Ototoxic brochure by league for hard of hearing.pdf
This pamphlet indicates which most commonly used
medications could potentially cause damage to your hearing, or aggravate
an already existing problem. It is important that you, the patient, take
responsibility in knowing which drugs you should try to avoid. Usually any
hearing problem will only be caused by exceeding the recommended dosage
of the medications. Often these problems are reversible upon discontinuation
of the drug. Occasionally there are times when this change in hearing can
be permanent. If you are experiencing a hearing problem, or if there is a
hearing disorder in your family, it is imperative that your treating physician
and pharmacist be aware of this fact. If you are prescribed one of the
medications found on this list, you should speak to your physician to see if
another, potentially less toxic drug, could be used in its place. If the drug
is over-the-counter, you should ask the pharmacist for a recommendation
In the lists that follow, the generic name of the drug
is given first, with the trade name, if available, followed in parentheses and
capitalized. Many times a particular generic drug is manufactured under
The trade names mentioned in this article were selected by the author randomly. The inclusion of a particular trade name and the exclusion of another should not be interpreted as prejudicial either for one nor against the other.Drugs that can cause hearing loss Salicylates (ear drum) is perforated. When a solutionof an aminoglycoside antibiotic is used onthe skin together with an aminoglycosideantibiotic used intravenously, there is arisk of an increase of the ototoxic effect,(Toxic effects appear to be dose related especially if the solution is used on aand are almost always reversible once wound that is open or raw, or if thepatient has underlying kidney damage. Neomycin is the drug that is most toxic Non-Steroidal Anti-Inflammatory to the structure involved in hearing, theDrugs (NSAIDS) cochlea, so it is recommended for topicaluse only. But even topical therapy hasMost NSAIDS have the potential forresulted in hearing loss when large areascausing hearing loss and/or tinnitus.were treated which allowed for largeBecause new drugs are being frequentlyamounts of the drug to be absorbed intoapproved for use, it is important that youthe body. Hearing loss caused by this check with your doctor or pharmacist toclass of antibiotics is usually permanent.)determine if the drug you were prescribedcan cause a problem.)• ibuprofen (Motrin, Advil, Nuprin, etc.)• naproxen (Naprosyn, Anaprox, Aleve)(Toxic effects are dose related and areintravenous doses of 2-4 grams per almost always reversible once medications24 hours, especially if there is underlyingkidney failure.)• vancomycin (Vancocin)Antibiotics (Similar to aminoglycosides in that it may be ototoxic when used intravenouslyin life-threatening infections. The fact thataminoglycosides and vancomycin are oftenused together intravenously when treatinglife-threatening infections futher exaggerates• polymixin B & amphotericin B
(Of particular interest is that topical eardrop medications containing gentamycin orneomycin do not appear to be ototoxic inhumans unless the tympanic membraneDrugs that can cause tin Diuretics Vapors, Solvents • bendroflumethazide (Corzide)• chlor-thalidone (Tenoretic)• ethacrynic acid (Edecrin)(These are usually ototoxic when givenintravenously for acute kidney failure,acute hypertensive crisis, or acute pulmonary edema/congestive heart failure.Rare cases of ototoxicity have been foundwhen these medications are taken orallyin high doses by people with chronic kidney disease.)Antibiotics • aminoglycosides (see previous section)Chemotherapeutic Agents • chloramphenicol (Chloromycetin)• bromocriptine (Parlodel)• carboplatinum (Carboplatin)
