Guidelines
Adverse Effects

Adverse Effects

Cranial Nerve VIII toxicity

Usually NOT reversible

Cochlear:

  • Hearing loss
  • Tinnitus

Vestibular:

  • Nausea
  • Vertigo
  • Balance

Assess for baseline impairment such as hearing deficits, balance issues, tinnitus, vertigo, etc

  • Inform patient of risk of ototoxicity and to report any symptoms.
  • Assess daily

Baseline and serial audiograms should be ordered for patients whose therapy is anticipated to exceed 14 days or in those at high risk for toxicity

Nephrotoxicity

May be reversible, single dose safe in sepsis

Higher risk when used with other nephrotoxins

  • Vancomycin
  • NSAIDS
  • Amphotericin B
  • Cyclosporine
  • Cisplatin
  • Contrast dye

Neuromuscular Blockade

Rare, flaccid paralysis, respiratory muscle weakness, contraindicated in myasthenia gravis