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  • O To Toxicity

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    李丞永
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    This document discusses various drugs that can cause ototoxicity or damage to the inner ear. It notes that aminoglycoside antibiotics are the most common cause when administered systemically but topical drops are FDA approved. Other potentially ototoxic drugs mentioned include macrolides, antineoplastic agents, loop diuretics, salicylates, gentamicin, tobramycin, amikacin, erythromycin, cisplatin, furosemide, aspirin, and vancomycin when combined with aminoglycosides. The document also briefly discusses genetics, mechanisms of toxicity involving free radicals, and potential prevention with iron chelators and antioxidants like vitamin E.

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    o to Toxicity

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    This document discusses various drugs that can cause ototoxicity or damage to the inner ear. It notes that aminoglycoside antibiotics are the most common cause when administered systemically but topical drops are FDA approved. Other potentially ototoxic drugs mentioned include macrolides, antineoplastic agents, loop diuretics, salicylates, gentamicin, tobramycin, amikacin, erythromycin, cisplatin, furosemide, aspirin, and vancomycin when combined with aminoglycosides. The document also briefly discusses genetics, mechanisms of toxicity involving free radicals, and potential prevention with iron chelators and antioxidants like vitamin E.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    5 views14 pages

    O To Toxicity

    Uploaded by

    李丞永
    This document discusses various drugs that can cause ototoxicity or damage to the inner ear. It notes that aminoglycoside antibiotics are the most common cause when administered systemically but topical drops are FDA approved. Other potentially ototoxic drugs mentioned include macrolides, antineoplastic agents, loop diuretics, salicylates, gentamicin, tobramycin, amikacin, erythromycin, cisplatin, furosemide, aspirin, and vancomycin when combined with aminoglycosides. The document also briefly discusses genetics, mechanisms of toxicity involving free radicals, and potential prevention with iron chelators and antioxidants like vitamin E.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    of 14

    Ototoxicity

    Ototoxicity of Ototopical Antibiotics


    • Systemic administration of
    Aminoglycosides cause both cochlear and
    vestibular toxicity
    • Aminoglycosides topical drops are noted
    FDA approved for use in the middle ear or
    open mastoid cavity
    Drugs with Ototoxicity
    • Aminoglycosides
    • Macrolides
    • Antineoplastic agents
    • Loop diuretics
    • Salicylates
    Gentamicin
    • 2~3%
    • Cupula semicircular canal
    – Type I hair cell loss
    • Cochlear
    – Outer hair cell damage
    Genetics of Ototoxicity
    • Mutation of mitochondrial DNA associated
    with hearing disorder
    Tobromycin
    • 3~4%, vestibular loss
    • 6%, cochlear loss
    Amikacin
    • 14%, cochlear loss

    • Neomycin and kanamycin with high


    incidence of cochlear loss
    Erythromycin
    • Transient cochlear loss
    • Rarely permanent loss
    • Dose related
    Cisplatin
    • 12~25%, cochlear loss
    – Cochlear hair cell loss
    – Degeneration of stria vascularis
    – Decrease in ganglion cells
    • Dose related
    Furosemide
    • < 1%
    • Transient loss
    • Abnormal stria vascularis
    Aspirin
    • Only transient hearing loss and tinnitus in
    doses over 2700mg/day
    Vancomycin
    • Rare cochlear loss
    • Become ototoxic combined with
    aminoglycosides
    Prevention
    • Iron chelator, deferoxime
    • Antioxidants
    • Vitamin E
    Mechanisms
    • Aminoglycosides, formation of iron
    complex, production of free radicals
    • Glutathione reduction secondary to free
    radicals production

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