How can cisplatin ototoxicity be prevented?
An Optimal Delivery Pattern. To summarize, the most suitable protocol for treating cisplatin-induced ototoxicity is intratympanic injection to be delivered 1h before each cisplatin injection, due to superior perilymph concentrations within 1 h of administration (Chandrasekhar et al., 2000; Hargunani et al., 2006).
How do you treat ototoxicity?
Research continues on ways to prevent ototoxicity or fix the damage it can cause. So far there’s no sure way to reverse it. The good news is that sometimes the ear just needs time to heal. And some kids may have no further hearing or balance problems if they can stop taking the medicine that’s causing their symptoms.
Is cisplatin hearing loss reversible?
Cisplatin induced hearing loss is usually bilateral and irreversible, and is particularly serious in the pediatric population (age 6 months and onwards) with cancers like neuroblastomas, CNS malignancies, head and neck cancers, where irradiation of the base of the skull or brain is also performed (Chen et al. 2006).
Why does cisplatin cause nephrotoxicity?
Cisplatin causes damage to nuclear and mitochondrial DNA and production of reactive oxygen species (ROS) which lead to activation of both mitochondrial and non-mitochondrial pathways of apoptosis and necrosis. Mitochondrial energetics are also disrupted by cisplatin and may contribute to nephrotoxicity.
Why do aminoglycosides cause ototoxicity?
Aminoglycosides appear to generate free radicals within the inner ear, with subsequent permanent damage to sensory cells and neurons, resulting in permanent hearing loss. Two mutations in the mitochondrial 12S ribosomal RNA gene have been previously reported to predispose carriers to aminoglycoside-induced ototoxicity.
Why does cisplatin affect hearing?
The stria vascularis helps maintain the positive electrical charge in inner ear fluid that certain cells need to detect sound. The research team determined that the accumulation of Cisplatin in the stria vascularis portion of the inner ear contributed to Cisplatin-related hearing loss.
What medications can cause ototoxicity?
List of Ototoxic Medications
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including aspirin, ibuprofen, and naproxen.
- Certain antibiotics, including aminoglycosides.
- Certain cancer medications.
- Water pills and diuretics.
- Quinine-based medications.
How do loop diuretics cause ototoxicity?
The most likely mechanism responsible for the potentiation of ototoxicity by loop diuretics is damage to the tight cell junctions in the blood vessels in the stria vascularis resulting in temporary disruption of the blood-cochlear barrier which increases the permeability of the lateral wall to ototoxic drugs.
How bad is hearing loss from cisplatin?
But cisplatin and other similar platinum-containing drugs can damage the cochlea, leaving 40%–80% of adults, and at least 50% of children, with significant permanent hearing loss, a condition that can greatly affect quality of life.
Does cisplatin cause acute tubular necrosis?
The pathophysiology of cisplatin-induced AKI involves proximal tubular injury, oxidative stress, inflammation, and vascular injury in the kidney. There is predominantly acute tubular necrosis and also apoptosis in the proximal tubules.
Does cisplatin cause neutropenia?
Neutropenia is found among people who take Cisplatin, especially for people who are male, 60+ old , have been taking the drug for < 1 month, also take medication Fluorouracil, and have Preventive health care.
Why do loop diuretics cause ototoxicity?
The most likely mechanism responsible for the potentiation of ototoxicity by loop diuretics is damage to the tight cell junctions in the blood vessels in the stria vascularis resulting in temporary disruption of the blood-cochlear barrier which increases the permeability of the lateral wall to ototoxic drugs.
Is ototoxic hearing loss reversible?
The effects of ototoxicity can be reversible and temporary, or irreversible and permanent. It has been recognized since the 19th century. There are many well-known ototoxic drugs used in clinical situations, and they are prescribed, despite the risk of hearing disorders, to very serious health conditions.
What is cisplatin toxicity?
Cumulative renal toxicity associated with cisplatin is severe and other major dose-related toxicities include myelosuppression, nausea, and vomiting. Ototoxicity, which may be more pronounced in children, is significant.