Share on Facebook Share on Twitter Email
Answers.com

Ototoxicity

 
Veterinary Dictionary: ototoxicity
Home > Library > Animal Life > Veterinary Dictionary

The property of being ototoxic.

Search unanswered questions...

Enter a question here...
Search: All sources Community Q&A Reference topics

Wikipedia: Ototoxicity
Top
Home > Library > Miscellaneous > Wikipedia
Ototoxicity
Classification and external resources
ICD-10 H91.0
DiseasesDB 2874
eMedicine ent/699

Ototoxicity is damage to the ear (oto-), specifically the cochlea or auditory nerve and sometimes the vestibular system, by a toxin. It is commonly medication-induced; ototoxic drugs include antibiotics such as the aminoglycoside gentamicin, loop diuretics such as furosemide, and platinum-based chemotherapy agents such as cisplatin. It can result in sensorineural hearing loss, dysequilibrium, or both. Either may be reversible and temporary, or irreversible and permanent.

Contents

Ototoxic agents

Antibiotics

Antibiotics in the aminoglycoside class, such as gentamicin and tobramycin, may produce cochleotoxicity through a poorly understood mechanism.[1] It may result from antibiotic binding to NMDA receptors in the cochlea and damaging neurons through excitotoxicity.[2] Aminoglycoside-induced production of reactive oxygen species may also injure cells of the cochlea.[3] Once-daily dosing[4] and co-administration of N-acetylcysteine[5] may protect against aminoglycoside-induced ototoxicity. The ototoxicity of gentamicin can be exploited to treat some individuals with Ménière's disease.[6]

Macrolide antibiotics, including erythromycin, are associated with reversible ototoxic effects.[7] The underlying mechanism of ototoxicity may be impairment of ion transport in the stria vascularis.[7] Predisposing factors include renal impairment, hepatic impairment, and recent organ transplantation.[7]

Loop diuretics

The loop diuretic furosemide is associated with ototoxicity, particularly when doses exceed 240mg per hour.[8] The related compound ethacrynic acid is particularly ototoxic.[7] Bumetanide confers a decreased risk of ototoxicity compared to furosemide.[7]

Chemotherapeutic agents

Platinum-containing chemotherapeutic agents, including cisplatin and carboplatin, are associated with cochleotoxicity characterized by high-frequency hearing loss and tinnitus, or ringing in the ears.[9] Ototoxicity is less frequently seen with the related compound, oxaliplatin.[10] Cisplatin-induced ototoxicity is dose-dependent, typically occurring with doses greater than 60 mg/m2, and tend to occur when chemotherapy is given every two weeks compared to every one week.[9] Cisplatin and related agents are absorbed by the cochlear hair cells and result in ototoxicity through the production of reactive oxygen species.[11] The decreased incidence of oxaliplatin ototoxicity has been attributed to decreased uptake of the drug by cells of the cochlea.[10] Administration of amifostine has been used in attempts to prevent cisplatin-induced ototoxicity, but the American Society of Clinical Oncology recommends against its routine use.[12]

The vinca alkaloids, including vincristine, are also associated with reversible ototoxicity.[7]

Others

Ototoxic effects are also seen with quinine and heavy metals such as mercury and lead.[7] At high doses, aspirin and other salicylates may also cause high-pitched tinnitus and hearing loss in both ears, typically reversible upon discontinuation of the drug.[7]

Symptoms

Symptoms of ototoxicity include partial or profound hearing loss, vertigo, and tinnitus.[7]

Treatment

No specific treatment is available, but immediate withdrawal of the drug may be warranted in cases where the consequences of doing so are less severe than the consequences of the ototoxicity.[7]

References

  1. ^ Dobie RA, Black FO, Pezsnecker SC, Stallings VL (March 2006). "Hearing loss in patients with vestibulotoxic reactions to gentamicin therapy". Archives of Otolaryngology--Head & Neck Surgery 132 (3): 253–7. doi:10.1001/archotol.132.3.253. PMID 16549744. http://archotol.ama-assn.org/cgi/pmidlookup?view=long&pmid=16549744. 
  2. ^ Basile AS, Huang JM, Xie C, Webster D, Berlin C, Skolnick P (December 1996). "N-methyl-D-aspartate antagonists limit aminoglycoside antibiotic-induced hearing loss". Nature Medicine 2 (12): 1338–43. PMID 8946832. 
  3. ^ Wu WJ, Sha SH, Schacht J (2002). "Recent advances in understanding aminoglycoside ototoxicity and its prevention". Audiology & Neuro-otology 7 (3): 171–4. PMID 12053140. http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=aud07171. 
  4. ^ Munckhof WJ, Grayson ML, Turnidge JD (April 1996). "A meta-analysis of studies on the safety and efficacy of aminoglycosides given either once daily or as divided doses". The Journal of Antimicrobial Chemotherapy 37 (4): 645–63. PMID 8722531. http://jac.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8722531. 
  5. ^ Tepel M (August 2007). "N-Acetylcysteine in the prevention of ototoxicity". Kidney International 72 (3): 231–2. doi:10.1038/sj.ki.5002299. PMID 17653228. http://dx.doi.org/10.1038/sj.ki.5002299. 
  6. ^ Perez N, Martín E, García-Tapia R (March 2003). "Intratympanic gentamicin for intractable Ménière's disease". The Laryngoscope 113 (3): 456–64. doi:10.1097/00005537-200303000-00013. PMID 12616197. http://dx.doi.org/10.1097/00005537-200303000-00013. 
  7. ^ a b c d e f g h i j Roland, Peter S. (2004). Ototoxicity. Hamilton, Ont: B.C. Decker. ISBN 1-55009-263-4. 
  8. ^ Voelker JR, Cartwright-Brown D, Anderson S, et al. (October 1987). "Comparison of loop diuretics in patients with chronic renal insufficiency". Kidney International 32 (4): 572–8. PMID 3430953. 
  9. ^ a b Rademaker-Lakhai JM, Crul M, Zuur L, et al. (February 2006). "Relationship between cisplatin administration and the development of ototoxicity". Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology 24 (6): 918–24. doi:10.1200/JCO.2006.10.077. PMID 16484702. http://www.jco.org/cgi/pmidlookup?view=long&pmid=16484702. 
  10. ^ a b Hellberg V, Wallin I, Eriksson S, et al. (January 2009). "Cisplatin and oxaliplatin toxicity: importance of cochlear kinetics as a determinant for ototoxicity". Journal of the National Cancer Institute 101 (1): 37–47. doi:10.1093/jnci/djn418. PMID 19116379. PMC 2639295. http://jnci.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19116379. 
  11. ^ Rybak LP, Whitworth CA, Mukherjea D, Ramkumar V (April 2007). "Mechanisms of cisplatin-induced ototoxicity and prevention". Hearing Research 226 (1-2): 157–67. doi:10.1016/j.heares.2006.09.015. PMID 17113254. http://linkinghub.elsevier.com/retrieve/pii/S0378-5955(06)00272-3. 
  12. ^ Hensley ML, Hagerty KL, Kewalramani T, et al. (January 2009). "American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants". Journal of Clinical Oncology 27 (1): 127–45. doi:10.1200/JCO.2008.17.2627. PMID 19018081. http://www.jco.org/cgi/pmidlookup?view=long&pmid=19018081. 

External links


This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

 

Copyrights:

Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Ototoxicity".  Read more