All of the following drugs can cause hearing loss except:
Ans. c. Metronidazole (Ref: Goodman Gillman I2/e p1512,1542.1407, Katzung 12/e p824)Metronidazole does not cause hearing loss."All aminoglycosides are ototoxic and nephrotoxic. Ototoxicity and nephrotoxicity are more likely to be encountered when therapy is continued for more than 5 days, at higher doses, in the elderly, and in the setting of renal insufficiency. Concurrent use with loop diuretics (eg, furosemide, ethacrynic acid) or other nephrotoxic antimicrobial agents (eg. vancomycin or amphotericin) can potentiate nephrotoxicity and should be avoided if possible. Neomycin, kanamycin, and amikacin are the most ototoxic agents. Streptomycin and gentamicin are the most vestibulotoxic, bleomycin, tobramycin, and gentamicin are the most nephrotoxic. --Katzung 12/e p824"Vestibular and auditory dysfunction can follow the administration of any of the aminoglycosides, and ototoxicity may become a dose-limiting adverse effect. Aminoglycoside induced ototoxicity results in irreversible, bilateral high-frequency hearing loss and temporary vestibular hypofunction. "--Goodman Gillman 12/e p1512"Auditory impairment, sometimes permanent, may follow the use of vancomycin or teicoplanin. Ototoxicity is associated with excessively high concentrations of these drugs in plasma (60-100 ug/mL of vancomycin). "-Goodman Gillman 12/e p1542"The fatal oral dose of quinine for adults is ~2-8 g. Quinine is associated with a triad of dose-related toxicides when given at full therapeutic or excessive doses. These are cinchonism, hypoglycemia, and hypotension. Hearing and vision are particularly affected Functional impairment of the eighth nerve results in tinnitus, decreased auditory acuity, and vertigo. Visual signs consist of blurred vision, disturbed color perception, photophobia, diplopia, night blindness, constricted visual fields, scotomata, mydriasis, and even blindness. "--Goodman Gillman 12/e p1407Drugs causing OtotoxicityAntibiotics* AminoglycosidesQ* VancomycinQChemotherapeutic drugs* CisplatinQDiuretics* Ethacrynic acidQ* FurosemideQOthers* QuinineQ* SalicylatesQ Aminoglycosides Side-Effects MaximumMinimumOtotoxicity* AmikacinQ (Auditory)* StreptomycinQ (Vestibular)* NetilmycinQNephrotoxicity* Neomycin >GentamicinQ* StreptomycinQNeuromuscular Blockade* Neomycin >StreptomycinQ* TobramycinQ
Vancomycin
Kanamycin
Metronidazole
Quinine
Anti Microbial