to apply F. in combination with kaliysbere-gayushchy diuretics. If necessary it is necessary to carry out also correction of acid-base equilibrium.
As side effects F. sometimes causes weakness, a passing hyperglycemia and a hyperuricemia. At high concentration in blood F. can show from - toxic properties therefore at prolonged use, especially in a combination with ototoksichesky drugs, T. can cause decrease in hearing.
It is contraindicated at heavy anemias, the expressed liver failure, and also in the first months of pregnancy.
Form of release; tablets on 0,04 g of an ampoule on 2 ml of 1% of solution (0,02 g in an ampoule). Storage: in the dry place protected from light.
See also Diuretics. Bibliography: B of e r x both E. B. Pharma's N
kologiya of kidneys and its physiological bases, M., 1979; Puschett J. Century of Sites and mechanisms of action of diuretics in the kidney, J. clin. Pharmacol., v. 21, p. 564, 1981. E. B. Berkhin.