Ototoxicity induced by gentamicin and furosemide

被引:38
作者
Bates, DE
Beaumont, SJ
Baylis, BW
机构
[1] Foothills Med Ctr, Dept Pharm, Calgary, AB T2N 2T9, Canada
[2] Audiol Consultants So Alberta, Calgary, AB, Canada
关键词
furosemide; gentamicin; ototoxicity;
D O I
10.1345/aph.1A216
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
OBJECTIVE: To present a case of ototoxicity induced by furosemide and once-daily gentamicin therapy. CASE SUMMARY: A 60-year-old white woman presented to the hospital with community-acquired pneumonia and urinary tract infection. The antibiotic regimen included gentamicin and, after 5 doses, the patient reported profound bilateral hearing loss. A Pure Tone Audiogram suggested moderate to moderately severe sensorineural hearing loss bilaterally. The only risk factors present included her age, elevated temperature, and the use of furosemide. DISCUSSION: Several risk factors may predispose a patient to developing aminoglycoside ototoxicity: the 1555 chromosomal mutation, preexisting disorders of hearing and balance, hypovolemia, bacteremia, liver and renal dysfunction, and the simultaneous administration of other ototoxic medications. The cumulative dose and duration of aminoglycoside therapy are more important than serum concentrations. Administration of an aminoglycoside followed by furosemide may increase the risk of ototoxicity. The aminoglycoside interacts with the cell membranes in the inner ear, increasing their permeability. This theoretically allows the loop diuretic to penetrate into the cells in higher concentrations, Causing more severe damage. CONCLUSIONS: Auditory toxicity occurred after only 5 days of gentamicin therapy and I 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.
引用
收藏
页码:446 / 451
页数:6
相关论文
共 48 条
[21]   KINETICS OF GENTAMICIN UPTAKE AND RELEASE IN THE RAT - COMPARISON OF INNER-EAR TISSUES AND FLUIDS WITH OTHER ORGANS [J].
HUY, PTB ;
BERNARD, P ;
SCHACHT, J .
JOURNAL OF CLINICAL INVESTIGATION, 1986, 77 (05) :1492-1500
[22]   KANAMYCIN OTOTOXICITY - POSSIBLE POTENTIATION BY OTHER DRUGS [J].
JOHNSON, AH ;
HAMILTON, CH .
SOUTHERN MEDICAL JOURNAL, 1970, 63 (05) :511-&
[23]   Cephalosporin allergy [J].
Kelkar, PS ;
Li, JTC .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (11) :804-809
[24]  
Lo SHE, 1999, AM J HEALTH-SYST PH, V56, P380
[25]   ISOLATED DEAFNESS FOLLOWING RECOVERY FROM NEUROLOGIC INJURY AND ADULT RESPIRATORY-DISTRESS SYNDROME - A SEQUELA OF INTERCURRENT AMINOGLYCOSIDE AND DIURETIC USE [J].
LYNN, AM ;
REDDING, GJ ;
MORRAY, JP ;
TYLER, DC .
AMERICAN JOURNAL OF DISEASES OF CHILDREN, 1985, 139 (05) :464-466
[26]   TONE DISCRIMINATION SECONDARY TO AMITRIPTYLINE [J].
MALONE, DA .
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 1991, 11 (03) :221-222
[27]  
MANIAN FA, 1990, REV INFECT DIS, V12, P236
[28]   OTOTOXICITY OF ETHACRYNIC ACID AND AMINOGLYCOSIDE ANTIBIOTICS IN UREMIA [J].
MATHOG, RH ;
KLEIN, WJ .
NEW ENGLAND JOURNAL OF MEDICINE, 1969, 280 (22) :1223-&
[29]   A CRITICAL REEVALUATION OF THE THERAPEUTIC RANGE OF AMINOGLYCOSIDES [J].
MCCORMACK, JP ;
JEWESSON, PJ .
CLINICAL INFECTIOUS DISEASES, 1992, 14 (01) :320-339
[30]  
MCEVOY GK, 2001, AM HOSP FORMULARY SE