One of your regular clients, 67-year-old Martin, has been recently diagnosed with congestive heart failure and takes several medications for this problem. One of his medicines is furosemide for fluid retention.
Martin is aware that the medication helps reduce excess water in his body but is complaining that since he started taking it, he is suffering from adverse effects. Martin says the worst side effect of taking the tablets during the day means he can never leave the house for long, and work is difficult because of potential incontinence if he can’t get to a toilet.
The half-life of furosemide is 2 hours and duration is about 6
https://www.nhs.uk/medicines/furosemide/common-questions-about-furosemide/#:~:text=A%20dose%20of%20furosemide%20works,your%20blood%20are%20properly%20balanced
Martin says his lack of sleep is increasingly detrimental to his general well-being. Upon questioning you ascertain that Martin is taking the furosemide each morning at the correct dose.
Today, Martin tells you he does not want to continue taking the furosemide, nor does he want the repeat prescription filled. When you express concerns, he asks you not to contact his doctor since he feels his doctor “doesn’t understand”.
You tell Martin that you are bound by professional confidentiality so you will respect his privacy and not contact his doctor. However, as you are talking with him you notice he is significantly breathless, even though he is sitting down.
He stands up with difficulty and stumbles toward the door. As he is leaving the pharmacy you can see that his lower legs are severely swollen, causing you a significant concern about Martin’s apparently worsening heart failure.