Which of the following is not an adverse effect of Furosemide?
**Core Concept**
Furosemide is a loop diuretic that works by inhibiting the sodium-potassium-chloride cotransporter (NKCC2) in the thick ascending limb of the loop of Henle. This action leads to increased excretion of sodium, chloride, potassium, and water, resulting in a diuretic effect.
**Why the Correct Answer is Right**
Furosemide's mechanism of action is associated with several adverse effects, including ototoxicity, hypokalemia, and hyponatremia. Ototoxicity is thought to result from the inhibition of the Na+/K+/2Cl- cotransporter in the stria vascularis, leading to damage to the hair cells in the cochlea. Hypokalemia and hyponatremia are due to excessive loss of potassium and sodium in the urine. Additionally, furosemide can cause hyperglycemia, hypocalcemia, and increased risk of nephrotoxicity.
**Why Each Wrong Option is Incorrect**
**Option A:** While furosemide is not typically associated with hepatotoxicity, other loop diuretics like bumetanide may cause liver injury. However, furosemide's primary adverse effect profile does not include hepatotoxicity.
**Option B:** Furosemide can cause hypokalemia, which is a well-documented adverse effect.
**Option C:** Ototoxicity is a recognized adverse effect of furosemide, especially at high doses or in susceptible individuals.
**Option D:** Furosemide can cause hyperglycemia by increasing glucose production in the liver and impairing insulin release from the pancreas.
**Clinical Pearl / High-Yield Fact**
When administering furosemide, it's essential to monitor patients for signs of ototoxicity, such as tinnitus or vertigo, and to adjust the dose or discontinue the medication if these symptoms occur.
**Correct Answer:** A.