• sulfonamides (Septra, Bactrim)• methotrexate (Rheumatrex)• nitrogen mustard (Mustargen)• vinblastin (Velban)Anti-neoplastics (The ototoxic effects can be minimized by• cis-platinum (Platinol)carefully monitoring blood levels.)• carboplatinum (Paraplatin)• methotrexate (Rheumatrex)• nitrogen mustard (Mustagen)• chloroquine phosphate (Aralen)Diuretics • quinine sulfate (Quinam)(The ototoxic effects are very similar to• bendrofluazide• clorothalidone (Hygroton, Tenoretic)Mucosal Protectant • ethacrynic acid (Edecrin)• furosemide (Lasix)Narcotic Analgesics • hydrochlorthiazide (Hydrodiuril)• hydrocodone (Lorcet, Vicodin)• methylchlorthizide (Enduron)Cardiac Medications • celiprolol• flecainide (Tambocar)• lidocaine• metoprolol (Lopressor)• procainamide (Pronestyl)• quinidine (Quinaglute, Quinidex)• isoxicam• ketoprofen (Orudis)Psychopharmacologic Agents • methyl salicylates (BenGay)• naproxen (Naprosyn, Anaprox, Aleve)• phenylbutazone (Butazolidine)
– quazepam (Doral)– temazepam (Restoril)Glucocorticosteroids • prednisolone (Prednisone)• ACTH (adrenocorticotrophic • carbamzepine (Tegretol)• diclofensine• doxepin (Sinequin)Anesthetics • desiprimine (Norpramin)Antimalarials • hydroxychloroquine (Plaquinil)• phenelzin (Nardil)• protriptilin (Vivactil)Miscellaneous Toxic Substances Non-Steroidal Anti-inflammatory Drugs (NSAIDS) • auronofin (gold, Ridaura)• carprofen• diclofenac (Voltaren)(Ironically, several of these drugs found to cause tinnitus, are also used to treat tinnitus (e.g., amitryptiline, benzodiazepineclass, carbamazapine, furosemide, lidocaine, • ibuprofen (Motrin, Advil, Nuprin)
A pioneer in hearing rehabilitation, human services, and
hearing conservation. The League for the Hard of Hearing,founded in 1910, is a private not-for-profit rehabilitation agency for infants, children and adults who are hard of hearing, deaf, and deaf-blind.
The mission of the League for the Hard of Hearing is to improve the quality of life for people with all degrees of hearing loss. This is accomplished by providing hearing rehabilitation and human service programs for people who are hard of hearing and deaf, and their families, regardless of age or mode of communication.
We strive to empower consumers and professionals to achieve their potential and to provide leadership to, and be the model for, disciplines that relate to hearing rehabilitation.
We promote hearing conservation and provide public education about hearing. Claussen, C.F, (1996). Chemically induced or drug induced tinnitus.Ototoxic Drugs: International Tinnitus Journal, 2, l-2.Bibliography Drug Facts & Comparisons. (1995) St. Louis, MO. J.B. Lippincott.Epstein, S. (1996) What you should know about ototoxic medications. Journal of Self Help for Hard of Hearing People, 16, 29-30.PDR Drug Interactions and Side Effects. (50th ed.). (1996). Montvale, N.J:Medical Economics Co.Physicians Desk Reference (50th ed.). (1996). Montvale, NJ: Medical Economics Co.Suss, E. When the Hearing Gets Hard. (pp. 167-216). New York, NY: Bantam Books.USP dispensing Information. (1997). In Drug Information for the Health Care Professional. Vol. 1. Rockville, MD: The United States Pharmacopeial Convention, Inc.
League for the Hard of Hearing50 BroadwayNew York, NY 10004917-305-7890
DESIGN: TRIBICH DESIGN ASSOCIATES, INC. / NYC
"El Parlamento Europeo estrena su nueva sede con protestas poragresión al patrimonio" en El País (30 septiembre 1993) Leyenda: Published in the Spanish daily newspaper El País on 30 September 1993, thisarticle retraces the steps that led to the successful construction of the new buildingfor the European Parliament in Brussels, despite adverse criticism from defendersof the
Fluid Phase Equilibria 207 (2003) 183–192Solubility of solid solutes in supercritical carbon dioxideQunsheng Li, Zeting Zhang, Chongli Zhong, Yancheng Liu, Qingrong Zhou Department of Chemical Engineering, Beijing University of Chemical Technology, P.O. Box 100, Beijing 100029, China Received 4 October 2002; accepted 14 January 2003 Abstract The solubility of 2-naphthol and anthracene in