Which aminoglycoside is most strongly associated with COCHLEAR (auditory) toxicity rather than vestibular toxicity?

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

Explanation

Amikacin and kanamycin preferentially damage the cochlear hair cells, causing high-frequency hearing loss and deafness. Gentamicin and tobramycin are predominantly vestibulotoxic, producing vertigo, nystagmus and ataxia, while streptomycin is classically vestibular as well. All aminoglycosides can cause both patterns, but the relative predilection of amikacin for the cochlea is the examined distinction. Toxicity is irreversible and related to cumulative dose.

Reference: Katzung Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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