The relationship between the intracanular concentrations of unbound (free) furosemide and its natriuretic effect is in the form of a sigmoid curve with a minimum effective furosemide excretion rate of about 10 g / min. Therefore, prolonged infusion of furosemide is more effective than repeated bolus administration. In addition, if a certain bolus dose is exceeded, no significant increase in the effect is observed. When the tubular secretion of furosemide decreases or when the drug binds to the albumin located in the lumen of the tubules (for example, in a nephrotic syndrome), the effect of furosemide decreases.
Jasper Collins (Risk: High) - Suicide & FaithSuicide & Faith

Faith Member Background

Jasper Collins (Risk: High)

Jasper CollinsJasper Collins is a 57-year-old Caucasian male. He has been married to Harriet for 30 years. The couple has two children, Jason (age 29) and Sarah (age 18). Jason lives out of state and Sarah, who recently joined the military, also lives out of state. Jasper and Harriet go to an Episcopal church regularly, and Harriet is involved in several church activities.

Jasper is a recovering alcoholic, and a Vietnam War veteran (drafted, rank of private) who was recently fired from his job from a water treatment plant. When Jasper returned from Vietnam, he suffered from the symptoms of post-traumatic stress disorder and was unable to focus enough to get himself through college. He was never diagnosed and he was able to focus well enough to have a string of jobs, if not a career.

Considering himself too old to find another job, he retreated to his home, where he has spent his time watching TV and has been unable to stay completely sober. One of the topics in the media that has caught his attention was the wars in Iraq and Afghanistan.

As Jasper watched the news reports of American soldiers in those countries, the memories of his own experiences in Vietnam crept back into his mind: the members of his platoon who died in his arms; the faces of the enemy whom he killed; the orders he didn’t always agree with; the “accidents” in which women and children civilians were mistakenly killed or wounded. In light of these memories, Jasper has increasing become more anxious and has been having strong panic attacks. With Sarah in the military, his thoughts of what could happen to her enhance the intensity of his anxiety. He has stopped going to church, has withdrawn from his bowling group, and has snapped at Harriet more than once. Harriet has been concerned and nervous, but Jasper has pushed her away and refuses to talk about it. She reached out to their priest for help, and today the priest has stopped by Jasper’s house to talk.

Guarded Memories:
When Jasper was in Vietnam, he spent several nights contemplating taking his life. The stress of war seemed too great to bear. He had been in country for 2 tours, he was exhausted, and got confused easily. He put the gun to his head a few times, to see how it felt there. Since he’s been back, he occasionally does the same with the .45 he keeps locked away. Because he loves his family, he doesn’t ever pull the trigger, or even load the gun. But with things going the way they are, he’s been considering loading the gun to see what happens.