Ototoxicity Associated with Salicylates

Brien, Jo‐anne E

doi:10.2165/00002018-199309020-00006

Cited by 67 publications

(37 citation statements)

References 31 publications

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“…A range of measured serum concentrations of salicylates are reported as correlating with documented ototoxicity (19.6 to >67 mg/dL). Localized drug accumulation and vasoconstriction in auditory microvasculature may be mediated by the antiprostaglandin activity of these agents [20].…”

Section: Opinion Statementmentioning

confidence: 99%

Acute hearing loss

Tamhankar

Solomon

2004

Curr Treat Options Neurol

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Acute hearing loss (AHL) is a medical urgency. The management of patients presenting with sudden deafness involves detecting the causal mechanism and administering emergency therapeutic drugs to restore hearing by minimizing the period of cellular ischemia to the inner ear. Acute management of AHL consists of administering a 10-day course of high-dose corticosteroids (prednisone 60 to 80 mg) until a cause can be established. Magnetic resonance imaging with gadolinium is indicated, with a study dedicated to the internal auditory canals. The natural history of idiopathic AHL is characterized by spontaneous improvement in two thirds of patients. Maximum improvement occurs within 2 weeks of onset of AHL. In the vast majority of patients (>90%), the AHL is idiopathic. For an identifiable etiology, the treatment is specific and may consist of stopping ototoxic medications, repair of perilymphatic fistulas, administering antimicrobial agents for viral or bacterial infections, correction of metabolic imbalances, management of stroke, and possible surgery for cerebellopontine angle tumors. Management of idiopathic AHL is controversial. Various therapeutic agents, such as vasodilators, diuretics, anticoagulants, plasma expanders, contrast agents, and carbogen inhalation, have been tried in single therapy or as a combination therapy. The empiric use of these drugs is mainly based on improving the blood circulation and restoring the oxygen tension to the inner ear. The use of interventional procedures, such as low-density lipoprotein apheresis as well as newer drug delivery systems for corticosteroids, and immunosuppressive agents have opened new options in the treatment of AHL secondary to immune-mediated diseases of the inner ear. Prognosis for AHL is best when patients are seen early, begin recovery within 2 weeks, and have a mild hearing loss (<90 dB) with upward-sloping audiograms. Greater than 90 dB of hearing loss along with flat or down sloping audiogram, advanced age, and presence of vertigo are adverse prognostic factors for recovery of hearing loss.

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Section: Opinion Statementmentioning

confidence: 99%

Acute hearing loss

Tamhankar

Solomon

2004

Curr Treat Options Neurol

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“…Tinnitus, a common side effect of high doses of salicylates, has been suggested by some to be due to inhibition of COX-1-dependent synthesis of PGEs by cells of the inner ear. Although conclusive data for this assertion are lacking, several studies have demonstrated the usefulness of PGE 1 analog misoprostal as a therapy for tinnitus [25,26]. Finally, most NSAIDS including aspirin promote salt and water retention, especially when heart or liver disease compromises renal blood flow.…”

Section: Toxic Effects Of Aspirin: the Cox-2 Hypothesismentioning

confidence: 99%

The pleiotropic functions of aspirin: mechanisms of action

Amin

Attur

Pillinger

et al. 1999

Cellular and Molecular Life Sciences (CMLS)

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Recent studies have suggested that aspirin and aspirin-like compounds have a variety of actions in addition to their well-studied ability to inhibit cyclooxygenases. These actions include inhibition of the uncoupling of oxidative phosphorylation, decreases in adenosine triphosphate stores. increases in extracellular adenosine, downregulation of the expression and activity of inducible nitric oxide synthetase, inhibition and/or stimulation of various mitogen-activated protein kinase activities and inhibition of nuclear factor binding kappaB site (NF-kappaB) activation. Moreover, aspirin-like compounds have recently been shown to have previously unappreciated clinical and biological effects, some apparently independent of cyclooxygenase. In this review we discuss the various mechanisms of action of aspirin-like compounds and their relevance to clinical disease and therapy.

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“…Because high doses of salicylate induce tinnitus in humans (Brien, 1993;Day et al, 1989;McFadden et al, 1984;Myers and Bernstein, 1965) in a predictable, dose dependent manner, many animal studies have used sodium salicylate to investigate the behavioral manifestation of tinnitus (Guitton et al, 2003;Jastreboff et al, 1988;Lobarinas et al, in press). The minimum dose needed to induce tinnitus in rats is on the order of 150 mg/kg (Jastreboff and Brennan, 1994;Lobarinas et al, 2004).…”

Section: Introductionmentioning

confidence: 99%