Furosemide + Potassium Chloride
Indications
Furosemide + Potassium Chloride is used for:
Cardiac oedema, pulmonary oedema, hepatic oedema, renal oedema and peripheral oedema of various aetiologies.
Adult Dose
Oral
Adult:
The usual dose is one tablet daily, usually in the morning
Child Dose
Renal Dose
Administration
Should be taken with food: Swallow whole, do not chew/crush.
Contra Indications
Hyperkalemia, pre-comatose states associated w/ hepatic cirrhosis; prostatic hyperplasia or impaired micturition. Pregnancy & lactation.
Furosemide: May compromise placental perfusion & inhibit lactation. Porphyria, hyperkalaemia, precomatose states associated with liver cirrhosis, Addison's disease and concomitant administration of potassium sparing diuretics.
Precautions
Concurrent use w/ cardiac glycosides, hypotensive agents & cephaloridine. Renal insufficiency. Pregnancy (1st trimester). Children.
Lactation may be inhibited due to maternal fluid depletion.
Pregnancy-Lactation
Interactions
Increased toxicity risk with cardiac glycosides, hypotensive agents, including ACE inhibitors and nephrotoxic antibiotics. Serum lithium levels may be increased with concomitant administration. Non-steroidal anti-inflammatory drugs antagonise the diuretic effect.
May enhance nephrotoxicity of cephalosporins eg, cefalotin. May enhance ototoxicity of aminoglycosides & other ototoxic drugs.
Adverse Effects
Side effects of Furosemide + Potassium Chloride :
Patients with prostatic hypertrophy or impairment of micturition have an increased risk of developing acute urinary retention. Latent diabetes may become manifest or the insulin requirements of diabetic patients may increase.
Water and electrolyte balance may be disturbed and serum calcium levels may be reduced. Raised urea and creatinine levels may occur. Bone marrow depression and acute pancreatitis have also been reported as rare complications and therapy should be withdrawn.
Bullous pemphigoid among elderly patients has also been reported as very rare complication: the therapy should be withdrawn.
Mechanism of Action
Furosemide inhibits reabsorption of Na and Cl mainly in the medullary portion of the ascending loop of Henle. Excretion of K and ammonia is also increased while uric acid excretion is reduced. It increases plasma-renin activity, plasma-norepinephrine and plasma-arginine-vasopressin concentrations.
Potassium chloride acts as an electrolyte replenisher of K ions. It is used as a source of K cation, the major cation of the intracellular fluid, essential for maintenance of acid-base and fluid and electrolyte balance of the cell. It also plays a vital role in the conduction of nerve impulses, contraction of cardiac, smooth and skeletal muscles, gastric secretion, normal renal function and carbohydrate metabolism.