Ethacrynic Acid

Ethacrynic Acid is an antihypertensive agent. Ethacrynic Acid is a prototype drug of Loop Diuretics. Loop diuretics have a much greater diuretic effects than the thiazides. Ethacrynic Acid is a phenoxyacetic acid derivative containing an adjacent ketone and methylene group. The methylene group forms an adduct with the free sulfhydryl group of cysteine. The cysteine adduct appears to be the active form of the drug. It increases the urination and decreases the amount of water retained in the body. Ethacynic acid is especially useful in patients who require an agent with greater diuretic potential than those commonly employed.

Brands
Adult Dose
Dose: 0.5 to 1 mg/kg
Single Dose: 0.75 (0.75)
Frequency: As recommended.
Route: IV
Instructions: As required
Neonatal
Dose: Avid under 2 yrs.
Single Dose:
Frequency:
Route:
Instructions:
Paedriatic
Dose: 2.5 mg/kg
Single Dose: 2.5 (2.5)
Frequency: 24 hourly
Route: Oral
Instructions: Can be Increased as per requirement ,avoid below 2 Yrs
Characteristics
. It is of Synthetic origin and belongs to Phenoxyacetic acid. It belongs to Na-K-Cl triple cotransport inhibitor pharmacological group on the basis of mechanism of action and also classified in Diuretic Loop pharmacological group.The Molecular Weight of Ethacrynic Acid is 303.20. Its pKa is 3.5.
Contraindications
Ethacrynic Acid is contraindicated in conditions like Gout,Anuria,Oliguria,Fluid depletion,Renal failure associated with hepatic coma.
Effects
The severe or irreversible adverse effects of Ethacrynic Acid, which give rise to further complications include Hallucinations, Thrombocytopenia, Hallucinations, Jaundice, Jaundice, Acute pancreatitis, Acute pancreatitis, Hyperglycemia, Mania, Hypoglycemia, Hyperglycemia.Ethacrynic Acid produces potentially life-threatening effects which include Electrolyte disturbances, Ototoxicity, Gastrointestinal hemorrhage. which are responsible for the discontinuation of Ethacrynic Acid therapy.The signs and symptoms that are produced after the acute overdosage of Ethacrynic Acid include Postural hypotension, Sodium and fluid depletion.The symptomatic adverse reactions produced by Ethacrynic Acid are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Anorexia, Diarrhea, Urinary retensionX, GI hemorrhage, Abdominal discomfort.
Indications
Ethacrynic Acid is primarily indicated in conditions like Ascites in malignancy, Edema caused by nephrotic syndrome, Idiopathic edema, Liver disease associated with ascites, Lymphoedema, Pulmonary edema, Refractory edema in congestive heart failure.
Interactions
Ethacrynic Acid is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAmikacin (Sulphate)ArbekacinCefaclor (Monohydrate)CefazolinCeftibutenCephaloridineCephradineCertoparinChloramphenicolDiuretics (e.g mannitol, hydrochlorothiazide, ethacrynic acid) increase renal excretion of chloramphenicol and its metabolites.DiazoxideGentamicinGentamicinDeafness may be more likely to occur if gentamycin is co-administered with IV ethacrynic acid.Indacaterolconcomitant therapy may increase the risk of hypokalemiamonitor closelyLithiumPancuronium (Br)Pirbuterol (Acetate)The ECG changes or hypokalemia that may result from the administration of Ethacrynic Acid can be acutely worsened by Pirbuterol (Acetate), especially when the recommended dose of the Pirbuterol (Acetate) is exceeded. Although the clinical significance of these effects is not known, caution is advised in the coadministration of beta-agonists with Ethacrynic Acid.ProbenecidStreptomycinTobramycinTubocurarine (Cl) Warfarin (Na) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
False decrease in urinary cortisol in fluorometric tests
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj (reconstituted soln) Store at room temperature. Use within 24 hrs if kept at room temperature. Powder for Inj Protect from Sunlight. Tab Store Between 15°C-30°C. Protect from Sunlight and Moisture.
Warnings
Ethacrynic acid should be used with caution in patients with history especially of kidney problems, unusual decrease in urine output, liver disease and of any drug allergy. This drug can reduce the potassium levels in blood, so take potassium supplements. It should be used with caution during pregnancy or lactation.
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