英文药名: Lasix(Furosemide)

中文药名: 速尿（呋塞米注射剂）

生产厂家: Aventis

药品名称
【别名】呋喃苯胺酸; 呋塞米; 腹安酸; 利尿磺胺; 利尿灵; 速尿; 速尿灵
【外文名】Furosemide, Frusemide, LASIX, Diural, Furanlral, Seguril, Urex
药理作用
1、利尿：作用强大、迅速而短暂。
(1)个体差异明显，应注意剂量个体化。
(2)利尿作用不受酸碱平衡失调及电解质紊乱的影响。
(3)易引起低血钾、低盐综合征及低氯性碱中毒。低血钾最常见
(4)还促进Ca2＋、Mg2＋排出，而抑制尿酸排出。
2、扩张血管：
(1)能扩张肾血管，增加肾血流量，改变肾皮质内血流分布；
(2)还能扩张小静脉，减少回心血量，减轻心脏负荷，降低左室充盈压，减轻肺水肿。
扩血管机制可能与本药促进前列腺素酶合成，抑制其分解有关。
适应症
临床上用于治疗心脏性水肿、肾性水肿、肝硬变腹水、功能障碍或血管障碍所引起的周围性水肿，并可促使上部尿道结石的排出。其利尿作用迅速、强大，多用于其他利尿药无效的严重病人。由于水、电解质丢失明显等原因，故不宜常规使用。静脉给药（２０～８０ｍｇ）可治疗肺水肿和脑水肿。药物中毒时可用以加速毒物的排泄。
用法用量
1.肌注或静注：每次２０ｍｇ，隔日１次，必要时亦可１日１～２次。１日量视需要可增至１２０ｍｇ。静注必须缓慢，不宜与其他药物混合注射。儿童用量酌减。
2.口服：开始时每日４０ｍｇ，以后根据需要可增至每日８０～１２０ｍｇ。当每日剂量超过４０ｍｇ时，可以每４小时１次分服。儿童口服量开始按每千克体重１～２ｍｇ，再视情况酌增。 长期（７～１０日）用药后利尿作用消失，故需长期应用者，宜采取间竭疗法：给药１～３日，停药２～４日。
任何疑问，请遵医嘱！
不良反应
1、水与电解质紊乱，常为过度利尿所引起，表现为低血容量、低血钾、低血钠、低氯性碱血症，长期应用还可引起低血镁。
2、耳毒性，表现为耳鸣、听力减退或暂时性耳聋，呈剂量依赖性。耳毒性的发生机制可能与药物引起内耳淋巴液电解质成分改变有关。肾功能不全或同时使用其他耳毒性药物，如并用氨基糖苷类抗生素时较易发生耳毒性。
3、高尿酸血症，袢利尿药可能造成高尿酸血症，并引发痛风。
4、其他，可有恶心、呕吐、大剂量时尚可出现胃肠出血。
注意事项
1.可能出现轻微恶心、腹泻、药疹、瘙痒、视力模糊等不良反应，有时可发生起立性眩晕、乏力、疲倦、肌肉痉挛、口渴，少数病人有白细胞减少，个别病人出现血小板减少，多形性红斑、直立性低血压。长期应用可致胃及十二指肠溃疡。
2.由于能减少尿酸排出，故多次应用后能产生尿酸过多症，个别病人长期应用可产生急性痛风。
3.糖尿病病人应用后可使血糖增高；尽管其升血糖远较噻嗪类利尿药弱，但与降血糖药合并应用时，仍有使血糖增高的可能。
4.由于利尿作用迅速、强大，因而要注意掌握开始剂量，防止过度利尿，引起脱水和电解质失衡。
5.肝炎病人服用后，因电解质（特别是钾离子）过度丢失，易产生肝昏迷。
6.长期大量用药时，应注意检查血中电解质浓度。顽固性水肿病人特别容易出现低钾症状，在同时使用洋地黄或排钾的甾体激素时，更应注意补充钾盐。
7.在脱水的同时，可出现可逆性血尿素氮水平升高。如果肌酐水平升高不显著和肾功能无损害时，可继续使用本品。
8.使用第１个月，要定期检查血清电解质、二氧化碳和血中尿素氮水平。与其他利尿药一样，当治疗进展中的肾脏疾患而有血清尿素氮值增加和少尿现象发生时，应立即停止用药。
9.能增强降压药的作用，故合并用药时，降压药的用量应适当减少。
10.因结构上本品是与氯噻嗪结构相似的一类磺胺型化合物，能降低动脉对升压胺（如去甲肾上腺素）的反应，并能增加筒箭毒碱的肌松驰及麻痹作用，故手术前１周应停用。
11.低钾血症、超量服用洋地黄、肝昏迷病人禁用。晚期肝硬变病人慎用。
12.大剂量静注过快时，可出现听力减退或暂时性耳聋。与氨基糖甙类抗生素配伍应用，更易引起听力减退。
规格
呋塞米口服液: 10mg/ml X 120ml。
注射液：每支２０ｍｇ（２ｍｌ）。
片剂：每片20mg,40mg,80mg,500mg

