A patient receiving rapid high-dose intravenous furosemide develops reversible hearing loss. The mechanism of loop diuretic ototoxicity involves inhibition of which specific transporter in the stria vascularis?
- A Na-K-2Cl cotransporter (NKCC1) ✓
- B Na-K-ATPase
- C Na-Cl cotransporter (NCC)
- D Epithelial sodium channel (ENaC)
Correct answer: A. Na-K-2Cl cotransporter (NKCC1)
Explanation
Loop diuretics inhibit the Na-K-2Cl cotransporter (NKCC1) in the stria vascularis of the inner ear, altering endolymph ionic composition and reducing the endocochlear potential. This is the same transporter family as NKCC2 in the kidney, though the isoforms differ. Risk is increased with rapid IV injection, high doses, renal impairment, and concurrent aminoglycoside use.
Reference: Katzung Basic & Clinical Pharmacology, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.