What is congestive heart failure and how can Lasix help?
Congestive heart failure is one of the most common health problems in the United States, impacting approximately 5.7 million people. Lasix, also known by the generic name furosemide, is a diuretic aimed at preventing the body from absorbing too much salt, instead sending it out of the body through urine.
What happens if Lasix is not recognized?
A person taking Lasix will already have heart troubles. A failure to recognize Lasix on a list of medications could cause medical errors that put additional pressure on the heart and lungs, leading to death because both organs are forced to work harder. When is a Prescription Drug Error Considered Malpractice?
What is Lasix used for?
Lasix is one of the first lines of treatment used to treat edema in those with congestive heart failure, liver disease or certain kidney disorders as well as high blood pressure. But there is a potential problem with the controversial drug, which is often prescribed for those with chronic congestive heart failure.
Can Lasix Shorten your lifespan?
Given to a patient suffering with lung conditions such as asthma, pneumonia or a pulmonary embolism (a blockage of the artery leading from the heart to the lung), Lasix could shorten a patient’s lifespan by constricting the blood vessel further, cutting off any flow of blood between the heart to the lungs.
Why would you not give Lasix?
systemic lupus erythematosus, an autoimmune disease. blood circulation failure due to serious heart condition. high amount of uric acid in the blood. abnormally high levels of nitrogen-containing compounds in your blood.
Can you withdraw from Lasix?
Withdrawal symptoms, however, are possible when Lasix is discontinued. When Lasix is no longer taken, the body sometimes overcompensates by retaining too much water and salt. As a result, fluid builds up in the body's tissues and bloodstream, causing rebound edema and high blood pressure for a few days.
When do you stop diuretics in heart failure?
Often physicians will stop active diuresis once the BUN levels begin to rise. The patient's weight should be measured at this point and be documented as the patients euvolemic (or “dry”) weight. Prior to discharge, the diuretics should be converted from an intravenous to an oral regimen.
When should you not use Lasix?
Who should not take LASIX?diabetes.a type of joint disorder due to excess uric acid in the blood called gout.low amount of magnesium in the blood.low amount of calcium in the blood.low amount of sodium in the blood.low amount of potassium in the blood.low amount of chloride in the blood.hearing loss.More items...
Is it okay to stop taking furosemide?
Furosemide controls high blood pressure and edema but does not cure these conditions. Continue to take furosemide even if you feel well. Do not stop taking furosemide without talking to your doctor.
Does Lasix affect heart rate?
The results revealed no significant effect between furosemide administration and heart rate in the first 24 hour (p = 0.904). However, a low correlation was found between furosemide and heart rate slowing effect in the first 8–16 hour (p = 0.003).
Can diuretics worsen heart failure?
The use of diuretics in the management of chronic heart failure may be limited by the increase in cardiovascular risk secondary to their adverse effects including electrolyte depletion (potassium and magnesium).
What happens when you stop taking diuretics?
Conclusion: Withdrawal of long-term diuretic treatment in elderly patients leads to symptoms of heart failure or increase in blood pressure to hypertensive values in most cases. Any attempt to withdraw diuretic therapy requires careful monitoring conditions, notably during the initial four weeks.
Do diuretics improve mortality in heart failure?
A meta-analysis of three small randomized clinical trials11–13 (n = 236, events = 15, follow up = 4−52 weeks) showed that diuretic use was associated with reduced mortality in HF. An observational study, in contrast, demonstrated that diuretics increased mortality and hospitalization in systolic HF.
What is Lasix used for in heart patients?
Lasix is a prescription medicine used to treat the symptoms of fluid retention (edema) in individuals with congestive heart failure, liver disease or kidney disorder. Lasix may be used alone or with other medications.
What are the most common side effects of furosemide?
This medication may cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any of these unlikely but serious side effects: muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, unusual dry mouth/thirst, nausea, vomiting, fast/irregular heartbeat.
Is Lasix safe for elderly?
Seniors who take the diuretic furosemide (Lasix) should know that their kidneys need to be functioning well in order for the drug to work. In general, older patients have not reacted differently to furosemide than younger ones. However, many people older than 65 have impaired kidney function.
How does Lasix work?
Lasix works by encouraging the kidneys to release more fluid, and although the drug works to help reduce fluid surrounding the heart, allowing the heart to pump more effectively, there are serious risk factors. Lasix can leave a patient so dehydrated that electrolytes become imbalanced enough to become deadly.
What is Lasix used for?
Lasix is one of the first lines of treatment used to treat edema in those with congestive heart failure, liver disease or certain kidney disorders as well as high blood pressure. 1. But there is a potential problem with the controversial drug, which is often prescribed for those with chronic congestive heart failure.
