Ototoxic Drugs Exposed

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  • 7/29/2019 Ototoxic Drugs Exposed

    7/21

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  • 7/29/2019 Ototoxic Drugs Exposed

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  • 7/29/2019 Ototoxic Drugs Exposed

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  • 7/29/2019 Ototoxic Drugs Exposed

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    -*,$6!*?$!%-!A8&>!YI-*&*7?%&Z!*->!A?*->!-*,$6!*?$!%-!%B*&%D6!Yh*68B$DZ(!![!F0$!A?*->!-*,$6!&%6B$>!0$?$!*?$!-$%B0$?!,8?$!8?!&$66!8B8B8L%D!B0*-!*-4!A?*->6!8:!B0%6!

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    G"@"/"#("8!

  • 7/29/2019 Ototoxic Drugs Exposed

    11/21

    ! ""

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    f$-B$?!:8?!T$*?%-;!3866!T$&7(!KJ!/%6B8-!f8+?B.!

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    !"W

    !

  • 7/29/2019 Ototoxic Drugs Exposed

    12/21

    ! "[

    203"+!%->$L!8:!6+67%D%8-.!*->!*?,$>!9%B0!8A@$DB%=$!>*B*.!48+!,%;0B!D8-B*DB!B0$!7046%D%*-!*->!6+;;$6B!B0*B!7$?0*76!*&B$?-*B%=$.!-8-\8B8B8L%D!*&B$?-*B%=$!,$>%D*B%8-6!

    ,%;0B!A$!*-!87B%8-(!

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    _8?!$L*,7&$.!6+7786$!*!7*B%$-B!D8,$6!B8!48+!9%B0!6$=$?$!047$?*D+6%6!90%D0!%6!>%6?+7B%-;!0$?!&%:$(!E0*B!>8!48+!>8]!18!48+!%,,$>%*B$&4!B0%-G!8:!68,$B0%-;!&%G$!T47$?*D+6%6!

    N$B?*%-%-;!F0$?*74.!8?!>8!48+!B0%-G!2>?+;6]2!!H!6+;;$6B!*6!*!:%?6B!6B$7SB0%-G!2>?+;6(2!

    !

    E0$-!7*B%$-B6!*6G!,$!90*B!B0$4!D*-!>8!*A8+B!B0$%?!047$?*D+6%6.!*,8-;!B0$!:%?6B!P+$6B%8-6!H!*6G!%6.!2E0*B!0*77$-$>!%-!48+?!&%:$!@+6B!A$:8?$!B0$!047$?*D+6%6!A$;*-]!1%>!48+!6B*?B!

    B*G%-;!-$9!,$>%D*B%8-6!8?!9*6!B0$?$!*!D0*-;$!%-!B0$!>86$!8:!$L%6B%-;!,$>%D*B%8-6]2!H!*6G!

    :8?!*!D8,7&$B$!&%6B!8:!B0$%?!,$>%D*B%8-6!*->!H!&88G!B0$,!+7!%-!&.0.0;6

  • 7/29/2019 Ototoxic Drugs Exposed

    13/21

    ! "V

    90*B!,$>%D*B%8-6!60$!0*>!A$$-!8-!*B!B0$!B%,$!B0$!047$?*D+6%6!A$;*-(!E0$-!H!?$D$%=$>!B0$!

    &%6B!8:!,$>%D*B%8-6.!H!>%6D8=$?$>!B0*B!B0%6!7*B%$-B!9*6!B*G%-;!-8B!@+6B!8-$.!A+B!B0?$$!>?+;6!G-89-!B8!D*+6$!047$?*D+6%6X!C:!*&&!B0$!B08+6*->6!8:!>?+;6!8-!B0$!,*?G$B.!8-&4!VU!*?$!

    G-89-!B8!D*+6$!047$?*D+6%6.!4$B!B0%6!788?!7*B%$-B!9*6!B*G%-;!B0?$$!8:!B0$,!*B!B0$!6*,$!

    B%,$X!!

