A 68-year-old patient is receiving an aminoglycoside IV for a serious infection. The patient develops heart failure and needs a diuretic. Which medication order would cause the nurse the most concern?
a. Ethacrynic acid (Edecrin)
b. Hydrochlorothiazide (HCTZ)
c. Furosemide (Lasix)
d. Bumetanide (Bumex)
ANS: A
The risk of injury to the inner ear is significantly increased by concurrent use of an aminoglycoside and ethacrynic acid, which has ototoxic actions of its own.
Hydrochlorothiazide is not known to have a drug-drug interaction with aminoglycosides, just the loop diuretics.
Combining furosemide and bumetanide with the aminoglycosides appears to cause no more ototoxicity than aminoglycosides alone.
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