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Toxicology – Ototoxic Drugs
Overview
Ototoxic medications can damage the inner ear, affecting either the cochlea (leading to sensorineural hearing loss), the vestibular system (causing balance disturbances), or both.
Clinical Features
Patients may present with hearing impairment, ringing in the ears (tinnitus), or problems with balance and coordination (disequilibrium). Symptoms can vary depending on whether cochlear or vestibular structures are involved.
Common Drug Classes
Medications known to cause ototoxicity include aminoglycoside antibiotics, loop diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, platinum-based chemotherapeutic agents, quinidine, quinine, salicylates, tetracyclines, and valproic acid.
Management
The primary approach is prompt discontinuation of the offending agent when possible. Patients should be referred for evaluation by an ear, nose, and throat (ENT) specialist and audiology testing to assess the extent of hearing or balance dysfunction.
Overview
Ototoxic medications can damage the inner ear, affecting either the cochlea (leading to sensorineural hearing loss), the vestibular system (causing balance disturbances), or both.
Clinical Features
Patients may present with hearing impairment, ringing in the ears (tinnitus), or problems with balance and coordination (disequilibrium). Symptoms can vary depending on whether cochlear or vestibular structures are involved.
Common Drug Classes
Medications known to cause ototoxicity include aminoglycoside antibiotics, loop diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, platinum-based chemotherapeutic agents, quinidine, quinine, salicylates, tetracyclines, and valproic acid.
Management
The primary approach is prompt discontinuation of the offending agent when possible. Patients should be referred for evaluation by an ear, nose, and throat (ENT) specialist and audiology testing to assess the extent of hearing or balance dysfunction.
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