Etacrynic acid

Thông tin thuốc gốc
Chỉ định và Liều dùng
Acute pulmonary oedema
Adult: 0.5-1 mg/kg or 50 mg via slow inj or infusion over 10 min; a 2nd dose may be given, if required, at a new inj site. Max: 100 mg.

Adult: Initially, 50 mg in the morning, increase if necessary, by 25-50 mg increments daily to min effective dose. Usual effective range: 50-200 mg daily. Severe cases: Up to 400 mg daily. Doses >50 mg should be given in divided doses.
Child: >2 yr Initially, 25 mg daily, increase cautiously if necessary, by 25 mg daily.
Hướng dẫn pha thuốc
Add 50 mL of dextrose 5% or NaCl 0.9% inj to the vial.
Tương kỵ
Incompatible w/ soln w/ pH <5.
Chống chỉ định
Anuria, history of severe watery diarrhoea. Infants.
Thận trọng
Patient w/ advanced hepatic cirrhosis, electrolyte imbalance, hepatic encephalopathy, severe myocardial disease and those undergoing surgery. Renal impairment. Childn. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Fluid/electrolyte loss (e.g. hyponatraemia, hypokalaemia, hypochloraemic alkalosis, hypomagnesaemia), nephrotoxicity, ototoxicity, wt loss, orthostatic hypotension, dehydration.
Nervous: Paraesthesia, dizziness, fainting, headache, fatigue, apprehension, malaise, mental confusion, vertigo.
GI: Thirst, anorexia, abdominal discomfort or pain, dysphagia, nausea, vomiting, diarrrhoea/profuse watery diarrhoea, acute pancreatitis.
Hepatic: Jaundice.
Genitourinary: Reversible hyperuricaemia, decreased urinary urate, interstitial nephritis, increased creatinine concentration.
Endocrine: Metabolic alkalosis, hyperglycaemia, dyslipidaemia, gout.
Musculoskeletal: Weakness, muscle cramps.
Otic: Deafness, tinnitus.
Dermatologic: Exfoliative dermatitis, Stevens-Johnson syndrome, bullous eruptions, rash.
Others: Local irritation, pain, thrombophlebitis.
Chỉ số theo dõi
Monitor BP, renal function, serum electrolytes, CO2, BUN, fluid status including input and output, wt, hearing.
Quá liều
Symptoms: Excessive diuresis w/ electrolyte depletion (e.g. hypokalaemia, hypochloraemia, hyponatraemia) and dehydration. Management: Symptomatic and supportive treatment. Induce emesis or perform gastric lavage. For resp depression, administer oxygen or employ artificial respiration, if necessary.
Tương tác
May increase the ototoxicity and nephrotoxicity of aminoglycoside antibiotics and some cephalosporins. May increase risk of GI bleeding when used w/ other gastric irritants, corticosteroids, anticoagulants. May cause orthostatic hypotension when used w/ other antihypertensive agents. Displaces warfarin from plasma protein. May increase risk of lithium toxicity. Decreased therapeutic effect w/ NSAIDs. May interfere w/ the hypoglycaemic effect of insulin or other antidiabetic agents. May potentiate kaliuresis and natriuretic effect of acetazolamide, dichlorphenamide, methazolamide.
Tương tác với thức ăn
Enhanced hypokalaemic effect w/ licorice. Diminished antihypertensive effect w/ yohimbine.
Ảnh hưởng đến kết quả xét nghiệm
May cause false-negative aldosterone/renin ratio (ARR). Alters glucose tolerance tests.
Tác dụng
Description: Etacrynic acid is a loop diuretic that binds w/ sulfhydryl groups of renal cellular proteins. It inhibits the reabsorption of Na and Cl in the ascending loop of Henle and distal renal tubules, interfering w/ the Cl-binding cotransport system, hence excretion of Na, K, Ca, Mg, and Cl ions are increased and water excretion enhanced.
Onset: Approx 30 min (oral); 5 min (IV).
Duration: 12 hr (oral); 2 hr (IV).
Absorption: Rapidly absorbed from the GI tract. Time to peak plasma concentration: 2 hr (oral); 30 min (IV).
Distribution: Plasma protein binding: >90%.
Metabolism: Metabolised in the liver (35-40%) to active cysteine conjugate.
Excretion: Via faeces and urine (30-60% as unchanged drug). Elimination half-life: 2-4 hr.
Đặc tính

Chemical Structure Image
Etacrynic acid

Source: National Center for Biotechnology Information. PubChem Database. Ethacrynic acid, CID=3278, (accessed on Jan. 22, 2020)

Bảo quản
Store at 25°C.
Phân loại MIMS
Thuốc lợi tiểu
Phân loại ATC
C03CC01 - etacrynic acid ; Belongs to the class of high-ceiling aryloxyacetic acid derivative diuretics.
Tài liệu tham khảo
Anon. Ethacrynic Acid. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 03/07/2017.

Buckingham R (ed). Etacrynic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 03/07/2017.

Ethacrynic Sodium Powder, for Soln (Oceanside Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. Accessed 03/07/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Ethacrynic Acid, Ethacrynate Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). Accessed 03/07/2017.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Etacrynic acid từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2022 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Already a member? Sign in
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Already a member? Sign in