Core62: Drug-induced adverse reaction: ototoxicity

👂 High-yield / 要点：Ototoxic drugs damage the cochlea, vestibulocochlear nerve, or vestibular system. Classic causes: aminoglycosides, loop diuretics, cisplatin, aspirin, heavy metals.

Definition / 定義

• Ototoxicity = toxic damage to structures involved in hearing and balance:
  • Cochlea.
  • Vestibulocochlear nerve.
  • Vestibular system.

Major ototoxic drugs / 主要な聴器毒性薬

• Aminoglycoside antibiotics
• Loop diuretics
• Cisplatin
• Aspirin
• Heavy metals

Symptoms / 症状

• Sensorineural hearing loss
• Tinnitus
• Vertigo
• Ataxia

Important mechanism / 重要機序

• Loop diuretics can cause ototoxicity because:
  • There are Na/K/2Cl transporters in the stria vascularis of the cochlea.
  • Inhibiting them disrupts the electrochemical potential needed for hearing.

Clinical idea / 臨床的ポイント

• Drug-induced ototoxicity can affect:
  • Hearing.
  • Balance.
• Vestibular involvement explains:
  • Vertigo.
  • Ataxia.
• Aminoglycosides and cisplatin are especially high-yield causes.

Remember / 覚え方

• Aminoglycosides + loop diuretics + cisplatin = classic ototoxic trio
• Tinnitus and sensorineural hearing loss are key clues
• Vestibular toxicity → vertigo + ataxia