    H!6+;;$6B$>!B0$!764D0%*B?%6B!D8-6%>$?!B*G%-;!B0$!7*B%$-B!8::!B086$!B0?$$!7*?B%D+&*?!,$>%D*B%8-6!Y%:!,$>%D*&&4!7866%A&$Z!*->!B0$-!6$$!90$B0$?!B0$!7*B%$-B56!047$?*D+6%6!9*6!

    ?$>+D$>!8?!$&%,%-*B$>(!!

    M!,*-!D8-B*DB$>!,$!B$&&%-;!,$!0*>!6$=$?$!B%--%B+6!*->!0$!9*-B$>!B8!G-89!%:!B0$?$!9*6!

    *-4B0%-;!0$!D8+&>!>8!*A8+B!%B(!H-6B$*>!8:!6+;;$6B%-;!*!B%--%B+6!,*6G$?!8?!F%--%B+6!N$B?*%-%-;!F0$?*74!YFNFZ!8?!8B0$?!B?$*B,$-B6.!H!%,,$>%*B$&4!B08+;0B!2>?+;6(2!H!*6G$>!%:!

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    >8DB8?!B8!D0*-;$!0%6!,$>%D*B%8-.!%:!7866%A&$.!*6!.&'$/'0$,-'#"!%6!G-89-!B8!D*+6$!B%--%B+6(!

    M!D8+7&$!8:!9$$G6!&*B$?.!0$!9?8B$!,$!*;*%-.!6*4%-;!B0*B!"[!>*46!*:B$?!0$!6B877$>!B*G%-;!B0$!.&'$/'0$,-'#".!0%6!B%--%B+6!9$-B!*9*4(!M;*%-.!B0$!68&+B%8-!9*6!6%,7&$!*->!$::$DB%=$(!

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    B*G%-;!&*?;$!>86$6!8:!%80'/'#!$*D0!>*4!:8?!B0$!-$*?&4\D8-6B*-B!0$*>*D0$6!60$!8:B$-!

    6+::$?$>(!!

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    0*=$!-8B%D$>!B0*B!H!*,!0$*?%-;!A$BB$?!-89(!H!0*=$!B0$!Fh!=8&+,$!6$B!*B!&$=$&!"U!%-6B$*>!8:!B0$!+6+*&![K(!F0$!?%-;%-;!%-!,4!$*?6!%6!6B%&&!B0$?$!A+B!%B!%6!-8B!*6!A*>(2!F0?$$!>*46!&*B$?!60$!*>>$>.!2F8>*4!90$-!68,$8-$!9*6!B*&G%-;!A$0%->!,$.!H!0$*?>!$=$?4!98?>!0$!6*%>(!Q4!

    0$*?%-;!6B%&&!%6-5B!7$?:$DB.!A+B!%B!%6!A$BB$?!B0*-!%B!9*6(2!

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    *%>6(!E0*B!B0$4!?$*&&4!-$$>$>!9*6!68,$8-$!B8!0$&7!B0$,!6$$!B0*B!B0$4!9$?$!>*,*;%-;!

    B0$%?!$*?6!>+$!B8!,$>%D*B%8-6!B0$4!9$?$!B*G%-;(!H-!,*-4!D*6$6.!48+5&&!A$!*A&$!B8!0$&7!48+?!

    7*B%$-B6!,8?$!90$-!48+!:%?6B!B0%-G!2>?+;6(2!!

    52'-"6_*B6./"632'#J'#C6^)/BC8`^632'#J6^=2"&'(%-8^63**6

    6HB!%6!-8B!8-&4!8B8B8L%D!>?+;6!B0*B!>*,*;$!8+?!$*?6.!B0$?$!*?$!*B!&$*6B!"KU!8B8B8L%D!

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    ,$B*&6(!

    !

  • 7/29/2019 Ototoxic Drugs Exposed

    14/21

    ! "K

    F0$?$!*?$!*!-+,A$?!8:!8?;*-%D!68&=$-B6(!%-;!8-!B0$!B47$!*->!6$=$?%B4!8:!B0$!*%?!78&&+B%8-.!7$87&$!D*-!$->!+7!9%B0!0$*?%-;!&866.!A*&*-D$!7?8A&$,6!8?!

