Ototoxic Medications Can Demage Your Hearing

By Lina Marie Barreneche

Monarch Hearing and Balance Center

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Ototoxic Medications Can Demage Your Hearing

Ototoxic medications have the potential to cause permanent or temporary hearing loss. A patient comes to the audiologist or the hearing professional's office to counsel, primarily arising concerns about his or her possible hearing loss bilaterally or onset. During the evaluation, the doctor inquires about the name, number and the doses of medications being taken by the patient at the time; this allows for the doctor to detect the ones that may be having some damaging effects on the patient's hearing.

Aminoglycosides are frequently the only affordable antibiotics, in most cases, that are sold over-the-counter. These antibiotics have been used for decades to treat several illnesses such as tuberculosis, renal infections and bacteria to name a few. Among the most ototoxic antibiotics, we have Kanamycin, Amikacin, Neomicin, Ketimicin and Streptomycin (affecting both cochlear and the vestibular system). There are signs and symptoms that will give us a red flag to whether the patient's hearing is being harmed by these drugs. These include tinnitus, and an increase in the thresholds of highest frequencies (4.000-6000-8000) Hz with progression. Usually, the whole speech spectrum becomes affected including the lowest frequencies. Symptoms of vestibular toxicity typically include imbalance and visual blurring. Several factors, such as the patient taking larger doses of drugs for a long term, higher blood pressure, as well as genetic predisposition increase the risk for ototoxicity.

In most cases, when an affecting drug is stopped or substituted for an alternative medication in the case of an existing hearing damage, further loss may be prevented and partial recovery of hearing is possible; however, the loss is usually permanent. Therapeutic intervention can be provided by the use of speech enhancers and hearing aids. Prevention for ototoxicity involves careful monitoring from physicians regarding the types of medications prescribed, as well as hearing evaluations. Identifying high-risk patients and selecting alternative drugs is the path that leads to prevention. It is important to highlight that Aminoglycosides remain in the cochlea even after treatment for an extended period of time and the patients may become more susceptible to cochlear damage.

Hearing professionals should inform patients and parents about the risks of ototoxic medications and emphasize the importance of reporting symptoms such as tinnitus, hearing loss and disequilibrium.