bumex vs lasix | allnurses

bumex vs lasix

  1. 0 Does anyone know what the difference between bumex and lasix is?
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  2. 12 Comments

  3. Visit  RNforLongTime profile page
    #1 0
    Bumex and lasix are both loop-diuretics. I've seen patients with kidney failure that don't respond to lasix respond nicely to bumex. The kidney docs in my area seem to like bumex better. We run bumex gtts a lot.
  4. Visit  iluvnoodles profile page
    #2 1
    I thought diuretics are contraindicated in kidney insufficiency. In school, the teachers said, if your patients aren't peeing, than don't give them diuretics. In my research it kept on showing that it's used to treat kidney disease. So I guess I'm a bit confused...
  5. Visit  netglow profile page
    #3 0
    OP, there's a lot of reasons. I find that if I am needing an explanation, I can go back to my physiology stuff. It's all there.
  6. Visit  CherryAims profile page
    #4 1
    Hi there, I am a student nurse and this subject came up this past Friday. It was explained that Bumex was given when high doses of Furosemide were not working.
  7. Visit  manncer profile page
    #5 0
    Loop diuretics are given to decrease fluid overload with malfunctioning kidneys and to prevent hyperkalemia. Eventually loops become less and less effective and doses of lasix can be 600mg/day or higher.
  8. Visit  meandragonbrett profile page
    #6 2
    Bumex will make a rock urinate when lasix won't. =)
  9. Visit  NS2SBowman profile page
    #7 0
    When we were discussing kidney failure for our last test, one of our instructors told us they give Lasix and Bumex together because the Bumex makes the Lasix work better.
  10. Visit  highlandlass1592 profile page
    #8 1
    Quote from iluvnoodles
    I thought diuretics are contraindicated in kidney insufficiency. In school, the teachers said, if your patients aren't peeing, than don't give them diuretics. In my research it kept on showing that it's used to treat kidney disease. So I guess I'm a bit confused...
    One important thing to remember about school: they are covering generalizations...when you get into practice, you may find out your school lectures weren't always right on for the specific population you are seeing.

    You aren't using diuretics to treat the kidney disease, you're using it to compensate for the renal insufficiency. Case in point, dealing with heart failure and renal insufficiency, the kidney's can't cause enough diuresis on their own, you give them diuretics to treat the heart failure. You need to get that fluid off in an acute flare-up and need to keep it off in chronic management. So you increase the renal sufficiency by adding the diuretic.

    You need to look at the overall process you're dealing with. You're not going to just deal with one system here, you're dealing with the whole body. So you're going to monitor kidney function (in the example cited) to deal with the heart failure. The kidney's are only going to let you diurese to a point....then you run the risk of kidney failure. This is definitely an area where clinician skill comes into play. You know your patients, you know how far you can push things. Make sense?
    Last edit by highlandlass1592 on Mar 6, '10 : Reason: spelling
  11. Visit  jackbeninja profile page
    #9 0
    There are several differences between these two diuretics which may influence why they are given. Lasix is slightly older, being patented in 1962, versus Bumex, which came out in 1970. Bumex is more potent than Lasix at a concentration of 40:1, such that 1mg IV Bumex is generally equivalent to 40mg IV Lasix. Given orally, Bumex is better absorbed than Lasix, and also food does not impact the absorption, which makes it a little more predictable, and can sometimes be preferred for that reason. If a patient is not responding to IV Lasix, sometimes they will switch to Bumex simply because it's an alternative. Some older studies have shown that Lasix can be more potent than Bumex, and I've heard anecdotally that Lasix is "harder" on the kidney, although I didn't see that reflect 100% in the literature. Check UpToDate.com if you have a prescription at your institution. Generally speaking, there are not HUGE differences between the two. A lot of it comes down to personal practice of the physician and the hospital convention.
  12. Visit  nutella profile page
    #10 1
    In addition to everything said I wanted to point out that when I worked in acute dialysis, some physicians preferred bumex for the liver patients who also had kidney failure and that bumex as a drip is very popular in the hospital I work with cardiologists to treat fluid overload in acute decompensation when lasix iv is not resulting in enough diuresis. Chronic kidney disease as well as heart failure is very common and the population is getting older. When heart failure requires longterm tx with diuretics like lasix it can also result in a worsening kidney function over time. Lately, there has been an increase of patients at a higher age - late 80s or in their 90s who end up in the hospital on bipap, diuretic drips, dopamin and dobutamin drips in an effort to treat acute HF in patients who have worsening chronic CHF with also worsening kidney function. In some patients it is successful and they go back home after a while, but not always. There are also those who go home for one or two weeks and come back in with shortness of breath and go another round. When it comes to the point where the patient can't come off bipap or have frequent re-admissions or even can't get off the drips it becomes a difficult situation as cardiologists in my area do not seem to have any discussions with their sicker frail patients about "what if this does not work" or "what if it turns out" and to talk about how far a person would want to go and what it means. Some families and patients seem even somewhat shocked when they discover that you can not live in the critical care area.....
    I think that every patient with HF class 3 and 4 ad CKD stage 4 should have a consult with palliative care or a conversation with their specialist about the future...
  13. Visit  NurseGirl525 profile page
    #11 0
    I'm also going to say, it depends why they aren't peeing. There could be several reasons why a patient isn't voiding properly. I see Lasix as like a little push to get those kidneys moving and to remove that excess fluid. A diuretic is given to help with fluid retention. They may be third-spacing that fluid for reasons that don't have much to do with the kidneys.

    I see bumex as a much bigger push to get that fluid off. Some people quite literally end up drowning in fluid. If the Lasix isn't cutting it, bumex should get it.

    Think of conditions that cause fluid overload. CHF is the big one. Think of why CHF is causing somebody to retain that fluid. I hope that helps a little.
  14. Visit  TheCommuter profile page
    #12 0
    An internal medicine physician once explained to me that Bumex has a nearly 100 percent bioavailability compared to Lasix. Therefore, Bumex is the more potent medication of the two diuretics.

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