0:01 Introduction
Hello people in this video let us look at ototoxicity soto means what you’re right so toxicity is bad for the year so outré toxicity we are talking about the drugs here which cause ototoxicity pharmacology okay so what are the drugs that cause rota toxicity doug send some chemicals they can damage the inner ear they can cause sensory neural hearing loss tinnitus
Right a vertigo what still it is ringing of the urate they can cause ringing of the year vertigo vertigo what dizziness imbalance type it can be similar to motion sickness vertigo it’s like you feel like you’re moving though you’re not moving so all vestibular problems so basically you have gotten idea what auto toxicities right and ototoxic drugs are the drugs
Or chemicals that lead to this problem right so have you understood what oprah toxicity is and who causes it that is over toxic drugs okay so there are many drugs guys so let us look at water non causes it let’s start off with aminoglycoside antibiotics so basically i aminoglycoside antibiotics like streptomycin gentamicin tobramycin these can cause vestibular
Toxicity okay they can cause what vestibular toxicity okay how do they do this they destroy the type one hair cells of the krista and canaris okay when administered and large those they can also damage the cochlea so they will lead to hearing loss also right in cochlea miss hearing loss also con so where is the cochlea so look at this image external your middle
Your inner ear in e area this final thing is the cochlea right then there’s another category of drugs the neomycin kanamycin amma carson so myself all these okay they’re talking about neomycin kanamycin amica cells so my son and the hydro streptomycin all these will lead to what will come to that there are different category they’re putting it as these will
Lead to cokely oh toxic mainly these are cochlea toxic these were vestibular toxic in higher doses they can cause damage to cochlea coming to neomycin kanima cinema castle so my son anne died hydro streptomycin these are cochlea toxic okay wester blow is which part is this this part misty below is this part cochlea is this part okay so was to be no toxic these
Ducts right and cochlea main main leave these drugs okay in aminoglycoside antibiotics so what are the side effects of aminoglycoside antibiotics you have already studied in pharmacology right photo toxicity nephrotoxicity and neuromuscular blocking but as we are looking in the year today they are more concerned only with the odor toxicity okay so how do how do
These damage the cochlea so basically they cause selective destruction of the outer hair cells so in the cochlea you have seen right in the organ of corti you have seen the structure outer hair cells etcetera do you remember the saqqaq this is the cochlea section here you can see the organ of corti in this organ of corti you have the outer hair cells guys so
These allow to herself please get damaged by whom the amika sin and all that neomycin kanamycin amica sell all these ok so they selectively destroy the outer hair cells starting we’re at the basal coil and then progressing to the effects of the cochlea from the basal coiled till the a pics of the cochlea what is getting damaged the outer hair cells outer hair
Cells are getting damaged right so who are at risk people who have renal function impaired so basically they’re not able to get the drug out right so they they’ll have more or ototoxicity elderly people who are about age of 65 people who are receiving other ototoxic drugs like diuretics and on that if they’re taking lot of ototoxic drugs together then people who
Are receiving high doses of ototoxic drugs right who have high level of this drum india sedum right who have genetic susceptibility to amino glycosides some people are very susceptible to the side effects of amino glycosides right so people who are genetically susceptible now what happens in them the cochlear cells can die okay so what will be the symptoms of
Ototoxicity you have already seen that here so you saw that there will be tinnitus hearing loss right and giddiness rate all these are because of water toxicity so all these problems with amino glycosides can come during the treatment or after the treatment also that will be delayed toxicity if it comes after the treatment so people you have seen amino glycosides
Now right so just look at the names of the others okay for now diuretics then we have antimalarials actually one thing is missing here week so people we have looked at aminoglycoside antibiotics let us look at the other drugs which are ototoxic just the names just look at the names there are headings diuretics right analysis takes like salicylic acid salicylic
Antimalarials like weaning chloroquine hydro quinn cytotoxic drugs like the ones used in treatment of cancer right chemicals like alcohol tobacco marijuana carbon monoxide miscellaneous drugs you have like a retro myosin macrolide antibiotic right propranolol ampicillin profile theo uracil is what anti a thyroid drug and even topical your drops its film can cause
Damage to the cochlea okay so you should be careful with draw top of the ear drops also so people you have understood the name of the drugs right what and all are there amino glycosides diuretics salicylic acid like nsaids then you have antimalarials like queenie’s chloroquine hydrochloric win cytotoxic drugs like nitrogen mustard cisplatin carboplatin etc then
