Furosemide Nitro Morphine

• Brand name: Lasix
• Class: Loop diuretic

• Inhibits electrolyte reabsorption in the ascending Loop of Henle.
• Excretion of sodium, potassium, chloride.
• Vasodilation increases venous capacitance
• Decreases afterload.
• Diuresis

• Pulmonary edema
• Congestive heart failure

• Anuria (non-passage of urine)
• Hypovolemia
• Hypotension

• Increase hypovolemia
• Hyperglycemia (due to hemoconcentration)
• Hypokalemia (low potassium) 
• Decrease the response to pressors

• Adult Dosage:
• On oral furosemide therapy:
• Initial dose 2 times daily; 
• if no effect in 20 mins may double initial dose
• Not on oral furosemide therapy:
• 0.5 to a max of 2 mg/kg
• (usually 20-40mg) IV slowly

Slow IV push

• Onset of Action: 5 minutes (vasodilation)
• Peak Effects: 20-60 minutes (diuresis)
• Duration of Action: Variable

• 20 mg:2 mL ampule, vial, syringe
• 40 mg: 4 mL ampule, vial, syringe
• 100 mg: 10 mL ampule, vial, syringe

An abnormal buildup of fluid in the air sacs of the lungs, which leads to shortness of breath

• BRAND NAME: Morphine Sulfate
• CLASS: Narcotic agonist

• Alleviates pain (pain receptors in the braiN) 
• Elevates pain threshold.
• Depresses: Central nervous system 
•                 Brainstem respiratory centers                       Responds to changes in PaC02.
• Increases venous capacitance (venous pooling) 
• Vasodilates arterioles 
• Reduces preload and afterload
•  
• Histamine release

• Analgesia patients:
• Burns
• Myocardial infarction
• Renal colic

Pulmonary edema

• Respiratory depression
• Head injuries
• Elevated Intra cranial pressure
• Asthma
• Abdominal pain

• Brady or Tachydysrhythmias
• Orthostatic hypotension
• Respiratory depression or arrest
• Excess sedation
• Seizures to coma and arrest
• Pupillary constriction
• Nausea and vomiting
• GI spasm
• Histamine release may cause local urticaria

• 1-3 mg slow IV PUSH (over 1-5 minutes)
• **until desired effect.

• Slow IV push
•  **can be given IM or SC

• Onset of Action: Seconds
• Peak Effects: 20 minutes
• Duration of Action: 2-4 hours

• 10 mg/ml ampules, only 

• BRAND NAME: Nitrostat, Tridil
• CLASS: Vasodilator,organic nitrate, antianginal

• Smooth muscle relaxant (vascular, uterine, bronchial, intestinal smooth muscle)
• Reduces workload (heart decreased preload)
• Arteriolar vasodilation (decreased afterload)
• Increases blood (heart)
• Decreases myocardial O2 demand 
• Coronary artery vasodilation

• Angina
• Myocardial infarction
• Congestive heart failure (pulmonary edema)

• Hypovolemia
• Increased Intra cranial pressure

• Hypotension
• Reflex tachycardia
• Bradycardia
• Decreased coronary perfusion at high
• doses (secondary to hypotension)
• Headache secondary to dilation of meningeal vessels

• SL: Chest pain: (0.4 mg) tablet or one full spray (may repeat x 3)
• SL: Pulmonary edema: 1-2 of the (0.4 mg) tablets 5-10 min systolic BP is > 90-100 systolic

• Routes of Administration:
• SL
• (IV special training needed)

• Onset of Action: Seconds
• Peak Effects: 5-10 minutes
• Duration of Action: 1-10 min after IV discontinued

• Dosage Forms/Packaging:
• Bottles of 25 1/150 grain/tablets
• Spray Bottle with 200 metered doses (0.4mg)