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Lasix push

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by pepino23 pepino23 (New) New

Has 3 years experience.

Can anybody tell me why Lasix needs to be pushed slowly? I keep getting different answers. I want to understand why it is that I have to push it over 1-2 minutes. Thank you

I would recommend reading an IV drug book for IV drug related questions.

"ototoxicity is associated with rapid injection, severe renal impairment, use of higher than recommended doses, concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs"

pepino23

Has 3 years experience.

Yes I understand but exactly what causes that ototoxicity? I keep reading that in the drug books but I don't understand the cause based on slow vs. rapid push.

Loop diuretics (e.g., furosemide, ethacrynic acid, bumetanide) affect the potassium gradient of the stria vascularis, as well as the electrical potential of the endocochlear structure.[2,3]These medications produce tinnitus and hearing loss. The hearing loss may be perceptible to patients or may be apparent only with audiometric testing. Their toxicity is dose-related.[12] Thus, ototoxicity is more likely when the patient receives a rapid infusion of injectable loop diuretics in renal failure, which allows the medications to accumulate. Furosemide-related ototoxicity is usually reversible but may be permanent in rare instances (e.g., in patients with renal failure).[7] Ethacrynic acid is virtually obsolete, partly due to the potential for ototoxicity, especially when it was given intravenously to patients whose regimen also included aminoglycosides.[7]

Found on first page of a Google search. Source is Medscape.

pepino23 said:
Yes I understand but exactly what causes that ototoxicity? I keep reading that in the drug books but I don't understand the cause based on slow vs. rapid push.

There are Na/K/Cl transporters in the stria vascularis. Large rapid doses disrupt or damage the transporters which will damage the stria vascularis which will kill the hair cells.

No hair, no hearing.

How the actual molecules bind and disrupt is beyond my knowledge of chemistry.