What are prescription drug errors?
While some prescription drug errors are clear-cut cases of medical malpractice, such as administering the wrong medication or the wrong dose of a medication, prescribing a drug that the patient has previously reported as an allergen or mislabeling a medication, some other drug-related errors are less concrete.
Why is knowing what drugs a patient is taking important?
Because of prescription drug interactions and other factors, knowing what drugs a patient is taking is a vital part of patient care, and failure to do so is a serious misstep that goes against the doctor’s oath to first do no harm.
Does Lasix cause heart failure?
Lasix reduces potassium to dangerous levels, which is a particularly troublesome problem for those with congestive heart failure because it can trigger dangerous, potentially fatal heart arrhythmias. Another issue associated with potassium is a drug called digoxin, which can reach toxic levels if the body does not have enough potassium to help regulate digoxin levels.
Can Lasix be deadly?
Lasix can leave a patient so dehydrated that electrolytes become imbalanced enough to become deadly.
Can you die from Lasix?
A person taking Lasix will already have heart troubles. A failure to recognize Lasix on a list of medications could cause medical errors that put additional pressure on the heart and lungs, leading to death because both organs are forced to work harder.
What is Lasix used for?
“Lasix ( furosemide) is an anthranilic acid derivative that is used as a strong di uretic in adults and children to treat excessive fluid accumulation (edema) caused by congestive heart failure …
Why do people pee on Lasix?
Lasix (furosemide) main use is to cause heart failure patients to urinate in an effort to reduce excessive fluid accumulation (edema) caused by congestive heart failure. The trouble is, lasix also causes a host of side effects.
How many patients were free of furosemide reuse?
It was found that 72 patients (75.3%) in the placebo group and 78 patients (83.9%) in the furosemide group were free of furosemide reuse during follow-up (p=0.16).
Can a doctor blow off side effects?
In my experience, medical professionals often blow off the seriousness of side effects. Nothing against M.D.’s but I have never had a relationship with a doctor (oncologist or cardiologist) who worried about what a prescribed medication might do to me. Never.
Is stopping diuretic use tolerated?
The team concluded that stopping diuretic use appeared “to be well tolerated in most of the patients and might deserve consideration in the appropriate clinical setting”.”
Why are diuretics used in heart failure?
The use of diuretics is common in patients with heart failure (HF), to relieve the congestive symptoms of HF. Although they are widely used, there are limited data on their ability to modulate HF-related morbidity and mortality. Diuretic efficacy may be limited by adverse neurohormonal activation and by ‘congestion-like’ symptoms. Diuretics are an extremely useful and varied class of agent for the management of hypervolaemic states. This review summarises the basic features of diuretics, including their mechanism of action, indications and adverse effects in heart failure.
Which loop inhibits Na-K-CI?
Inhibition of Na-K-CI co-transporter in the thick ascending loop of Henle
What is HF syndrome?
HF is the most common cause of hospitalisation in patients over the age of 65.[2] The main manifestations of the syndrome are symptoms resulting from vascular congestion, such as shortness of breath, abdominal distension, oedema formation and symptoms resulting from low systemic perfusion. HF syndrome is of relevant economic importance and in the ADHERE study signs and symptoms of congestion were the most frequent cause of hospital admission.1 Congestion often develops gradually before admission and many patients may have elevated left ventricular (LV) filling pressures even when congestion (dyspnoea, jugular venous distension or oedema)[3] is absent. Diuretic therapy, and especially loop diuretic therapy, are the usual way of managing congestion, especially in volume-overloaded patients.[4] The most commonly used diuretics in HF are loop diuretics, thiazides and potassium-sparing diuretics.
Why are sodium ducts less effective in glomerular filtration?
They are less effective in patients with reduced glomerular filtration, because they exert their diuretic effects from the luminal side of the nephron.
What is the effect of loop diuretics on sodium?
This causes decreased sodium and chloride reabsorption and increased diuresis.[5]
Why do we need diuretics?
Diuretics are used to achieve and maintain euvolaemia (the patient’s ‘dry weight’) with the lowest possible dose. This means that the dose must be adjusted, particularly after restoration of the dry body weight, to avoid the risk of dehydration, which leads to hypotension and renal dysfunction.[10] .
Is furosemide a diuretic?
Furosemide is by far the most common oral loop diuretic, but patients with resistance to oral furosemide therapy may benefit from trials with second-generation oral loop diuretics (bumetanide and torasemide). These may be more efficacious, due to their increased oral bioavailability and potency. The longer half-life of torasemide may limit the previously described rebound phenomenon.[11] In the prospective TORasemide In Chronic heart failure (TORIC) study, the use of torasemide was associated with lower mortality than furosemide in patients with HF. Furthermore, torasemide has been reported to attenuate LV remodelling in patients with congestive HF (CHF) to a greater extent than furosemide.[12] Torasemide has also been reported to attenuate LV remodelling in patients with HF to a greater extent than furosemide.[13] Although international guidelines do not define which diuretic should be preferred, there is not enough strong evidence to recommend torasemide and bumetanide over furosemide in HF.
