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Mechanism of action
Inhibits electrolyte reabsorption and promotes excretion of sodium, potassium, chloride.
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Indications
CHF, pulmonary edema, hypertensive crisis.
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Contraindications
Hypovolemia, anurea, hypotension (relative conrtaindication); hypersensitivity, hepatic coma.
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Adverse reactions
May exacerbate hypovolemia, hypokalemia, ECG changes, dry mouth, hypochloremia, hyponatremia, hyperglycemia (due to hemoconcentration).
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Drug interactions
Lithium toxicity may be potentiated by sodium depletion. Digitalis toxicity may be potentiated by potassium depletion.
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How supplied
100 mg/5 ml, 20mg/2 ml, 40 mg/4-ml vials.
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Dosage and Administration
- Adult: 0.5-1.0 mg/kg injected IV over 1 to 2 minutes. If no response, double the dose to 2 mg/kg over 1 to 2 minutes.
- Pediactric: 1 mg/kg/dose IV, IO.
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Duration of action
- Onset: 5 minutes
- Peak effects: 20-60 minutes.
- Duration: 4-6 hours.
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Special considerations
Pregnancy safety: Category C. Ototoxicity and deafness can occur with rapid administration. Should be protected from light.
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