alexa Drug Induced Ototoxicity | Open Access Journals
ISSN: 2161-1459
Journal of Clinical & Experimental Pharmacology
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Drug Induced Ototoxicity

Ryan W and Sachin D*

LECOM-School of Pharmacy Bradenton, FL, USA

*Corresponding Author:
Sachin D
LECOM-School of Pharmacy, Bradenton,FL, 34203, USA
Tel: 941-782-5941
E-mail: sdevi@lecom.edu

Received date: October 16, 2014 Accepted date: October 17, 2014; Published date: October 20,2014

Citation: Ryan W, Sachin D (2014) Drug Induced Ototoxicity. Clin Exp Pharmacol 4:e132. doi:10.4172/2161-1459.1000e132

Copyright: 2014 Ryan W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Clinical & Experimental Pharmacology

Drugs causing damage to the inner ear are commonly referred as ototoxic and can result in symptoms of tinnitus, vertigo or hearing loss. Specifically, if hearing is impaired they are designated as “cochleotoxic” and if balance is impaired, they are termed “vestibulotoxic” [1]. Ototoxicity remains a clinical concern due to its reported association with at least 130 medications [2]. Symptom severity is varied among patients, but in general, initially includes high-frequency hearing loss. Unfortunately, the incidence of otoxicity has been largely underreported because high-frequency hearing loss does not tend to interfere with routine communication and usually goes unnoticed. Perhaps the most disconcerting issue with cochleotoxic drugs is if hearing impairment becomes permanent. This can significantly impact quality of life, and therefore should be considered when choosing drug therapy to minimize risk. Thankfully, many reported ototoxic medications such as the aminoglycoside antibiotics have well documented risk or are considered alternative therapy. However, with renewed interest in the use of prophylactic antibiotics to improve quality of life and reduce frequency of exacerbations in chronic obstructive pulmonary disease (COPD) it is timely to discuss this potentially irreversible complication.

Antibiotics and antineoplastic agents are perhaps the most commonly used medications that can cause hearing loss. Although both cause ototoxicity due to oxidative stress, the mode of cell death differs. Cisplatin primarily triggers an apoptotic cell death pathway, whereas aminoglycosides trigger both necrotic and apoptotic cell death pathways. Understanding of this mechanism of action has aided the development of novel ways to protect the cochlea [1]. Aminoglycosides have a long-standing history and all oral formulations are considered to have some form of ototoxicity. While the overall risk of ototoxicity associated with any topical aminoglycoside remains low, the overall prevalence of complications such as acute otitis media warrants caution with routine use should another agent with similar efficacy be available [3]. It should be noted that the clinical impact of ototoxicity due to aminoglycosides is minimal in current practice with appropriate monitoring. This is not the case however with the use of certain macrolide antibiotics such as azithromycin. While periodic use does not impose a significant threat, chronic administration can cause permanent hearing loss [4,5]. This is of concern with renewed interest in the use of prophylactic antibiotic use for the treatment of COPD. A recent review assessing the impact of azithromycin, erythromycin, clarithromycin and moxifloxacin found that continuous use resulted in a clinically significant benefit in reducing exacerbations in COPD patients [4]. At first glance, these are promising results in a disease that is difficult to manage, however among other adverse events, hearing loss was commonly reported [4]. As a result, the general recommendation is to avoid antibiotic use, other than for treating infectious exacerbations of COPD and other bacterial infections [5,6].

Beyond recognition of commonly used medications that can cause ototoxicity, clinicians can consider several factors when designing a medication regimen including, but not limited to concomitant use of ototoxic agents, dose and frequency of administration and renal function. Not surprisingly, co-administration of ototoxic agents, utilization of high dosages, or frequent administration may warrant close assessment through monitoring of laboratory values or clinical status of the patient. This is especially important in the case of renal decomposition, as this may increase the risk for ototoxicity. Antioxidants, including salicylates, have been shown to have otoprotective effects when used with aminoglycosides [7]. However, this approach to prevention of toxicity should be used with caution as it could be associated with additional adverse effects and drug interaction potential.

Ototoxicity is a detrimental adverse effect, but its impact can be minimized by following precautionary standards. Assessment of any past medical history including hearing loss, dizziness or tinnitus, baseline hearing and review of the medication regimen for ototoxic agents help reduce overall incidence. Additionally, utilization of ototoxic agents at the lowest effective dose for the shortest duration necessary should be emphasized. Further research is needed to prevent or augment ototoxicity, but utilization of these techniques can help minimize its impact in practice.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

Article Usage

  • Total views: 11625
  • [From(publication date):
    November-2014 - Sep 25, 2017]
  • Breakdown by view type
  • HTML page views : 7844
  • PDF downloads :3781
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsonline.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsonline.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsonline.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsonline.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsonline.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsonline.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsonline.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsonline.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsonline.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsonline.com

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

materialsci@omicsonline.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsonline.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsonline.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsonline.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsonline.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsonline.com

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords