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Extra info for Pharmacology for Student and Pupil Nurses and Students in Associated Professions

Example text

Frusemide — ' L a s i x ' — a v . dose 2 0 - 4 0 mg by injection — „ „ 20 mg 50 mg Ethacrynic A c i d — ' E d e c r i n ' — 50 mg by injection — 1 mg Bumetanide —'Burinex'— 0-5 mg by injection — Frusemide is also available in high strength tablets (500 mg) 32 PHARMACOLOGY FOR STUDENT NURSES and injections (250 mg); these are used in kidney failure of both chronic (of long duration) and acute (of short duration and more severe) nature. Thus, dramatic improvement may be achieved, for example, in shortening the period of oliguria (scanty urinary output) which may follow peritoneal dialysis; reducing the number of dialyses needed; relieving the occasionally stubborn oedema of "waterlogged" patients; overcoming serious uraemia (accumulation of waste products in the blood normally excreted in the urine); and, when kidney failure is imminent following shock, in stimulating production of urine before failure has set in.

Such failure may be acute but remediable, or it may become chronic and without expectation of any improvement in kidney function. A measure that can be used with dramatic effect is peritoneal dialysis. The dialysis process resembles osmosis, but with the difference that it is the dissolved solids which cross the membrane and not the water, the latter being prevented from doing so as will be explained. The membrane concerned is the peritoneum, which lines the abdominal and pelvic cavities and has an approximate area (unfolded) in the adult of over 2 sq.

28). Hence normal saline may be alternated with solutions of dextrose 4 - 3 % with sodium chloride 0-18%, or dextrose 5 % in water, thus reducing the salt intake. These sugar solutions are used to provide calorie value also, and this important point is referred to when discussing intravenous nutrition (p. 45). Examples of hypotonic solutions of sodium chloride are "half normal" saline, which contains 0-45%, and " l / 5 t h normal" saline which contains 0 - 1 8 % ; examples of hypertonic solutions are "double strength" saline, which contains 1-8%, and the powerful 4 - 5 % .

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