IV Frusemide

suzanne4, RN · Aug 8, 2005

What the drug book is telling you is that the drug cannot be infused faster than 4mg/min. So you can give 40 mg in 10 minutes, 80 mg in 20 minutes, 120 mg in 30 minutes. So with that information, giving 250 mg in 30 minutes would not be a safe way to administer it.

Hope that this helps.

Tweety, BSN, RN · Aug 8, 2005

Lasix should not be given more than 4 mg/min so I would question the order.

But more than question the rate of administration I would question the dose of 250 mg. I've never heard of such a massive dose being given. But I've only worked med-surg. I've given 120 mg. once. Otherwise I've give 20 to 40 commonly. Occasionally 60, and rarely 80. Never have I seen/heard of a dose that high.

Good luck.

RoxanRN · Aug 8, 2005

Hi, I finished my nursing lab today and I came out of it feeling OH BOY, I dont know how to do this. So I have this question regarding order of IV Lasix 250mgs over 30minutes (Stock 250mgs in 25mls). In the drug handbook it states 'Infuse at 4mg/minute'.
Is the order safe to give? How do I figure out if so?
So bamboozled by this pharmacology stuff. If anyone knows then I will be very appreciative. :)

This is quite a hefty dose! I'd question it immediately. But to answer the question using the information provided in your problem............

My math: (probably not the most scientific - and not by the method I learned in school [couldn't make that work]). I hope it make sense.

4mg per min given for 30min = 120mg given over 30min

250mg per 30min = 8.3mg per min

To answer the questions "Is the order safe to give?" I say NO, this amount would need to be given over 63 minutes

If you are interested, I have some math worksheets (and the answers) using Dimensional Analysis (the method I learned in school). It's very easy to learn. Just PM with your email addy.

sjt9721, BSN, RN · Aug 8, 2005

Lasix should not be given more than 4 mg/min so I would question the order.
But more than question the rate of administration I would question the dose of 250 mg. I've never heard of such a massive dose being given. But I've only worked med-surg. I've given 120 mg. once. Otherwise I've give 20 to 40 commonly. Occasionally 60, and rarely 80. Never have I seen/heard of a dose that high.
Good luck.

Good point about the massive dose. I was helping some 1st year students with their drug calculations and noticed the same thing: drugs & dosages that did not make sense!

My thought is that the instructors (or book publishers) want the students to concentrate on the math problem itself rather than the appropriateness of the order.

pricklypear · Aug 8, 2005

Large doses of lasix are given sometimes to "shock" kidneys back into function. Most often they are ordered by nephrologists like that. I've only worked with one who routinely ordered doses like 200 mg at a time, sometimes he ordered 200mg q 6hours. I usually put it on a pump, in a syringe, and run at 24cc/h. Which works out to 4mg/min since lasix is 10mg/1ml.

Tweety, BSN, RN · Aug 8, 2005

Large doses of lasix are given sometimes to "shock" kidneys back into function. Most often they are ordered by nephrologists like that. I've only worked with one who routinely ordered doses like 200 mg at a time, sometimes he ordered 200mg q 6hours. I usually put it on a pump, in a syringe, and run at 24cc/h. Which works out to 4mg/min since lasix is 10mg/1ml.

Thanks. I was sure it wasn't unheard of. Just not in my practice. I would definately however, not give 250 mg of Lasix without being 100% sure it's what the doc ordered and is warrented in this patients condition. If I saw that order, I'd be on the phone with the md and a pharmacist. I'd definately check electrolytes and vital signs carefully prior as well.

AussieKylie · Aug 9, 2005

Thank you so much Everyone. I totally appreciate your kind educational help. I am so glad that there is a forum like this :)

caroladybelle, BSN, RN · Aug 9, 2005

Hi, I finished my nursing lab today and I came out of it feeling OH BOY, I dont know how to do this. So I have this question regarding order of IV Lasix 250mgs over 30minutes (Stock 250mgs in 25mls). In the drug handbook it states 'Infuse at 4mg/minute'.

Is the order safe to give? How do I figure out if so.

Well, I have given a boat load of lasix, but I have never given 250mg at one time, much less over 30 minutes.

I would seriously question the amount and the rate.

I would also question a unit that keeps 250mg/25cc stocked on the floor. Most places carry 20mg/2cc, 40mg/4cc, 100mg/10cc. Because it is rare to need more than 120mg at a time.

jmgrn65, RN · Aug 9, 2005

I think the most at one time I have heard of is 200mg, and that was in the ICU, I think if the patient needs that much they would just place them on a lasix gtt. It would make more sense anyway.

rjflyn, ASN, RN · Aug 9, 2005

Ok that is a large dose, however I have given 200mg at one time. Also my reference calls for intermittent doses to be given at 4mg min. It also though lists a bolus does of 80mg over 2-5mins, the rate is generally gets given in the ED. A 100mg dose in the ED is quite frequent, also I have never seen anyone spend 25 minutes giving it as well. ALso another poster mentioned use of a pump to give this medication, typically thats not very feasable as the type of pt getting those kind of dosages isnt getting IV fluid hence nothing to flush it from the tubing.

rj