How to reduce the risk of hearing loss?
Fragile hearing
Mikhail Alekseev, "Russian pharmacies" No. 9, 2012
Published in ABC magazine
Hearing loss when taking medications is one of the most common side effects of pharmacotherapy. Currently, about 200 drugs and chemicals are known that can damage the structures of the inner ear.
For the first time, cases of ototoxicity of drugs were described in the 40s of the last century, when antibiotics from the group of aminoglycosides (streptomycin, kanamycin, neomycin, gentamicin and others) began to be actively used for the treatment of bacterial infections. It was quickly established that these drugs can accumulate in the endolymph of the inner ear, reaching dangerous concentrations exceeding their level in the blood.
What's happening?Getting into the inner ear, aminoglycosides disrupt the most important processes of the vital activity of the hair cells of the hearing organ and balance.
Defeat, as a rule, is selective: the greatest damage is caused either to the vestibule and semicircular canals, or to the snail. In the first case, dizziness, nausea, loss of balance are observed. In the second – tinnitus, irreversible (complete or partial) hearing loss.
Risk factorsThe susceptibility to the ototoxic effect of antibiotics is hereditary.
Families in which cases of hearing loss as a result of aminoglycoside therapy have been recorded for several generations in a row are described. At the end of the XX century, geneticists found that the predisposition to such reactions is due to mutations in the genes of mitochondria – the "power stations" of the cell that have their own genome. The risk of hearing damage when taking medications increases with impaired kidney function: aminoglycosides are excreted from the body in the urine and also have a nephrotoxic effect themselves.
In addition to aminoglycosides, taking a number of other drugs can lead to permanent or temporary hearing loss:
- antibiotics – glycopeptides and macrolides;
- cytostatic drugs – cisplatin, carboplatin, etc.;
- NSAIDs – salicylates, pyrazolone derivatives (phenylbutazone), acetic acid derivatives (indomethacin);
- loop diuretics (furosemide);
- antimalarial drugs (quinine, chloroquine).
The use of ototoxic drugs is allowed only when the benefits of treatment exceed the possible harm. Aminoglycosides are recommended to be used in a hospital setting that allows careful monitoring of the drug level in the blood, kidney condition, as well as the patient's hearing, and only in the absence of a safer alternative. In developed countries, genetic studies are increasingly being used to identify patients susceptible to the ototoxic effects of drugs.
Too loudNoise haunts modern man almost everywhere, and even relatively quiet work does not protect us, the first-timers, from its negative impact.
Household appliances, highways, audio devices with headphones, loud music – all these are additional threats to our hearing. We reduce the risk!
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