Eosinophilia diuretics

Acute drug-related hypersensitivity reactions (allergic responses) may cause tubulointerstitial nephritis, which will damage the tubules and interstitium. These reactions are most commonly observed with administration of methicillin and other synthetic antibiotics as well as furosemide and the thiazide diuretics. The onset of symptoms occurs in about 15 days. Symptoms include fever, eosinophilia, hematuria (blood in the urine), and proteinuria (proteins in the urine). Signs and symptoms of acute renal failure develop in about 50% of the cases. Discontinued use of the drug usually results in complete recovery however, some patients, especially the elderly, may experience permanent renal damage. 

Disp Tabs, susp SE D, dizziness, rash, eosinophilia, T transaminases Interactions T Nephrotox W/ aminoglycosides, loop diuretics T effects W/probenecid i effects W/ antacids, chloramphenicol EMS T Risk of nephrotox w/ loop diuretics monitor for signs of electrolyte disturbances and hypovolemia d/t D monitor pt for super Infxn OD May cause NA /D, Szs, muscles spasms symptomatic and supportive... 

All loop diuretics, with the exception of ethacrynic acid, are sulfonamides. Therefore, skin rash, eosinophilia, and less often, interstitial nephritis are occasional adverse effects of these drugs. This toxicity usually resolves rapidly after drug withdrawal. Allergic reactions are much less common with ethacrynic acid. 

The diuretics can result in an acute interstitial nephritis, which may have an immunologic basis and can persist, if undetected, as a chronic lesion leading to renal insufficiency. The acute form may or may not be associated with other hallmarks of an allergic phenomenon such as fever and rash, but eosinophilia and eosi-nophiluria are often present, if looked for. Thus far, this lesion has been associated with the administration of the thiazides and furosemide, but ethacrynic acid may also be involved. Persistent hypokalemia may also... 

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