Lasix represents a powerful medication that makes an impact on the thick ascending limb segment of the loop of Henle (its entire length) and blocks the reuptake of filtered Na+ ions by 15-20%. Furosemide, the main active ingredient, is released into the lumen of the proximal renal tubules, increasing the excretion of phosphate, bicarbonate ions, Mg2 +, Ca2 +, K + and the pH of urine. Lasix also makes a number of secondary effects, which are caused by redistribution of blood flow and the release of intraurethral intrarenal mediators.
The medication is designed for various types of administration, it is absorbed adequately and rapidly. If taken periorally, the bioavailability is usually 60-70%. The plasma protein binds to 91-97%, while the half-life takes as little as 30 min – 1 hour. Lasix is biotransformed in the liver, where inactive metabolites are formed (mainly - glucuronide). Furosemide is excreted by kidneys (88%) and bile (12 %).
A diuretic effect of the medication is characterized by short duration, significant effect and dosage dependence. When taken orally, it develops in 15-30 minutes and reaches a maximum concentration in 1-2 hours, lasting for 6-8 hours. When administered intravenously, it manifests itself in 5 minutes, peaking in 30 minutes with the duration of 2 hours. During the action of furosemide, an excretion of sodium ions increases significantly, but after abandonment of treatment the rate of sodium ions decreases to less a lower level in comparison with the initial one. The phenomenon develops due to sharp activation of the renin-angiotensin and other antinatriuretic neurohormonal regulation links in response to the massive diuresis. Lasix is a stimulating an effect on the sympathetic nervous system, and arginine vasopressin, reduces plasma levels of atrial natriuretic factor and causes vasoconstriction. Due to the phenomenon of rebound, when receiving a preparation once a day a significant impact can hardly be achieved due to the daily excretion of Na + furosemide.
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