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    *?$!8?;*-%D!68&=$-B6(!E0$-!7$87&$!%-0*&$!:+,$6!:?8,!B0$6$!68&=$-B6.!B0$4!6&89&4!A+B!

    6+?$&4!>*,*;$!B0$%?!$*?6(!!

    C-$!6B+>4!8:!98?G$?6!%-!*!?+AA$?!:*DB8?4!?$=$*&$>!Kb`!0*>!6+AD&%-%D*&!*A-8?,*&%B%$6!%-!B0$!*+>%B8?4!7*B09*46!*->!%-!B0$%?!A?*%-6B$,6.!>+$!B8!68&=$-B6!+6$>!%-!,*-+:*DB+?%-;!

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    C-$!7*B%$-B!&86B!0$?!0$*?%-;!?$6+&B%-;!:?8,!6$=$?*&!4$*?6!8:!+6%-;!67?*4!=*?-%60!%-!0$?!;*?*;$!9%B08+B!*>$P+*B$!=$-B%&*B%8-(!3*-B"#"!%-!B0$!=*?-%60!9*6!B0$!D+&7?%B(!!

    *,*;$!:?8,!8?;*-%D!68&=$-B6!%6!8A=%8+6S6+D0!*6!90$-!%B!?$6+&B6!%-!

    ,*66%=$!0$*?%-;!&866!8?!?8*?%-;!B%--%B+6(!T89$=$?.!%-!8B0$?!D*6$6!Y6$$!*A8=$!6B+>4Z!?$6+&B6!D*-!A$!%-6%>%8+6!*->!6+AB&$.!7?$6$-B%-;!*6!%,7*%?$>!D$-B?*&!*+>%B8?4!7?8D$66%-;(!I=$-!

    B08+;0!B0$!D0$,%D*&!0*6-5B!D*+6$>!?$>+D$>!20$*?%-;2!*6!,%;0B!A$!$L7$DB$>!8-!*-!

    *+>%8;?*,.!B0$!7$?68-!*::$DB$>!D*-5B!+->$?6B*->!$=$?4B0%-;!B0$4!0$*?(!

    !M!A%B!8:!7?8A%-;!,*4!?$=$*&!B0*B!0$*?%-;!&866!%6!B0$!?$6+&B!8:!$L786+?$!B8!*-!8B8B8L%D!

    D0$,%D*&!90$?$!48+!&$*6B!$L7$DB!B8!:%->!%B(!F0$?$:8?$.!%-!*>>%B%8-!B8!B0%-G%-;!2>?+;6.2!*&68!

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  • 7/29/2019 Ototoxic Drugs Exposed

    15/21

    ! "a

    4$*?6(!

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    ;?$*B$?!0$*?%-;!&866!B0*-!,%;0B!8B0$?9%6$!A$!$L7$DB$>(!!

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  • 7/29/2019 Ototoxic Drugs Exposed

    16/21

    ! "c

    >?+;6!*->!-8%6$!*&68!8DD+?6!A$B9$$-!D$?B*%-!D0$,%D*&6!*->!-8%6$(!f0$,%D*&6!B0*B!,*G$!

    8+?!$*?6!,8?$!7?8-$!B8!0$*?%-;!&866!*6!*!?$6+&B!8:!-8%6$!%-D&+>$!8?;*-%D!68&=$-B6!6+D0!*6!

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    !

  • 7/29/2019 Ototoxic Drugs Exposed

    17/21

    ! "b

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  • 7/29/2019 Ototoxic Drugs Exposed

    18/21

    ! "U

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  • 7/29/2019 Ototoxic Drugs Exposed

    19/21

    ! "J

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  • 7/29/2019 Ototoxic Drugs Exposed

    20/21

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  • 7/29/2019 Ototoxic Drugs Exposed

    21/21

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