Toxic responses of ear Flashcards

1
Q

typical drugs that cause tinnitus

A

salicylates

quinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

whats presbycusis and how does it occur

A
hearing loss caused by natural aging
atrophy of the basal end of organ of corti
loss of hair cells
stiffening of basilar membranes
vascular changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what might patients experiences if vestibular function compromised

A
lghtheadedness
headahce
whirling 
nystagmus 
ataxia
unsteady gait and function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does vestibular function improve with time

A

increased reliance on visual and proprioceptive inputs and central compensatory mechanisms for equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do diuretics cause hearing loss

A

physiologic dysfunction
loss of hair cells
edema at striavascularis
inhibition of potassium pump and g protein associated with adenylcyclase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

type of damage with diuretics

A

reversible

permanent reported

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

salicyclate hearing loss reversible after

A

24-72hr after d/c drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

dose of salicylate causing damage

A

doses above 2.7g inreased ototoxicicyt,

dose >4g/d produces tinnitus and hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

type of hearing loss in salicylates

A

bilateral and symmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

type of hearing loss in erythromycin

A

bilateral impairment of hearing at all freuencies
slurred speech, double vision, confusion
with all forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

erythromycin dose leading to hearing loss

A

> 4g/day

<2g in renal or hepatic failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

risk factors for erythromycin hearing loss

A
high doses with renal or hepatic failure
iv admin
age
use with other ototoxic agents 
use with inhibitors of erythromycin metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

quinine mechanism of hearing loss

A

prostaglindine and phosphoslipase a2 enzyme inhibition
inhibition of clacium channels
vasoconstriction
inhibition of potassium channel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

presentation of phosphodiesterase 5 inhibitor ototoxicity

A

sudden hearing loss - very rare
unilateral!!
first 24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

most toxic aminoglycosides

A

neomycin

kanamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

mechanism of aminoglycoside hearing loss

A

binding to hair cell membrane polyphosphoinositides
membrane disruption
loss of electrolytes
loss in enzyme function and inhibition of protein synthesis

17
Q

risk factors for aminoglycoside toxicity

A
severity of illness
pre existing hearing loss
previous exposure to aminoglycosides
duration of therapy
peak valley variation
other ototoxic drugs
pre existng renal failure
age
noise exposure
previous ear infection
genetic predisposition
18
Q

presentation of cisplatinum hearing loss

A
bilateral 
cochlear(hearing loss) and vestibular symptoms 2-5days after first or second dose
19
Q

cisplatinum mechanism of hearing loss

A

damage to the outer hair cells and stria vascularis

20
Q

doses for cisplatin ototoxicity

A

50-100mg/m2

21
Q

drugs causing irreversible hearing loss

A

aminoglycosides

cisplatin

22
Q

drugs causing reversible hearing loss

A

erythromycin
salicylate
quinine
phosphodiesterase 5 inhibitors