Aminoglycoside ototoxicity is characterized as predominantly cochlear (hearing loss) or vestibular (balance loss) depending on the agent. Which aminoglycoside preferentially causes VESTIBULAR toxicity?

• A Amikacin
• B Neomycin
• C Tobramycin
• D Gentamicin ✓

Explanation

Gentamicin and streptomycin preferentially damage vestibular hair cells, causing vertigo, nystagmus, and imbalance. Amikacin, neomycin, and tobramycin preferentially cause cochlear toxicity (high-frequency hearing loss). Netilmicin has the least ototoxicity overall. Ototoxicity results from drug accumulation in inner ear fluids and formation of reactive oxygen species damaging hair cells. The toxicity is permanent and monitoring for vestibular and auditory symptoms is essential.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.