Pharmacology Antibiotics #5

Question

Which antibiotic(s) are ototoxic and nephrotoxic? Select all that apply.

Answers

  1. Neomycin
    • Rationale:

      This answer is correct because neomycin has side effects of ototoxicity and nephrotoxicity. Nephrotoxicity produces kidney damage and is reflected in elevated blood urea nitrogen (BUN) and creatinine blood levels with decreasing urinary output. Tinnitus (ringing in the ears) and vertigo (dizziness) can indicate ear damage related to ototoxicity. Peak and trough blood level measurements are indicated to monitor toxicity and assure adequate levels of the medication.

  2. Gentamicin
    • Rationale:

      This answer is correct because gentamicin has side effects of ototoxicity and nephrotoxicity. Nephrotoxicity produces kidney damage and is reflected in elevated blood urea nitrogen (BUN) and creatinine blood levels with decreasing urinary output. Tinnitus (ringing in the ears) and vertigo (dizziness) can indicate ear damage related to ototoxicity. Peak and trough blood level measurements are indicated to monitor toxicity and assure adequate levels of the medication.

  3. Vancomycin
    • Rationale:

      This answer is correct because vancomycin has side effects of ototoxicity and nephrotoxicity. Nephrotoxicity produces kidney damage and is reflected in elevated blood urea nitrogen (BUN) and creatinine blood levels with decreasing urinary output. Tinnitus (ringing in the ears) and vertigo (dizziness) can indicate ear damage related to ototoxicity. Peak and trough blood level measurements are indicated to monitor toxicity and assure adequate levels of the medication.

  4. Azithromycin
    • Rationale:

      This answer is not correct because azithromycin (a macrolide antibiotic) is a “-thromycin” drug, not a “-mycin/micin” drug. This drug is not ototoxic or nephrotoxic.

  5. Levofloxacin
    • Rationale:

      This answer is not correct because levofloxacin (a fluoroquinolone antibiotic) ends in -“cin”, not a “-mycin/micin”. This drug is not ototoxic or nephrotoxic.

Overview

Neomycin, gentamicin, and vancomycin are antibiotics which are super toxic to the ears (ototoxic) and to the kidneys (nephrotoxic).

Explanation

Learning Outcomes

Vancomycin (a glycopeptide antibiotic) and neomycin/gentamicin (both aminoglycoside antibiotics), and are classes of antibiotics which are used with caution since they each have serious side effects, including ototoxicity and nephrotoxicity. Nephrotoxicity produces kidney damage and is reflected in elevated blood urea nitrogen (BUN) and creatinine blood levels with decreasing urinary output. Tinnitus (ringing in the ears) and vertigo (dizziness) can indicate ear damage related to ototoxicity. Peak and trough blood level measurements are indicated for these antibiotics to monitor toxicity and assure adequate levels of the medication.

Test Taking Tip

The “-mycin mouse” helps the student remember the two major toxicities related to some -micin/-mycin drugs (neomycin, gentamicin, and vancomycin). Draw a kidney shaped mouse body, add extremely large ears, Add eyes, feet, and a tail for a complete “mouse” figure. The kidney shaped body represents nephrotoxicity and the large ears of the mouse will represent ototoxicity.

Video Rationale