Indications

• Ascites (see Ascites, [[Ascites]])
• Congestive Heart Failure (CHF) (see Congestive Heart Failure, [[Congestive Heart Failure]])
• Edema
  • Cirrhosis
  • Congestive Heart Failure (CHF) (see Congestive Heart Failure, [[Congestive Heart Failure]])
  • Renal Failure: nephrotic syndrome, etc
• Hypertension (see Hypertension, [[Hypertension]])

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Pharmacology

• Npn-Sulfonamide Loop Diuretic: inhibition of sodium-potassium-chloride cotransport in the ascending loop of Henle
  • Unlike the other loop diuretics, ethacrynic acid is not a sulfonamide (therefore, Its use is not contraindicated with sulfa allergy)
• Inhibition of Glutathione S-Transferases: due to ethacrynic acid itself and its glutathione adduct
  • Glutathione S-transferases are involved in xenobiotic metabolism

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Administration

• PO:
• IV:

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Adverse Effects

Renal Adverse Effects

• Hypokalemia (see Hypokalemia, [[Hypokalemia]])
• Hypomagnesemia (see Hypomagnesemia, [[Hypomagnesemia]])

Other Adverse Effects

• Increased Risk of Gastric Hemorrhage Associated with Corticosteroid Treatment
• Ototoxicity with Reversible/Permanent Hearing Loss: more commonly occurs in patients with severe renal impairment
  • May also increase the ototoxicity of other drugs, such as aminoglycosides and cephalosporins

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References

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