Questions and Answers
What is the brand name of Torsemide?
Demadex
What is the drug class of Torsemide?
Loop diuretic
What is the dosing for Torsemide in edema related to heart failure?
10-20 mg po daily, may titrate to maintenance dose (max 200 mg/d)
What is the MOA (Mechanism of Action) of Torsemide?
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What is the dose adjustment renal for Torsemide?
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Are there pharmacogenetics for Torsemide?
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What are the contraindications to Torsemide?
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What are the boxed warnings for Torsemide?
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What are the drug interactions with Torsemide?
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What are COMMON adverse reactions to Torsemide?
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What are RARE BUT SERIOUS adverse reactions to Torsemide?
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What are the efficacy monitoring parameters for Torsemide?
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What are the toxicity monitoring parameters for Torsemide?
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Study Notes
Torsemide Overview
- Brand name: Demadex
- Drug class: Loop diuretic
Dosing Information
- For edema related to heart failure, renal failure, hepatic cirrhosis: initial dose of 10-20 mg PO daily (titrate to max 200 mg/d)
- For hypertension: starting dose of 5 mg PO daily, titrate based on patient response
Mechanism of Action
- Acts as a loop diuretic, inhibiting sodium reabsorption in the thick ascending limb of Henle's loop
- Competes for the chloride site on the Na+-K+-2Cl- cotransporter
Renal Dose Adjustment
- No adjustments required for renal impairment
Pharmacogenetics
- No known pharmacogenetic implications
Contraindications
- Hypersensitivity to torsemide or sulfonylureas
- Anuria
- Hepatic coma
Boxed Warnings
- None specified
Drug Interactions
- ACE-inhibitors: Increased risk of postural hypotension; start with a low dose and monitor blood pressure
- Aminoglycosides: May increase serum concentrations, leading to ototoxicity and/or nephrotoxicity; avoid use
- Antidiabetic drugs: May reduce hypoglycemic effects; monitor closely
- Antiarrhythmic agents: Increased risk of ventricular arrhythmias due to hypokalemia; monitor potassium and magnesium levels
- Bile acid resins: Reduced efficacy of torsemide; advise administration of cholestyramine 4 hours after torsemide
- Diuretics: Can lead to increased diuretic response; monitor usage
- Lithium: Increased risk of lithium toxicity; consider reducing lithium dose
- NSAIDs: Reduced antihypertensive effect, potential nephrotoxicity; avoid concurrent use
Adverse Reactions
- Common adverse reactions: None reported
- Rare but serious reactions: Angioedema, thrombocytopenia, electrolyte abnormalities, anuria
Efficacy Monitoring Parameters
- Target outcomes include decreased blood pressure, increased urine output, reduction in edema, and daily weight monitoring
- For renal failure treatment, monitor increase in urine volume, creatinine clearance (CrCl), blood urea nitrogen (BUN), and electrolyte levels
Toxicity Monitoring Parameters
- Monitor for severe volume depletion and check serum and urine electrolytes, uric acid, and blood glucose at baseline and every 3-6 months post-therapy
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Test your knowledge on Torsemide with these flashcards. This quiz includes information about the brand name, drug class, and dosing guidelines for Torsemide. Perfect for students and professionals in the healthcare field!