You have chemicals like tobacco alcohol marijuana carbon monoxide poisoning miscellaneous drunks like ampicillin erythromycin propranolol propylthiouracil def ferox i’m and then you also have topical ear drops itself which can cause photo toxicity what are we discussing today ototoxic drugs otd ototoxic drugs so now let us look at the details of diuretics what
You say so diuretics like furuse amide etc what they do they are going to create some imbalance right in the sodium chloride ions etcetera so there can be a team artistic changes in this trial vasculitis of the cochlear duct okay so in most cases what will happen this change can be reversed but permanent damage if it has occurred then you cannot do anything
Whatever happens here that leave bilateral right it will usually be bilateral problem so let’s make it bilateral then so make it by finitely so you have bilateral problem okay and usually it be symmetrical and it may even be sudden and onset interestingly okay next moving on to energy 6 like salicylic acid salicylates these caused the tinnitus bilateral sensory
Neural hearing loss okay which actually higher frequencies are affected most okay in hearing in this case also what happens if the drug is discontinued the damage is reversed okay then so we finished diuretics and salicylates right now let’s move on to antimalarials like we lean flora quinn he drops a chloroquine so first look at winning sok winning ototoxic
Symptoms are like chill it is sensory neural hearing loss same thing both of which are again reversible here okay hi dogs this will cause permanent loss same thing what they have told so far for others also one thing extra here is if it is given to mothers during pregnancy in the first trimester the child the born can have congenital deafness and hyperplasia
Of the cochlea okay basically this how does it work it causes vasoconstriction of the way so comes friction it causes vasoconstriction oh the visceral small vessels in the cochlea and straya vascular is okay so this leads to even there can be cunning genital deafness right and hypoplasia off the cochlear this is something new here everything else you have
Seen in that this is new tonight congenital deafness hyperplasia of the cochlea vasoconstriction that is how queening works what about chloroquine and hydrochloric win it is a very similar to quinion only the effect okay and again it is reversible sometimes permanent damage can occur as you have seen in all other cases so far so what did we just finish should
We finished anti-malarials so guys shall we move on to the cytotoxic drugs which cause ototoxicity so these are anti-cancer drugs like nitrogen mustard that is me klore ether mine so splatted carboplatin all these are going to be cytotoxic drugs they affect the outer hair cells of the cochlea so what do these affect eyes the outer hair cells off yeah okay
Let’s move on no chemicals chemicals like tobacco alcohol marijuana carbon monoxide poisoning also can cause damage to the you they cause damage to the inner ear less these cause damage to the inner you miscellaneous drugs like there let’s look at this very def arrow oxman de ferro also mine okay d fair on semi okay so this one or this very ox mine it is an ion
Chelating substance correct you have heard this in chelating agents in pharmacology it is used in the treatment off now people who get repeated blood transfusion rate for them like thalassemia etc where there be a overload of iron for those people they’ll get chelating agent of iron that is despero ox mine okay this can also lead to high frequency sensory neural
Hearing loss okay similar to many other drugs this can lead to high frequency sensory neural hearing loss okay then coming to the toxicity here they are saying this now children are affected a lot in this okay this very ox women is a chelating agent which lands the causing or autopsy but if you don’t give it rock city strange right now let us go to the other
Drugs here isolated cast cases of deafness have been reported with erythromycin ampicillin and chloramphenicol indomethacin phenol buta is own ibuprofen so many so many propranolol propylthiouracil all these isolated cases of deafness deafness has been have been reported okay lastly we wanted topical year drops so some of these year drops they cause damage to
The cochlea okay because of absorption through the overland round window basically the examples of this this is collect low hexa diene and some aminoglycoside antibiotics itself okay so basically the potential over toxic potential of drugs containing polymyxin b propylene glycol and anti-fungal agents all these have ototoxic potential so that is why you should
Always use only approved drugs for middle ear infection you should not use whatever okay just use the approved drops for middle ear infection so we’re done with ototoxic drugs guys hope you have understood ouput ototoxicity so we looked at what ototoxicity is what who causes them the drugs that are causes them are aminoglycoside antibiotics diuretics analysis
Anti-malarials phytotoxic drugs chemical miscellaneous drugs and even topical year drops okay that’s all for now in ototoxic drugs okay bye bye you
Transcribed from video
ENT 050 a Ototoxicity OtoToxic Drugs Ear Damage Medicines Adverse Effects Side By MBBS VPASS
