Re: vertigo

Posted By CCF Neurology MD on September 18, 1997 at 22:57:07:

In Reply to: vertigo posted by D. Keynes on September 14, 1997 at 19:01:36:







: Could you please provide me with information regarding possible damage to the otic nerve by parenteral gentamycin.
I'm especially interested in the risks to the eldery patient.                                                                                        




Dear D. Keynes:
A neurologist is hardly the expert on the subject of gentamicin ototoxicity. You should ideally consult an infectious diseases specialist and an otorhinolaryngologist for precise details.
Overall, the compication may occur in as many as 5-10 percent of cases. It is more frequent in the elderly, and in patients with renal insufficiency. The risk increases with a longer duration of treatment. Since toxicity is more related to trough levels of the drug in the system, once-a-day dosing is believed to be less toxic. Close monitoring of trough and peak doses, and appropriate adjustment of doses, as is the practice in most hospitals, is a measure that can minimize toxicity. Aminoglcosides (antibiotics of the class of gentamicin) differ somewhat in their ototoxicity, and you may want to discuss possible drug options with the treating doctor.
Symptoms of the toxicity include vertigo, high frequency hearing loss, tinnitus, imbalance, and nause/vomiting. Pre-symptomatic toxicity may precede symptomatic toxicity. Toxicity is often irreversible.
I hope I have answered your question.