Disorders of the Inner Ear: Ototoxicity and Management

Vocabulary flashcards covering key terms related to ototoxicity, ototoxins, and management strategies from the lecture notes.

Ototoxicity

The property of being toxic to the ear, especially the cochlea or auditory nerve (and sometimes the vestibular system) as a side effect of a drug.

Ototoxins

Chemicals or agents that are toxic to the auditory system and affect hearing.

Synergistic effects

Two or more agents that together cause more hearing loss than either would alone (e.g., noise plus antibiotics).

Vestibulotoxins

Ototoxic agents that affect balance; some may also affect hearing.

Ototoxic drugs

Drugs that can cause hearing disorders and are used for serious health conditions.

Aminoglycosides

Antibiotics (e.g., streptomycin, gentamicin, netilmicin, tobramycin, kanamycin, amikacin) that are often ototoxic; many end with 'mycin'.

Gentamicin

An aminoglycoside antibiotic; highly vestibulotoxic; used for infections (including in newborns) with careful blood-level monitoring to avoid ototoxicity.

Streptomycin

An aminoglycoside antibiotic; first TB treatment; notable cochlear and vestibular toxicity.

Menière's disease

A disorder with episodes of dizziness and progressive hearing loss; vestibulotoxic drugs may be used to destroy vestibular hair cells as treatment.

Cisplatin

A platinum-based chemotherapy drug; the most ototoxic; causes high-frequency hearing loss first; requires serial hearing monitoring.

Carboplatin

A platinum-based chemotherapy drug with ototoxic risk; used as an alternative to cisplatin in some cases.

DFMO

Alpha-difluoromethylornithine; listed as an ototoxic chemotherapeutic agent.

Serial monitoring of hearing

Repeated audiograms over time to track progression and guide treatment to minimize loss.

Baseline audiogram

An initial hearing test conducted before therapy to establish pre-treatment status.

High-frequency pure-tone testing

Testing high-frequency thresholds to detect early hearing loss during treatment.

Loop diuretics

Drugs that increase urine output by inhibiting the Na-K-2Cl transporter in the loop of Henle; can cause temporary hearing loss and may enhance ototoxicity when used with aminoglycosides.

Salicylates (ASA)

Aspirin; can cause temporary hearing loss at high doses or with prolonged use.

Quinine

An antimalarial drug that can cause temporary hearing loss with high or prolonged use.

Chemoprotective agents

Drugs used with chemotherapy to protect healthy tissues (e.g., kidneys, cochlear hair cells) from toxic effects; examples include amifostine, dexrazoxane, and mesna.

Amifostine

A chemoprotective agent used to reduce chemotherapy-related toxicity.

Dexrazoxane

A chemoprotective agent used to reduce chemotherapy-related toxicity.

Mesna

A chemoprotective agent used with certain chemotherapies to protect the bladder and kidneys from toxic metabolites.

Cochlear implants

Devices that replace neural transmission of auditory signals from the cochlea to the VIII cranial nerve when hearing is severely impaired.

Brainstem implants

Devices that bypass the cochlea and VIII nerve to stimulate the brainstem for hearing when cochlear implants are not possible.