Why loop diuretic are contraindicated with aminoglycosides?
Why loop diuretic are contraindicated with aminoglycosides?
It is known that aminoglycoside antibiotics can damage the vestibular and auditory sensory epithelia, and the loop diuretics can enhance the ototoxic effect of aminoglycosides.
Is furosemide and gentamicin contraindicated?
gentamicin furosemide Gentamicin can cause hearing loss, ringing in the ears, vertigo, and kidney problems, and combining it with certain diuretics like furosemide may increase the risks. Patients who may be particularly susceptible include the elderly and those who are dehydrated or have preexisting kidney disease.
Are loop diuretics ototoxic?
The most likely mechanism responsible for the potentiation of ototoxicity by loop diuretics is damage to the tight cell junctions in the blood vessels in the stria vascularis resulting in temporary disruption of the blood-cochlear barrier which increases the permeability of the lateral wall to ototoxic drugs.
Is gentamicin ototoxicity reversible?
Ototoxicity is irreversible and may result in cochlear damage, vestibular damage or both. Incidence of cochlear and vestibular toxicity is low in children and neonates. There is no significant difference in the incidence of ototoxicity between once daily dosing and multiple doses per day.
Which drug should not be used with gentamicin?
Avoid potent diuretics (e.g., ethacrynic acid, furosemide) because they increase the risk of ototoxicity; when administered intravenously, diuretics may enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. This medication contains gentamicin.
Why are loop diuretics not used in hypertension?
Loop diuretics are not recommended in current hypertension guidelines largely due to the lack of outcome data. Nevertheless, they have been shown to lower blood pressure and to offer potential advantages over thiazide-type diuretics. Torsemide offers advantages of longer duration of action and once daily dosing (vs.
How does gentamicin cause nephrotoxicity?
Gentamicin (GM) is causing tubular damage through: 1) necrosis of tubular epithelial cells, predominantly in proximal segment and 2) alteration of function of main cellular components involved in transport of water and solutes. The central aspect of GM nephrotoxicity is tubular cytotoxicity.
Does gentamicin cause hearing loss?
Physicians should monitor both auditory and vestibular function when aminoglycosides, especially gentamicin, must be used. Aminoglycosides can cause permanent damage to inner ear hair cells, resulting in hearing loss (cochleotoxicity) and/or vestibular disturbances such as disequilibrium (vestibulotoxicity).
Which diuretic is ototoxic?
diuretic furosemide
The loop diuretic furosemide is associated with ototoxicity, particularly when doses exceed 240 mg per hour. The related compound ethacrynic acid has a higher association with ototoxicity, and is therefore used only in patients with sulfa allergies.
How do you treat ototoxicity?
Aminoglycoside antibiotics, platinum-based chemotherapeutic agents, loop diuretics, macrolide antibiotics, and antimalarials are the commonly used ototoxic drugs [2] with well-documented efficacy against various infections and malignancies in children and adults.
Does gentamicin cause nephrotoxicity?
Aminoglycoside type antibiotic gentamicin is one of the leading cause of drug-induced nephrotoxicity. In recent years gentamicin nephrotoxicity is significantly reduced by shifting to once daily dosage as well as by eliminating known risk factors.
Can gentamicin and furosemide cause auditory toxicity?
Auditory toxicity occurred after only 5 days of gentamicin therapy and 1 dose of furosemide. An aminoglycoside followed by furosemide may increase the risk for ototoxicity. Clinicians need to be aware of the synergistic potential of ototoxic medications. Ototoxicity induced by gentamicin and furosemide Ann Pharmacother.
How do loop diuretics potentiate ototoxicity?
The most likely mechanism responsible for the potentiation of ototoxicity by loop diuretics is damage to the tight cell junctions in the blood vessels in the stria vascularis resulting in temporary disruption of the blood-cochlear barrier which increases the permeability of the lateral wall to ototoxic drugs.
Can loop diuretics and antibiotics cause hearing loss?
The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity).
What is the prevalence of ototoxicity from Gentamicin toxicity?
Gentamicin ototoxicity, leading to hearing loss or deranged vestibular function, has been widely reported and is often irreversible. The prevalence of clinically evident ototoxicity with multiple daily regimens has been estimated at 11%.
