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Summary
Furosemide, a common diuretic, can cause hearing damage (ototoxicity). Strategies like slow infusion and dose adjustments may minimize this risk, with bumetanide as an alternative.
Area of Science:
- Pharmacology
- Ototoxicology
- Nephrology
Background:
- Furosemide is a widely prescribed loop diuretic.
- Ototoxicity is a serious, potentially permanent side effect of furosemide.
- The precise mechanisms of furosemide-induced ototoxicity remain unclear.
Purpose of the Study:
- To investigate the mechanisms of furosemide ototoxicity.
- To identify factors that potentiate or do not affect furosemide ototoxicity.
- To propose methods for mitigating furosemide ototoxicity.
Main Methods:
- Pharmacologic, neurophysiologic, and morphologic investigations.
- Assessment of furosemide interaction with aminoglycoside antibiotics and noise trauma.
- Evaluation of different administration methods and blood level monitoring.
Main Results:
- Aminoglycoside antibiotics potentiate furosemide ototoxicity.
- Noise trauma does not appear to potentiate furosemide ototoxicity.
- Suggested methods include slow continuous infusion, divided oral doses, and maintaining furosemide blood levels below 50 mcg/ml.
Conclusions:
- Furosemide ototoxicity is a significant clinical concern.
- Specific administration strategies and therapeutic drug monitoring can reduce ototoxicity risk.
- Bumetanide may serve as an alternative diuretic to maintain efficacy while minimizing ototoxicity.