ototoxicity is also known as the poisoning of the ear and this is a chronic condition which need proper treatment as it cannot be detected early so knowledge of this condition can be useful for making differential diagnosis and proper treatment of the patient for the nursing students bsc and gnm and also can be used for their learning understanding and for their exam too

1. OTOTOXICITY
DEPARTMENT
OF
MEDICAL SURGICAL NURSING

2. Learning Objectives
At the end of this lecture, students sholud be able
to:
• define ototoxicity
• list out the causes
• describe the management

3. Definition
Ototoxicity is term used for ear poisoning and can
affect the hearing due to various chemical changes in
the ear
A variety of medications may have adverse effects on the
cochlea, vestibular apparatus or VIII cranial nerve.
Such as aspirin, quinine cause irreversible hearing loss.

5. Incidence
• 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
condition

6. CAUSES
• At high dose of aspirin toxicity also can produce tinnitus.
• IV medication such as aminoglycosides
• Ototoxic drugs include antibiotics such
as gentamicin, streptomycin, tobramycin,
• loop diuretics such as furosemide (lasix) and
• platinum-based chemotherapy agents such
as cisplatin and carboplatin.

7. • Occupational exposure like painting, printing,
fueling vehicles, pesticide spray, construction, fire
fighting
• destroy the hair cells in the organ of corti.

8. Sign and symptoms
• Partial or profound hearing loss
• Vertigo
• Tinnitus
• Sensory neural deafness

9. Assessment and diagnosis
• The diagnosis is based upon the patient’s history,
symptoms, and test results.
• There is no specific test for ototoxicity; this makes a
positive history for ototoxin exposure crucial to the
diagnosis.

10. TREATMENT
• Note the effects of medication .
• Blood levels of medication should be monitored.
• Audiogram twice in a week during long term IV antibiotic
therapy.

11. • Treatments focus on reducing the effects of the
damage and rehabilitating function.
• Medical or surgical treatment is usually not
effective. Use of ototoxic drugs should be avoided
whenever possible.
• Specifically, individuals with hearing loss may be
helped with hearing aids; those with profound
bilateral (two-sided) hearing loss have been shown
to benefit from cochlear implants.

12. • Usual treatment given for sudden sensori- neural
deafness can be advised.
• Withdrawal of ototoxic drug may prevent further
damage in early cases.
• Hearing aids are advised in clients with established
deafness.
• Cochlear implants clients with profound bilateral
sensorineural deafness

13. Nursing management
• Assessment
• Positive history of used of ototoxic medication
• Occupational exposure of chemicals
• Physical examination/ ear assessment – hearing loss
, tinnitus , vertigo
• Nursing diagnosis
• Impaired hearing activity related to exposure or long
term use of medication

14. • Anxiety related to hearing loss
• Knowledge deficit related to prognosis
• Intervention
• Assess the patient condition
• Provide comfortable position
• Check for vitals sign
• Monitor use of long term medication
• Provide psychological support

15. • Reduce or stop use of medication that cause
ototoxicity
• Provide iv fluids as prescribed
• Improve nutritional status
• Provide safe and calm enviroment to patient
• Educate patient regarding use of hearing aids and
disease process

16. • Evaluation
• Check for the active improvement of hearing activity
of patient
• Regular follow up

17. Summary
So far we have discussed about definition, etiology, and
managements of ototoxicity.

18. Bibliography
• Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7th edition.
• Joyce.M.Black et al, Medical Surgical Nursing,
Saunders publication.
• Brunner and Siddhartha, Medical Surgical Nursing,
Lippincott Williams and Wilkins.

19. Thank You