GN nurse asking about Lasix

[mad6w3]

I'm studying my meds for NCLEX prep and just for my own knowledge and I came across Lasix. I know that Lasix IVpush is to be given slow or your going to cause ototoxicity, bla bla bla. I know that. I want to know an exact number that it is to be pushed like how many mg/min? I read somewhere in a drug book that you need to give the smallest vial of Lasix (20mg/2mL) at least over 2 minutes. Now, as I'm reading over this Lasix flashcard it says to give Lasix no more than 4mg/min. I googled it and now I'm finding that you don't give IV Lasix AT ALL when your dose is over 20mg? I've been instructed to give 80mg of Lasix IV push. I gave that at about 5 minutes. I'm hoping this is all making sense. Can someone please clear up the confusion. How fast am I supposed to push IV Lasix undiluted? Please don't just say "slow".

[McGyverRN]

Each facility will have a drug guide that will tell you how fast to push meds. At my facility, we give Lasix at a rate of 40mg/minute. Check your google reference again...perhaps that was an unusual circumstance. Lasix 40mg iv push is a very common dose. I have given doses as high as 160mg, but that is very rare.

[ObtundedRN, BSN, RN]

Check with your facility resources and pharmacy. I very commonly give up to 80mg IV push. I forget at times, but believe the correct way is 1-2 mins for every 20mg. But once you reach a high enough dose (I believe 160mg) then it all changes. If you are giving that large of a dose, it all has to be given as an IV infusion with a max rate of 4mg/min.

[SRDAVIS]

I have given 80mg IVP a million times. So it's ok. I was taught to not give more than 4mg/min. And I just verified in my drug book. You can never go wrong going slow.

[NPinWCH]

Ok, my book says to push doses up to 100mg over 1-2min. I found a website that lists in one place 4mg/min, but later in the monograph under a part labeled "Continuous Infusion" it says that up to 80mg can be pushed over 1-2 min, if more is needed to consider continuous infusion. That's pretty close to my book.

http://www.globalrph.com/furosemide_dilution.htm

[kyleRN]

Lasix 80 IVP is very common... you can push at 40mg/min if you want, but if their BUN/Creatinine is off, you might want to push a lot slower because they can be vascularly dry. Slow is always better. You can always take your time pushing a med. Unless it's Adenosine or something.

A Lasix gtt shouldn't be more than 4mg/min.

[simboka]

The highest I've seen was 220 or 240mg q8 or 12hrs (don't remember, it was probably 1-2yrs ago), in a pt who wasn't very responsive to lasix. Out policy is in the process of changing, but it used to be 10mg/min, now larger doses are going to be sent from pharm in a piggy back bag, but I'm not sure if the rate'll change with that or not.

[nursej22, MSN, RN]

I looked up Lasix on my Micromedex app and agree it is misleading. It says you can push over 1-2 minutes, or dilute and give at a rate of 4mg/min.

FWIW, when I give >20 mg Lasix, I draw it up into a 10 cc syringe, pull in enough NS to make 10 cc and put it on a syringe pump and give it over 20 minutes. 80 mg is a very common dose.

[imintrouble, BSN, RN]

I am so out of touch. I learned in school.......ages ago, 1mg/10ml per min. That's the way I still do it.

[GRUNGE]

40 mg over two minutes or one minute for every 20mg or 30sec for every 10mg or 15sec for every 5mg