Tobramycin and deafness

[Guest guest]

Aminoglycoside antibiotics such as gentamicin and tobramycin are

known to be ototoxic. Oto refers to the ear, so otoxic means

something is toxic to the auditory (hearing) and vestibular (balance)

system.

These meds cause hearing loss and vestibular damage. Vestibular

damage results in vertigo (dizziness). In some people, vertigo can be

so severe that the person finds it difficult to function normally.

This is not just your typical dizziness, but more like constant room

spinning or rocking.

This is one reason doctors (are supposed to) closely monitor blood

levels while you're on gentimicin or tobramycin. Doctors used to

believe inhaling TOBI wouldn't cause ototoxicity but they're

rethinking this. Another reason to monitor blood levels is to protect

the kidneys.

In 1995, the Hopkins School of Medicine, Center of Hearing and

Balance, posted the following statement to their web site:

" A daily Romberg test and measurement of the visual acuity with head

rotation are simple bedside techniques that should be done every day. "

Here's a link from NurseWeek that briefly explains the Romberg test.

If your healthcare provider isn't doing this, then you can easily do

it.

http://216.155.28.162/nurse/courses/NurseWeek/NW0170/c5/p14.htm

Also, keep in mind that gentamicin and tobramycin (including inhaled

TOBI) greatly deplete the body of magnesium. Magnesium deficiency is

more common in people who develop ototoxicity.

There are a couple studies showing that if you give magnesium

supplements BEFORE taking aminoglycoside antibiotics, then you can

reduce instances of ototoxicity. And another study suggests that if

you give magnesium supplements as soon as possible after ototoxicity

develops, then you can lessen symptoms. You have to do this within 8

days.

Because most people with CF take daily meds that deplete magnesium

(such as albuterol, xopenex, steroids, antifungals, and nearly every

oral antibiotic on the market, including IV antibiotics), it's a wise

idea to take a good quality, highly bioavailable magnesium supplement

daily. This will also help prevent bone loss.

Just be sure to watch the timing of taking magnesium. You can take it

two hours *after* swallowing an antibiotic, or:

2-4 hours *before* taking Zithromax

6-7 hours *before* taking Cipro.

Kim

[Guest guest]

>

> Because most people with CF take daily meds that deplete magnesium

> (such as albuterol, xopenex, steroids, antifungals, and nearly

every

> oral antibiotic on the market, including IV antibiotics), it's a

wise

> idea to take a good quality, highly bioavailable magnesium

supplement

> daily. \

I am most impressed Kim. Great information.

jan