Home Drug Guide Ethacrynate Sodium

Drug Guide

Generic Name

Ethacrynate Sodium

Brand Names Edecrin

Classification

Therapeutic: Diuretic

Pharmacological: Loop diuretic

FDA Approved Indications

Edema associated with heart failure, renal failure, or hepatic cirrhosis

Mechanism of Action

Ethacrynate sodium inhibits the reabsorption of sodium and chloride at the proximal and distal tubules, and the loop of Henle, leading to increased diuresis and natriuresis.

Dosage and Administration

Adult: Initial dose: 50-200 mg IV or IM as a single dose, may be repeated every 4-6 hours. Adjust based on response.

Pediatric: Dose based on body weight; typical initial dose: 1-2 mg/kg IV or IM, may repeat as needed.

Geriatric: Start at lower dose due to potential decreased renal function, monitor closely.

Renal Impairment: Adjust dosage according to renal function, titrate based on response and renal parameters.

Hepatic Impairment: Use with caution; no specific adjustment established.

Pharmacokinetics

Absorption: Poor oral absorption; administered parenterally.

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Minimal metabolism; mostly excreted unchanged.

Excretion: Excreted primarily via the kidneys.

Half Life: Approximately 1-2 hours.

Contraindications

Hypersensitivity to ethacrynate sodium or sulfonamides.
Anuria in severely impaired renal function.

Precautions

Electrolyte imbalances (hypokalemia, hyponatremia), dehydration, gout, renal impairment, hepatic impairment, cardiovascular disease. Use cautiously in pregnant women; data limited.

Adverse Reactions - Common

Electrolyte imbalance, dehydration (Common)
Hypotension (Common)

Adverse Reactions - Serious

Ototoxicity (temporary or permanent hearing loss) (Rare)
Allergic reactions including rash, urticaria (Rare)
Electrolyte disturbances leading to cardiac arrhythmias (Rare)

Drug-Drug Interactions

Aminoglycosides (increased ototoxicity), NSAIDs (reduced diuretic effect), Lithium (toxicity risk), other antihypertensives

Drug-Food Interactions

Salt substitutes containing potassium

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor BP, HR, electrolytes, renal function, and hearing.

Diagnoses:

Fluid volume excess or deficiency
Electrolyte imbalance
Impaired renal function

Implementation: Administer as prescribed, monitor vital signs and labs, observe for signs of ototoxicity.

Evaluation: Assess response: decreased edema, stable electrolytes, normal renal function, no adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of electrolyte imbalance (muscle weakness, irregular heartbeat), hearing changes, or allergic reactions.
Maintain adequate fluid and electrolyte intake.
Attend regular follow-up appointments.

Special Considerations

Black Box Warnings:

Ototoxicity risk, especially with high doses or rapid IV infusion.

Genetic Factors: No specific genetic considerations currently.

Lab Test Interference: May affect serum electrolyte levels, renal function tests.

Overdose Management

Signs/Symptoms: Severe electrolyte imbalance, dehydration, hypotension, ototoxicity.

Treatment: Discontinue medication, provide supportive care, correct electrolyte imbalances, and manage hypotension if present.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F). Protect from light.

Stability: Stable when stored properly; check manufacturer's expiration date.