In the described intraoperative setting, the rationale for administering 5 to 10 mg of furosemide is to offset the effects of increased antidiuretic hormone (ADH).

In the described intraoperative setting, the rationale for administering 5 to 10 mg of furosemide is to offset the effects of increased antidiuretic hormone (ADH).

• A. Offset the effects of increased antidiuretic hormone (ADH)
• B. Improve renal blood flow
• C. Convert oliguric renal failure to nonoliguric renal failure
• D. Offset the effects of increased renin

Answer: (A)

In this setting, the key idea is that ADH rise during surgery promotes water reabsorption, lowering urine output. Furosemide counters this by inhibiting the Na-K-2Cl transporter in the thick ascending limb, which disrupts the medullary concentration gradient and increases sodium delivery to the distal nephron. This drives diuresis even in the presence of ADH, helping maintain urine output and protect renal function during anesthesia. So the rationale is to offset the effects of increased ADH. It doesn’t primarily aim to improve renal blood flow, convert oliguric renal failure to nonoliguric, or counteract renin effects.

In this setting, the key idea is that ADH rise during surgery promotes water reabsorption, lowering urine output. Furosemide counters this by inhibiting the Na-K-2Cl transporter in the thick ascending limb, which disrupts the medullary concentration gradient and increases sodium delivery to the distal nephron. This drives diuresis even in the presence of ADH, helping maintain urine output and protect renal function during anesthesia. So the rationale is to offset the effects of increased ADH. It doesn’t primarily aim to improve renal blood flow, convert oliguric renal failure to nonoliguric, or counteract renin effects.