A patient receiving intravenous furosemide for acute decompensated heart failure develops bilateral hearing loss. The mechanism of furosemide-induced ototoxicity involves inhibition of the Na-K-2Cl cotransporter in which structure?
- A Organ of Corti
- B Tympanic membrane
- C Stria vascularis ✓
- D Cochlear nerve
Correct answer: C. Stria vascularis
Explanation
Furosemide inhibits the Na-K-2Cl cotransporter in the stria vascularis of the cochlea, disrupting the endolymph potassium gradient essential for hair cell function. This reduces the endocochlear potential and causes hearing loss, especially with rapid IV administration or concurrent aminoglycoside use. The organ of Corti contains the sensory hair cells but the primary site of drug action is the stria vascularis.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.