Vestibular nerve damage

All aminoglycosides are associated with auditory or vestibular nerve damage, especially during the second and third trimesters. The risk is greatest with streptomycin and is lower with gentamicin and tobramycin. 

Q7 has an increased risk of neonatal haemolysis during the third trimester Q8 may cause vestibular or auditory nerve damage Q9 should be stopped at least 2 days before delivery Q10 consists of a folate antagonist that poses a teratogenic risk... 

The risk of severe neurotoxic reactions is sharply increased in patients with impaired renal function or prerenal azotemia. These include disturbances of vestibular and cochlear function, optic nerve dysfunction, peripheral neuritis, arachnoiditis, and encephalopathy. The incidence of clinically detectable, irreversible vestibular damage is particularly high in patients treated with streptomycin. 

All the aminoglycosides produce cochlear and vestibular damage (ototoxicity) which is a dose and duration of treatment related side effect. Another serious side effect is nephrotoxicity. Aminoglycosides also reduce the acetylcholine release from the motor nerve endings and cause neuromuscular blockade. 

Platinum-based chemotherapeutics induced hair cell death in rodents, albeit in variable patterns. In guinea pig, mice, and rat, cisplatin caused hearing loss that correlated to the loss of hair cells [36]. In the chinchilla, cisplatin predominantly affected outer hair cells and neurons [57], In contrast, carboplatin damaged IHCs, vestibular hair cells and auditory nerves only in chinchillas, and showed little ototoxic potency in other rodents and humans [41, 57, 58]. 

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