Later on, antibiotics belonging to amino glycoside also started to display similar side effects as Streptomycin. These effects were collectively termed ototoxicity. Many other types of medications, including chemotherapy (platinum-based), loop diuretics and quinine were also found to cause the same effects. The age-old salicylates that are commonly used to treat fever symptoms are not an exception also. In fact, the toxicity of all these medications is so much that, they affect the cochleo-vestibulat system adversely. In other words, these medicines hold out harmful (toxic) effects to both the inner ear (Cochlea) as well as his/her vestibular (balance) system of the ear. As a result, the affected person can experience difficulty in hearing, and might also develop vertigo lose his or her state of equilibrium, and start having tinnitus problems. Other related health issues are also not uncommon.

Drugs that are by nature ototoxic, are not uniform in their way of working, and have differing modus operandi. Those medicines that belong to the amino glycoside group apparently activate the receptors of the glutamate. This in turn, quickens the pace at which the hair cells degenerate. The cochlear neurons are affected adversely by these medicines as well. As an automatic consequence, the free radicals also get damaged, leading to increase in the extent of damage that is caused to the hair cells as well as the cochlear neurons as well.

It should be taken into account that, in the initial stages, the outer cells of hair, present in the inner row, get damaged. The adverse effects then spreads along, moving to the inner hair cells, those that are present in the outer row. Usually, the symptoms of these problems become apparent as soon as, or just after, therapeutic treatment is withdrawn. Tinnitus is mainly caused by the auditory problems experienced by people at high frequencies, when the ototoxic drugs are taken in the initial period. Patients can even find recognizing the source of voices difficult over time, as the problem extends to the lower frequency levels too.

Medical practitioners generally like to prescribe antioxidants before recommending any type of drugs with ototoxic effects. This is because the effects caused by ototoxicity cannot generally be reversed. The antioxidants ensure that the free radicals do not get mutilated. As a result, auditory problems as well as risks of losing the internal balance of the vestibule get reduced considerably. Hence, it is indeed a wise decision to prescribe antioxidants.

So that there can remain no scope of confusion regarding this, a list of the six types of medicines that were believed to have ototoxic effects was published in the September 1996 issue of the Tinnitus Today magazine. Prepared by a renowned Doctor of Medicine, the list is exhaustive. Here, we would look into this list as it was published. This would do away with any chances of wrong interpretation.

1. Drugs that cause tinnitus: Salicylates, Aspirin and other drugs of similar nature: if individuals consume around 6 to 8 pills everyday, toxicity is likely to occur. Fortunately, these effects can be easily reversed as soon as the consumption is stopped.

2. Drugs that prevent inflammations (of the NSAIDS (non-steroidal group) ” Second type of drugs that cause tinnitus. There are several such medicines that cause tinnitus. Among them, Aleve, Anaprox, Clinoril, Advil, Lodine, Poradol, Motrin, Indocin, Nuprine, Naprosyn, Feldene and Nalfon are worth a mention. As in the earlier case, problems commence when individuals form a habit of having 6 to 8 tablets everyday over the long-run. These problems disappear when these medicines are withdrawn.

3. Amino glycosides, Erythromycin, Vancomycin and other related antibiotics:

Amino glycoside group: When medicines belonging to this group are applied to patients intravenously, ototoxic effects may be seen. This ototoxicity can be effectively tackled if the blood pressure level is monitored on a regular basis. Some of such drugs under this group are Tobramycin, Kanamycin, Gantamycin, Amikacin, Streptomycin, Neomycin and Netilmycin. However, ear drops or topical medications that use Gantamycin or Neomycin as ingredients are not ototoxic in nature.

Erythromycin group: When the newer derivatives of this group of antibiotics are administered in an intravenous method (at dosages of 2 to 4 grams at intervals of 24 hours), ototoxic effects can be detected. There can be a number of resultant health hazards, with renal failures being the chief among them. However, if these drugs are taken orally at reduced dosages (less than one gram at intervals of 24 hours), ototoxicity does not occur. Some of the notable medications that fall under this class are EES, Pediazol, Eryc, E-mycin, Biaxine, Llosone and Zithromax.

Vancomycin: The Vincocin antibiotic is found to possess similar features as the amino glycoside drugs. When administered intravenously to combat potentially fatal infections, these medicines can display ototoxic effects. They are usually prescribed in conjunction with amino glycosides, thereby raising the total effects of ototoxicity.

4. Loop diuretic drugs that cause tinnitus (like Bumex, Lasix and Endecrin): When administered to patients suffering from hypertensions or acute kidney related problems intravenously, these loop diuretics can display ototoxic properties. On the other hand, even if patients are given high doses, no ototoxicity is observed, only if the medium of administration is oral. Thus, those who have serious problems with their kidneys should be given oral doses rather than intravenous injecting methods.

5. Nitrogen Mustard, Vincristine, Cisplatin (Chemotherapy Drugs) ” Fifth type of drugs that cause tinnitus. These drugs are used widely for treating cases of cancer. However, they are ototoxic in nature. Doctors generally carry out serial audiograms at fixed time gaps, and record the blood pressure levels continuously to reduce the ototoxic effects. However, it is impossible to control the harmful effects of ototoxicity, if patients are also consuming amino glycoside drugs and/or loop diuretics simultaneously.

6. Anti-malarial drugs that cause tinnitus (like Quinine), and other medicines that are used to prevent night cramps (like Atabrine, Legatrin, Aralen, and Q-Vel Muscle relaxants): The ototoxic effects associated with quinine are somewhat similar to the ones that come with the usage of aspirin. As and when the medicines are withdrawn, the problems also make an exit. This list also notes the major indicators of ototoxicity-related problems, according to their frequency levels. These symptoms can be listed as under: (1) if patients experience in either, or both of their ears; (2) a new source of noise, complicating existing tinnitus problems; (3) due to the tinnitus infection, the ears feeling heavy or full, and (4) either starting to have problems in hearing, or experiencing added auditory problems for people who are already hard of hearing.

It is evident that tinnitus can be caused by many medications. In addition, we need to consider that the conventional medications treat only the symptoms of tinnitus, and do not deal with the actual underlying reasons of the ailment. Hence, hoping for a permanent cure is rather futile. Nor can remedial products prepared at home, or medicines with herbal ingredients work well on a consistent basis. The best bet is holistic remedies that detect the main causes of the disease. Once done, these factors can be effectively resolved, thereby bringing about a complete cure.

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