Cell membrane alterations in the stria vascularis of the guinea pig after ethacrynic acid treatment studied by freeze-fracture

A freeze-fracture examination of the stria vascularis during the first 2 h after injection of ethacrynic acid was performed. This showed a re-distribution of the particles on the membrane fracture faces of both marginal and intermediate cells. As oedematous spaces developed, particle-poor, vesicle-like structures were found associated with both cell types. The tight junctions at the apices of the marginal cells and around basal cells were unaffected.

Effects of modern loop diuretics on the inner ear a quantitative evaluation using computer technics

The effects of some modern high ceiling loop diuretics on the guinea-pig's inner ear are tested. Short-time experiments are run registrating the cochlear microphonic potentials (CMP) before and after i.v. bolus injections of a diuretic. A 100-point matrix program is performed by automatic sampling of the CMPs after stimulating by five frequencies at 20 sound pressure levels each. Data can be plotted in different scales within 10 min after the end of a whole-day experiment. The data are on-line processed by a IBM 1800 computer.

Drug-induced gastrointestinal bleeding. Report from the Boston Collaborative Drug Surveillance Program, Boston University Medical Center

Rates of drug-induced gastrointestinal bleeding were estimated from data on 16 646 consecutively monitored medical inpatients who had no known predisposing illness. Heparin, warfarin, ethacrynic acid, steroids, and aspirin-containing drugs were associated with gastrointestinal bleeding and were estimated to account for about two-thirds of such bleeds. Major gastrointestinal bleeding, defined as bleeding severe enough to require transfusion, occurred in only 57 patients (0.3%).

[Functional morphology of stria vascularis after treatment with ethacrynic acid or atoxyl (author's transl)]

Surface alterations of the stria vascularis and Reissner's membrane were studied in guinea pigs following intravenous or intraperitoneal administration of ethacrynic acid or atoxyl. DC-potential was measured in the same animals during intoxication. In addition we studied changements in potassium concentration (perilymph, endolymph) of the atoxyl-treated animals.

Drugs used in the management of toxemia of pregnancy

Drugs used in the management of pregnancy-induced hypertension have been reviewed, and their value and adverse effects on both mother and fetus have been considered. Although magnesium and hydralazine remain the stalwarts of therapy, a number of other drugs have potential that may be realized in the future. Several new medications have promise in correcting the derangements of toxemia, but safety for the fetus has yet to be demonstrated. For the physician confronted with the complexities of old and new drugs in toxemia of pregnancy, the prayer of Lord Berkely may be just as appropriate in 1977 as it was dicades ago: From inability to let well enough alone, From too much zeal for the new, From too much contempt for what is old, From putting knowledge before wisdom and science before art, From making the cure of the disease more grievous than its endurnace, Good Lord, deliver us.

Ototoxic interactions of ethacrynic acid and streptomycin

Various aminoglycoside antibiotics and potent diuretics are known to depress cochlear and vestibular function. Several clinical and research studies suggest that the drugs administered together produce enhanced ototoxicity. The present series of experiments determines the depressive effects of ethacrynic acid and streptomycin, alone or in combination, upon the vestibular system of the cat. The changes in function, when quantified, indicate an addition, rather than a potentiation of toxicity, and suggest different sites of action.

The ototoxic effects of ethacrynic acid in man and animals

A review of the literature was carried out to summarize the ototoxic effects of ethacrynic acid on man and animal. The effects of this drug on the electrolytes of the endolymphatic and perilymphatic systems, on the cochlear potentials and the auditory cortical-evoked responses, were reviewed. Histological animal studies determined by light and electron microscopy were described. Potentiation of this drug with previous aminoglycoside therapy was discussed. In this paper, a human case report with temporal bone findings was present in addition to the histopathological effects of this drug which were shown in a series of animals receiving this drug over a period of time. Edematous and cellular changes in the stria vascularis, especially with animals receiving large doses of the drug, were described. No permanent alterations in the cochlear potentials resulted from the long-term therapy with ethacrynic acid.

Drug-induced deafness and its treatment

A comprehensive review is presented of the ototoxic effects of drugs which may damage hearing. These have been classified in tabular form together with the recommended dose, method of administration, and ill-effects upon the inner ear. Special emphasis is laid upon the hazard of prescribing such drugs in certain conditions, including in particular the presence of renal or hepatic insufficiency, and the importance of laboratory assessment of new antibiotics for ototoxicity before undertaking clinical trials.