Details
Furosemide(Lasix) is the most powerful and most widely used diuretic drug in the world. The injectable version is fast-acting, and dries someone out like prune. Its used in the medical field, mostly in the emergency room, to purge people who have ingested large doses of toxins, hoping that the toxins can be excreted before they enter the system and so avoiding worse problems. It also makes a good shock treatment for people who are admitted with dangerously high blood pressure. Its very multi-functional, but its also a very dangerous drug. It signals the body to immediately excrete both intracellular and extracellular water, and with it the key electrolytes sodium and potassium. This can lead to severe problems. Muscle contraction is based on the exchange of electrolytes. That means in first instance an electrolyte imbalance can causing cramping and other irregularities in muscle contraction. Now if its only a calf or a bicep, no harm done in the long run. But when its your heart muscle, that's another story. In 1985 professional bodybuilder Mohammed "Momo" Benazziza fell dead after winning a Grand Prix, the cause of death was believed to be his pre-contest use of the diuretic Lasix.
In most sports diuretics are used to lose small amounts of weight in a hurt. If you compete in weight classes and need to drop a pound in an hour, lasix will do the trick for you. Cleans the water from your body and you are lighter. If you have a match the next day, you are probably heavier again, so a major advantage. In bodybuilding the use of diuretics is for another reason entirely. The aim is after all to show as much muscle as possible, and to show as much definition and striation within that muscle. Unfortunately even at the dangerously low body-fat percentages bodybuilders compete at, a lot of that definition may still be hidden under layers of subcutaneous water. By using diuretics, that water can be shed and the maximum potential of a physique can be retained. In many cases, the levels of water retained by an athlete has made the difference between doing very well and doing very poorly. And the differences in the water household between the pre-judging of a contest and the evening show have sometimes made the difference between several placings. So diuretics have become an integral part of bodybuilding over the last 20 years.
Furosemide comes in oral tablets of 20 and 40 mg and in an injectable form. The injectable is the most potent. Its injected intravenously, as opposed to most steroids which are injected intramuscularly. It can become active in a matter of minutes and has a drastic effect. But as described previously, also a very dangerous one. The orals will usually take 60-90 minutes to kick in, but have a fairly drastic effect themselves. Furosemide is without a doubt the most potent diuretic in the world. An athlete will rarely opt to take more than 40 mg daily, and only in the last 4 or 5 days leading up to a show. The Injectable version is only used pre-contest, especially if there is testing. Testing for diuretics has become very popular in bodybuilding of late, and that has driven more athletes to wait until after taking their piss, and then inject some Lasix to get rid of the last bit of water. Needless to say this is a reckless practice. If a stronger effect is required, athletes are more likely to opt for adding another, milder diuretic like spironolactone (Aldactone), instead of increasing the dosage of lasix. There are a number of combination diuretics like Lasilactone that enjoy great popularity in the sports sector. Usually they near the potency of using twice as much lasix, but with much less hazard.
Store in temperature not exceeding 77oF(25oC), away from excess moisture.