Anticoagulation, endocrine and GI
Bumetanide (Bumex) drip
Bumex
Dosing
| Start | 1 mg IV over 1–2 minutes, then 0.5 mg/h (CrCl over 75), 0.5–1 mg/h (CrCl 25–75) or 1–2 mg/h (CrCl under 25) (Brater 1998) |
|---|---|
| Titrate | No response after an hour: repeat the 1 mg bolus, then double the rate (Brater 1998) |
| Maximum | 2 mg/h (Brater 1998); the label caps intermittent dosing at 10 mg a day, which these infusions exceed. 1 mg ≈ 40 mg furosemide (label); the heart failure page equates it with 40 mg oral or 20 mg IV furosemide |
| Common bags | 25 mg in 100 mL (250 mcg/mL) |
| Dose units | mg/h |
Line and administration
- ASHP standard 0.25 mg/mL, usually undiluted; use diluted solutions within 24 hours; protect from light
- Peripheral or central
Watch for
- Low K, Mg and Na, contraction alkalosis and hypovolemia: electrolytes at least daily
- Muscle cramps; ototoxicity, more with aminoglycosides or kidney failure
- Sulfonamide allergy may cross-react; furosemide-allergic patients have been treated successfully (label)
Bumetanide: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
Other anticoagulation, endocrine and gi
- Heparin
- Insulin (regular)
- Amiodarone
- Diltiazem
- Octreotide
- Pantoprazole
- Furosemide
- Argatroban
- Bivalirudin
- Procainamide
- Lidocaine
- Magnesium sulfate
- Naloxone
- Eptifibatide
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.