Spino M, Sellers E M, Kaplan H L, Stapleton C, MacLeod S M
Can Med Assoc J. 1978 Jun 24;118(12):1513-8.
Nurse monitors collected clinical and laboratory data from 204 hospitalized patients receiving furosemide (122 men and 82 women; mean age 69.6 years). Biochemical abnormalities and clinical problems definitely or probably induced by any drug occurred in 70.6% and 49.0% respectively of the patients, and were attributed to furosemide in 81.3% and 13.0% respectively of these patients. The most important clinical events were dehydration and hypotension. Furosemide-induced hypochloremia, hypokalemia and hyponatremia occurred in 35.8%, 25.0% and 24.5% of the patients respectively. Most of the biochemical changes were slight, and only 3.9% of the patients had a furosemide-induced decrease in the serum potassium concentration to less than 3.0 mmol/L. Surprisingly, 24.5% of the patients also manifested drug-induced hyperkalemia. Administration potassium supplements or spironolactone, or both, concurrently with furosemide was responsible in most cases for the development of hyperkalemia. The occurrence of drug-induced adverse effects after 2 weeks of hospitalization was significantly associated (P less than 0.05) with subsequent prolongation of hospitalization. The high frequency of drug-induced events warrants careful monitoring of all patients receiving furosemide in spite of the low frequency of serious toxic effects produced by the drug.
护士监测人员收集了204例接受呋塞米治疗的住院患者的临床和实验室数据（122名男性和82名女性；平均年龄69.6岁）。任何药物明确或可能导致的生化异常和临床问题分别发生在70.6%和49.0%的患者中，而这些患者中分别有81.3%和13.0%的异常及问题归因于呋塞米。最重要的临床事件是脱水和低血压。呋塞米引起的低氯血症、低钾血症和低钠血症分别发生在35.8%、25.0%和24.5%的患者中。大多数生化变化轻微，只有3.9%的患者血清钾浓度因呋塞米降低至低于3.0 mmol/L。令人惊讶的是，24.5%的患者还出现了药物性高钾血症。在大多数情况下，高钾血症的发生是由于同时给予呋塞米和钾补充剂或螺内酯，或两者兼用。住院2周后药物性不良反应的发生与随后住院时间延长显著相关（P小于0.05）。尽管该药物产生严重毒性作用的频率较低，但药物性事件的高发生率仍需要对所有接受呋塞米治疗的患者进行仔细监测。
