Symptoms: Profound water loss, volume and electrolyte depletion (manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps), dehydration, reduction of blood volume and circulatory collapse w/ possible thrombosis and embolism. Management: Supportive and symptomatic treatment, including fluid and electrolyte replacement. Perform gastric lavage or emesis.
Drug Interactions
Reduced diuretic and natriuretic effect w/ probenecid. May potentiate the effects of antihypertensive agents. Decreased effect when used w/ indometacin. May increase risk of digitalis toxicity. Increased risk of ototocixity when used w/ aminoglycosides or other ototoxic drugs (e.g. cisplatin). Increased risk of nephrotoxicity when used w/ nephrotoxic agents.
Potentially Fatal: May increase risk of lithium toxicity.
Action
Description: Mechanism of Action: Bumetanide inhibits Na and Cl reabsorption in the loop of Henle and proximal renal tubule, interfering w/ the Cl-binding cotransport system, thus inducing excretion of water and electrolytes. Onset: 0.5-1hr (oral, IM); 2-3 min (IV). Duration: 4-6 hr (oral); 2-3 hr (IV). Pharmacokinetics: Absorption: Almost completely and rapidly absorbed from the GI tract; completely absorbed (IM). Bioavailability: Approx 80-95%. Time to peak plasma concentration: 0.5-2 hr (oral). Distribution: Volume of distribution: 9-25 L. Plasma protein binding: 94-96%. Metabolism: Partially metabolised in the liver via oxidation of the N-butyl side chain to form alcohol metabolites. Excretion: Via urine (approx 75-80%, w/ 50% as unchanged drug); faeces (approx 10%) Elimination half-life: 1-1.5 hr.
C03CA02 - bumetanide ; Belongs to the class of high-ceiling sulfonamide diuretics.
References
Anon. Bumetanide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/08/2016.
Buckingham R (ed). Bumetanide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/08/2016.
Bumetanide Inj, Solution (Hospira, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/08/2016.
Bumetanide Tablet (Edenbridge Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/08/2016.
Joint Formulary Committee. Bumetanide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/08/2016.
McEvoy GK, Snow EK, Miller J et al (eds). Bumetanide. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 03/08/2016.