MEDizzy - An 87-year-old woman who is taking multiple medications for

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Drugs acting on renal and cardiovascular system

An 87-year-old woman who is taking multiple medications for her “heart disease” is prescribed gentamicin for diverticulitis. After a few days of taking the antibiotic, she complains of dizziness and tinnitus. What “heart medication” might she be on?

ExplanationOtotoxicity, as demonstrated by tinnitus and dizziness, is a common side effect of loop diuretics, especially ethacrynic acid. This effect is magnified when aminoglycoside antibiotics are added to the regimen. Spironolactone is not associated with tinnitus. Hydrochlorothiazide can cause gout in susceptible individuals. Mannitol and urea are osmotic diuretics and are not indicated in patients with heart disease, especially congestive heart failure (CHF).