Ostroumova O D, Chikh E V, Rebrova E V, Ryazanova A Yu, Pereverzev A P
Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia, 119991; Federal State Budgetary Educational Institution of Higher Education 'N.I. Pirogov Russian National Research Medical University' of the Ministry of Health of the Russian Federation.
Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia, 119991.
Vestn Otorinolaringol. 2019;84(4):72-80. doi: 10.17116/otorino20198404172.
The ability of drugs to have an ototoxic effect has been studied for a long time, however, the true prevalence of this undesirable phenomenon is unknown, which is due to the use of various audiological protocols, a wide range of reactions to drugs in different ethnic groups, and most importantly, the lack of caution with regard to otological symptoms due to their reversibility or lack of immediate threat to life. Drug-induced ototoxicity is a functional disorder of the inner ear (cochlea and/or vestibular apparatus) or eighth pair of cranial nerves. Pharmacotherapy, associated with the development of ototoxic drug reactions, may remain undervalued for a long time, often until irreversible hearing impairment is formed. The most frequently prescribed drugs that cause ototoxic phenomena include anticancer drugs, antibacterial drugs of the aminoglycoside group, loop diuretics, calcium channel blockers, non-steroidal anti-inflammatory drugs, antimalarial drugs, salicylates, etc. Monitoring the degree of hearing impairment before and during therapy is important in preventing the development of drug-induced ototoxicity and makes it possible to consider alternative treatment regimens in a timely manner. It is in this connection that the role of participation in the appointment of rational pharmacotherapy to patients with a potential risk of developing otological phenomena of a clinical pharmacologist and audiologist undoubtedly increases.
药物产生耳毒性作用的能力已经被研究了很长时间，然而，这种不良现象的真实发生率尚不清楚，这是由于使用了各种听力学检测方法、不同种族对药物的广泛反应，以及最重要的是，由于耳科症状具有可逆性或对生命没有直接威胁而缺乏对其的谨慎关注。药物性耳毒性是内耳（耳蜗和/或前庭器官）或第八对脑神经的功能障碍。与耳毒性药物反应发生相关的药物治疗可能长期未得到重视，通常直到形成不可逆的听力损害。最常引起耳毒性现象的药物包括抗癌药物、氨基糖苷类抗菌药物、袢利尿剂、钙通道阻滞剂、非甾体抗炎药、抗疟药、水杨酸盐等。在治疗前和治疗期间监测听力损害程度对于预防药物性耳毒性的发生很重要，并且能够及时考虑替代治疗方案。正是在这方面，临床药理学家和听力学家参与为有发生耳科现象潜在风险的患者制定合理药物治疗的作用无疑增加了。
