Which drug is implicated in causing irreversible cochleotoxicity with a predilection for outer hair cell damage, especially in the basal turn of the cochlea, causing high-frequency hearing loss first?

• A Furosemide
• B Aspirin
• C Aminoglycoside antibiotics (e.g., gentamicin) ✓
• D Hydroxychloroquine

Explanation

Aminoglycoside antibiotics (gentamicin, amikacin, neomycin, tobramycin) are classically associated with irreversible cochleotoxicity through generation of reactive oxygen species that damage outer hair cells. The basal cochlear turn (which processes high frequencies) is affected first, causing high-frequency sensorineural hearing loss progressing toward lower frequencies with prolonged exposure. Furosemide and ethacrynic acid cause reversible SNHL. Aspirin causes reversible tinnitus and SNHL. Gentamicin is also vestibulotoxic.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.