Rapid intravenous administration of high-dose furosemide in a patient concurrently receiving gentamicin places the patient at risk for which adverse effect?

• A Nephrogenic diabetes insipidus
• B Metabolic acidosis with Kussmaul breathing
• C Hypercalcemia with nephrocalcinosis
• D Ototoxicity with permanent sensorineural hearing loss ✓

Explanation

Loop diuretics can impair hearing by affecting the stria vascularis of the cochlea, and this ototoxicity is dose dependent and additive with aminoglycosides, which share the same liability. Rapid IV boluses carry the highest risk, so furosemide should be infused slowly in patients receiving gentamicin or vancomycin. Thiazides cause hypercalcemia, loops cause hypocalcemia, and loop diuretics produce metabolic alkalosis rather than acidosis.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.