May 2011 - OutreachNC Magazine

8 OutreachNC • • May 2011
Ototoxic medications are those that are toxic
to the cochlea or vestibular structures (inner
ear) in the ear. These medications have the potential to
cause hearing loss, tinnitus (or ringing in the ear) and/or
disequilibrium such as dizziness or vertigo.
Ototoxicity came to the forefront of clinical attention
with the discovery of streptomycin in 1944. This early
antibiotic was used successfully in the treatment of
tuberculosis; however, a large number of patients
developed irreversible hearing problems. Listed below
are six categories of ototoxic medications.
1. Calculates – aspirin and aspirin containing products.
Toxic effects usually appear after consuming an average
of six to eight pills per day. Toxic effects are almost always
reversible once medications are discontinued.
2. Non-steroidal anti-inflammatory drugs (NSAIDS)
– Advil, Aleve, Anaprox, Clinoril, Feldene, Indocin, Lodine,
Motrin, Nalfon, Naprosyn, Nuprin, Poradol, Voltarin. Toxic
effects usually appear after consuming an average of six
to eight pills per day. Toxic effects are usually reversible
once medications are discontinued.
3. Antibiotics – aminoglycosides, erythromycin,
vancomycin. These drugs are usually administered
intravenously in serious life-threatening situations.
4. Loop diuretics – Lasix, Endecrin, Bumex. These are
May is Better Hearing Month
usually ototoxic when
given intravenously for
acute kidney failure or
acute hypertension.
Audiology Health
Kate Tuomala
5. Chemotherapy agents – cisplatin, nitrogen mustard,
vincristine. These medications are ototoxic when given
for treatment of cancer. Maintaining blood levels of
the medication and performing serial hearing tests can
minimize their ototoxic effects.
6. Quinine – Aralen, Atabrinc (for treatment of malaria),
Legatrin, Q-Vel Muscle Relaxant (for treatment of night
cramps). The effects of these are very similar to aspirin
and the effects are usually reversible once medication is
discontinued.
Listed are signs of ototoxicity, in order of their frequency:
• Development of tinnitus (ear ringing)
• Worsening of existing tinnitus
• Fullness or pressure in the ears
• Awareness of hearing loss
• Development of vertigo or a spinning sensation,
which may or may not be accompanied by nausea.
If you have developed any of these signs while taking
these medications, contact your physician immediately.
Tuomala, a clinical audiology and owner of Audiology of the
Sandhills can be reached at (910) 692-6422.
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