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Ototoxic Drug
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Ototoxic Drug
, Ototoxic Medication, Ototoxicity, Ototoxic Hearing Loss
See Also
Hearing Loss
Sensorineural Hearing Loss
Causes
Medications
Analgesic
s
Aspirin
(>2.7 g/day) and other
Salicylate
s
NSAID
s
Acetaminophen
Sulfasalazine
(
Azulfidine
)
Hydrocodone
Antibiotics
Aminoglycoside
s (
Gentamicin
,
Streptomycin
)
Starts with
Tinnitus
and rapidly progresses to
Hearing Loss
Ototoxicity symptoms are permanent if last >2-3 weeks after stopping the
Aminoglycoside
Streptomycin
Vancomycin
Erythromycin
(dose >2 g/day) and other
Macrolide
s
Chloramphenicol
Tetracycline
s such as
Doxycycline
or
Minocycline
(transient vestibular toxicity)
Imipenem-Cilastin (Primaxin)
Linezolid
(
Zyvox
)
Sulfonamide
Fluoroquinolone
s
Voriconazole
Amphoteracin B
Ganciclovir
Ribavirin
Loop Diuretic
s (especially at high dose with rapid infusion)
Ethacrynic Acid
Furosemide
(
Lasix
)
Antineoplastic
Cisplatin
Carboplatin
Bleomycin
Vincristine and other Vinca Alkaloids
Nitrogen Mustard
Methotrexate
Etoposide
Protein kinase inhibitor
Other medications
Quinine
Chloroquine
Mefloquine
PDE5 Inhibitor
s (e.g.
Sildenafil
or
Viagra
)
Caffeine
Atorvastatin
(
Lipitor
)
Bupropion
(
Wellbutrin
)
Risedronate
(
Actonel
)
Verenicline (
Chantix
)
Misoprostol
(
Cytotec
)
Causes
Industrial and Home
Poisoning
s
Background: Exposure Settings
Automotive repair
Boat building
Manufacturing (leather, metal, battery, petroleum)
Painting
Pesticide
spraying
Fueling vehicles including aircraft
Asphyxiants
Carbon Monoxide Poisoning
Tobacco
Smoke
Heavy metal
Poisoning
Mercury Poisoning
Lead Poisoning
Organic Tin Compounds
Nitriles
Acrylonitrile (
Hydrogen cyanide
with a replaced ethenyl group)
3-Butenenitrile (Allyl
Cyanide
)
Solvents
Toluene
Styrene
P-Xylene
Trichloroethylene
Causes
Ilicit Drugs and
Poisoning
s
Ilicit Drugs
Ecstasy
Symptoms
Sensorineural Hearing Loss
from Ototoxic Drugs typically develops over weeks after exposure
Hearing Loss
be transient for some agents used at therapeutic levels (e.g.
Erythromycin
,
Tetracycline
s,
Analgesic
s)
Hearing Loss
is often reversible after decreasing or stopping the offending agent
Evaluation
See
Sensorineural Hearing Loss
Resources
Preventing
Hearing Loss
Caused by Chemical (Ototoxicity) and Noise Exposure (CDC NIOSH)
https://www.cdc.gov/niosh/docs/2018-124/
References
Cianfrone (2011) Eur Rev Med Pharmacol Sci 15(6): 601-36 [PubMed]
Ganesan (2018) J Audiol Otol 22(2): 59-68 [PubMed]
Seligmann (1996) Drug Saf 14(3): 198-212 [PubMed]
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