ear, nose, and throat disorders
Drug Induced Ototoxicity
Prevention of Drug Induced Ototoxicity
Ototoxic antibiotics should be avoided during pregnancy because they can damage the fetal labyrinth. Older adults and people with preexisting hearing loss should not be treated with ototoxic medications if other effective medications are available. The lowest effective dosage of ototoxic medications should be used and levels should be closely monitored, particularly for aminoglycosides (both peak and trough levels). If possible before treatment with an ototoxic medication, hearing should be measured and then monitored during treatment; symptoms are not reliable warning signs. Risk of ototoxicity increases with the use of multiple medications that have ototoxic potential and the use of ototoxic medications excreted through the kidneys in patients with renal compromise; in these cases, closer monitoring of medication levels is advised. In patients known to have Mitochondrial DNA Abnormalities that predispose to aminoglycoside toxicity, aminoglycosides should be avoided. 