Hearing impaired

This drug is contraindicated in patients with known hypersensitivity to vancomycin. Vancomycin is used cautiously in patients with renal or hearing impairment and during pregnancy (Category C) and lactation. 

Older patients ear pain (mild, moderate, or severe), ear fullness, hearing impairment... 

Presence of middle ear effusion in the absence of symptoms is not an indicator of treatment failure. Children who complete therapy and are otherwise healthy should be reevaluated after 3 months for the presence of effusion that requires a hearing evaluation. Preschool-aged and younger children may need reexamination 3 to 6 weeks after therapy because speech and hearing impairment is more difficult to assess in this age group. 

Schwartz J, Otto D. 1991. Lead and minor hear impairment. Arch Environ Health 46 300-305. 

Significant impairment of motor coordination and loss of good judgment Speech can be slurred balance, vision, reaction time, and hearing impaired. Euphoria. It is illegal to operate a motor vehicle at this level of intoxication. 

Always put the person ahead of the disability, as in person with impaired hearing, rather than hearing-impaired person. 

Ofofox/c/fy. Tinnitus, reversible and irreversible hearing impairment, deafness, and vertigo with a sense of fullness in the ears have been reported. Deafness is usually reversible and of short duration (1 to 24 hours) however, irreversible hearing impairment has occurred. Usually, ototoxicity is associated with rapid injection, with severe renal impairment, with doses several times the usual dose, and with concurrent use with other ototoxic drugs. 

Miscellaneous Epistaxis dry nose or mouth transient chest pain (rarely persists after discontinuation) vasculitis (including Wegener s granulomatosis) anemia lymphadenopathy edema tinnitus hearing impairment weight loss. 

WARNING Systemic absorption of oral route may cause neuro/oto/nephrotox may result resp paralysis possible w/ any route of administration Uses Hepatic coma, bowel prq) Action Aminoglycoside, poorly absorbed PO -1- GI bacterial flora Dose Adults. 3-12 g/24- h PO in 3-4 doses Peds. 50-1 (X) mg/kg/24 h PO in 3-4 doses Caution [C, /-] Renal failure, neuromuscular disorders, hearing impair Contra Intestinal obst Disp Tabs, PO soln SE Hearing loss w/ long-term use rash, NA EMS Use neuromuscular blockers w/ caution, reduced dose may be necessary t bleeding risk w/ concurrent anticoagulant use OD May cause neuromuscular block and kidney failure calcium salts can be used to revise neuromuscular block... 

The pharmacological effect is exerted by unbound drug molecules. Thus, if only total drug concentrations (e.g. in plasma) are analysed, one should consider whether these measurements are reflective of the concentrations at the site of action. If the unbound drug fraction is more relevant than the total concentration, e.g. because of saturable protein binding, it should be used as the independent variable in the PK-PD model. Figure 5 shows the consistency of the PK-PD relationship between total, as well as unbound quinine concentration and hearing impairment in man. 

Fig. 6. Counterclockwise hysteresis appearing between hearing threshold shift and quinine plasma concentration in a subject who received two identical oral doses (dotted and solid lines) and an infusion (dashed line) of quinine. (From Paintaud G, Alvan G, Beminger E et al. The concentration-effect relationship of quinine-induced hearing impairment. Clin Pharmacol Ther 1994 55 317-23, with permission from MOSBY Inc.)...

The concentration-effect relationship of qninine-induced hearing impairment. Clin Pharmacol Ther... 

Vetter DE, Li C, Zhao L, Contarino A, Liberman MC, Smith GW, Marchuk Y, Koob GF, Heinemann SF, Vale W, Lee KF (2002) Urocortin-deficientmice show hearing impairment and increased anxiety-like behavior. Nat Genet 31 363-369... 

Anorexia, headache, vomiting, flatulence, dizziness, somnolence, insomnia, fatigue, hearing impairment... 

Cunningham, M., Cunningham, K., Lydiard, R.B. (1990) Eye tics and subjective hearing impairment during fluoxetine therapy. Am J Psychiatry 147 947-948. 

Methylmercury intoxication affects mainly the central nervous system and results in paresthesias, ataxia, hearing impairment, dysarthria, and progressive constriction of the visual fields. Signs and symptoms of methylmercury intoxication may first appear several weeks or months after exposure begins. Methylmercury is a reproductive toxin. High-dose prenatal exposure to methylmercury may produce mental retardation and a cerebral palsy-like syndrome in the offspring. Low-level prenatal exposures to methylmercury have been associated with a risk of subclinical neurodevelopmental deficits. 

Hearing loss is typically measured as the shift in auditory threshold relative to that of a normal ear for the detection of a pure tone. Hearing loss varies in severity, and the classification of hearing impairment is presented in Table 6.1 [Goodman, 1965],... 

Brey et ah, 1987] Brey, R., Robinette, M., Chabries, D., and Christiansen, R. (1987). Improvement in speech intelligibility in noise employing an adaptive filter with normal and hearing-impaired subjects. J. Rehab. Res. and Devel., 24 75-86. 

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