Is this safe in the home setting....IM Lasix, huge dose!

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Hello everyone, Ok, I am not new to home health, been doing this for quite a few years. Today I have been asked to administer 100mg Furosemide IM to a patient in the home setting. Patient has history of heart transplant, on the list for kidney transplant, HTN, DM. I feel very uncomfortable doing this. MD says "patient has had lasix in the hospital before". Ok, maybe so, but 100 mg at a time. I also work in a hospital and have never administered more than 80 mg at a time IV push. Patients BP is usually 150's over 70's. BP can sustain this kind of dose but still, it concerns me. Any thoughts or advice?

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Specializes in Nephrology, Cardiology, ER, ICU.

I wouldn't question the doseage but rather the route. Why not give oral? This pt has had a heart tx, probably developed renal failure from the anti-rejection meds so I assume they are receiving some type of dialysis or soon may need dialysis?

I care for ESRD pts and if my pts still urinate, I often give 120mg twice per day!

However, that said, if the pt produces little to no urine, then any amt of diuretic is useless.

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Specializes in Anesthesia.
Hello everyone, Ok, I am not new to home health, been doing this for quite a few years. Today I have been asked to administer 100mg Furosemide IM to a patient in the home setting. Patient has history of heart transplant, on the list for kidney transplant, HTN, DM. I feel very uncomfortable doing this. MD says "patient has had lasix in the hospital before". Ok, maybe so, but 100 mg at a time. I also work in a hospital and have never administered more than 80 mg at a time IV push. Patients BP is usually 150's over 70's. BP can sustain this kind of dose but still, it concerns me. Any thoughts or advice?

Max dose according to lexi-comp drug database is 200mg IM. I think you are well within the safe zone. It probably is not going to have much effect on this patient anyways, so I am assuming that is the reason for the large dose.

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Doc want so quickly diuresis patient. Doesn't want to give PO lasix. I was just concerned because I have never given those dose but I do understand that if renal failure is severe enough, it won't have a huge effect anyway. Just worried about my patient's blood pressure bottoming out when I am not there to assess her. Maybe I am overly concerned...

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Specializes in COS-C, Risk Management.

If the patient is on the list for kidney transplant, s/he should already be on dialysis, which is likely a much better route for massive diuresis.

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