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Pharmacy Prereg exam 2008 Bumetanide question.

I've heard alot about this question causing problems. Here's my theory on the answer...

The question something like this:
Which of these are suitable infusion fluids for bumetanide:
1. Sodium chloride 0.18% and Glucose 4%
2. Sodium chloride 0.9%
3. Sodium lactate

Is the answer:
A. 1, 2 and 3 are correct
B. 1 and 2 are correct
C. 2 and 3 are correct
D. 1 only is correct
E. 3 only is correct

My theory
To help you look up it up in the BNF: (1) referenced in BNF inappendix 6 under bumetanide and (2) and (3) referenced in BNF under Sodium Chloride infusion chapter 9.2.2

I think the answer is 2 and 3 is true, so B

1. MAYBE FALSE: cause "injudicious use of solutions such as sodium chloride 0.18% and glucose 4% may also cause dilutional hyponatreamia especially in children and elderly" quoted from the BNF. Not sure what dilutional hyponatraemia means but I'm guessing it causes hyponatraemia and bumetide causes hyponatraemia, so this combination can't be good

2. TRUE: clearly shown in the infusion tables in bnf as what is recommended

3: MAYBE TRUE:not much information in the BNF but heres my theory... Bumetamide causes hypokalaemia sodium lactate iv infusion contains potassium so may help counter this.

The one that was clearly right was definitely 2, therefore one or both of the others must be true as there's no option to have 2 correct only.

So this is my theory, however, I still don't know if its correct.

I have heard someone comment in a forum about this question being a trick concerning Furosemide, as Furosemide has greater incompatibility with IV fluids than Bumetanide. However the person that commented this has yet to explain to me what his theory of the answer is.

Anyone know the answer?

I will update this post as I get more information.

If you know the answer or have a better theory then please email me at admin@pharmacyknowledge.co.uk

General Information on Bumetanide:
- Bumetanide is a loop-diuretic
- Acts within 1 hour of oral administration
- diuresis is complete after 6 hours
- Bumetanide not be taken at night as diuresis may interfere with sleep. However can be taken twice a day without interferring.
- bumetanide and furosemide has a peak effect after 30 minutes after intravenous infusion.