Why do people with CHF need hospitalization?
The commonest cause for hospitalisation in patients with CHF is fluid retention and congestion .[4] Hospitalisation itself is associated with an adverse prognosis, and repeated hospitalisations are associated with increasingly poor survival.[33] Congestion itself, and not just reduced cardiac function, thus appears to be associated with a poor prognosis.
How does chronic fluid accumulation affect heart failure?
Chronic fluid accumulation is responsible for a substantial number of hospital admissions, and identifies patients with a worse prognosis than those admitted due to a sudden increase in LV filling pressures.[4] Peripheral congestion in patients with heart failure usually develops over weeks or even months, and patients may present ‘acutely’ having gained over 20 litres of excess fluid, and hence over 20 kg of excess weight. The aim of management is to remove the excess fluid, so that the patient is no longer congested when they leave hospital, now transitioning to a diagnosis of ‘chronic HF (CHF)’. However, for many patients, some degree of congestion remains even with treatment,[5,6] and it is not clear how many patients with CHF have subclinical congestion – that is, have an excess of body fluid falling short of the volume required to cause overt peripheral oedema.
What is the mainstay of management for patients with congestion?
Diuretics are the mainstay of management for patients with congestion. It has become a truism to state that their use is based on empirical judgement and subjective clinical evaluation, rather than evidence-based medicine.
How often is LA pressure taken?
In the HOMEOSTASIS trial, measurements of LA pressure were taken twice daily in 40 patients with advanced HF. After the first 3 months, treatment was personalised based on the readings, which led to a fall in LA pressure (17.6 mmHg in the first 3 months to 14.8 mmHg; P =0.003), the prescription of higher doses of angiotensin-converting-enzyme inhibitors (ACE-I) and beta-blockers, a lesser need for high doses of loop diuretics and improvement in both New York Heart Association (NYHA) class and LVEF.[28]
Why is congestion important for HF patients?
Congestion is an important cause of symptoms in patients with HF. The discomfort of swollen legs and ascites precipitates hospitalisation. Congestion is associated with the sensation of breathlessness, particularly when patients develop pulmonary oedema and pleural effusions. Congestion reduces hepatic function, and the congested liver can itself be a source of discomfort. As described above, congestion causes renal dysfunction by reducing the transrenal pressure gradient. Anaemia, which is highly prevalent among HF patients, can be made worse by congestion through dilution, and can further exacerbate symptoms and cardiac dysfunction.[32]
How does HF affect the kidneys?
The development of peripheral oedema in patients with HF is related to fluid excess. As the heart starts to fail, renal perfusion falls . The kidneys respond by increasing the production of renin, leading to more aldosterone production, which is consequently followed by sodium and water retention.[7] Arginine vasopressin (AVP) is also released,[8,9] further enhancing fluid retention and stimulating thirst. The activation of the renin–angiotensin–aldosterone and AVP systems maintain cardiac preload (more fluids) and afterload (vasoconstriction, mainly due to angiotensin II), thereby maintaining the homeostasis of the cardiovascular system but at a cost of increased systemic venous pressure (VP). The heart itself tends to worsen with time as the failing LV tends to dilate, as does the left atrium, particularly if mitral regurgitation develops. The elevated VP can further reduce renal blood flow as the gradient between mean renal arterial pressure (often itself decreased by the HF process) and VP declines. Glomerular filtration rate falls, enhancing and perpetuating the vicious cycle.[10]
Why do people have HF?
Heart failure (HF) is one of the most common reasons for admission to hospital. It is associated with long in-patient stays, and has a high in-hospital and post-discharge morbidity and mortality, whether left ventricular ejection fraction (LVEF) is reduced (HFREF) or normal (HeFNEF).[1,2] Congestion, or fluid overload, is a classic clinical feature of patients presenting with HF. In some patients, pulmonary congestion develops very rapidly because of a sudden increase in LV filling pressures, and a precipitating factor is often recognised, such as acute myocardial ischaemia, or uncontrolled hypertension. In this circumstance, the oedema is localised predominantly to the pulmonary airspaces (pulmonary oedema), while the total amount of fluid in the cardiovascular system remains unchanged.[3] For most patients, however, congestion is a more generalised process that usually develops more gradually (peripheral oedema), and its management will be the focus of discussion in this review.