The Fluoroquinolone Toxicity Research Foundation

 
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Kidney Damage Research   See downloads for: Adobe Files



Quinolones associated with damage to the kidneys by a toxic substance


The aminoglycosides are capable of causing nephrotoxicity
(damage to the kidneys by a toxic substance) and
ototoxicity (damage to the organs of hearing by a toxic
substance). Signs and symptoms of nephrotoxicity may
include protein in the urine (proteinuria), hematuria
(blood in the urine), increase in the blood urea nitrogen
level, decrease in urine output, and an increase in the
serum creatinine concentration. Nephrotoxicity is usu-ally
reversible once the drug is discontinued. Signs and
symptoms of ototoxicity include tinnitus, dizziness,
roaring in the ears, vertigo, and a mild to severe loss of
hearing. If hearing loss occurs, it is most often permanent.
Ototoxicity may occur during drug therapy or
even after the drug is discontinued. The short-term
administration of kanamycin and neomycin as a prepa-ration
for bowel surgery rarely causes these two adverse
reactions.


Neurotoxicity (damage to the nervous system by a
toxic substance) may also be seen with the administration
of the aminoglycosides. Signs and symptoms of
neurotoxicity include numbness, skin tingling, circumoral
(around the mouth) paresthesia, peripheral paresthesia,
tremors, muscle twitching, convulsions, muscle
weakness, and neuromuscular blockade (acute muscular
paralysis and apnea).

Additional adverse reactions seen with administration
of the aminoglycosides may include nausea, vomiting,
anorexia, rash, and urticaria. When these drugs are
given, individual drug references, such as the package
insert, should be consulted for more specific adverse
reactions.


Like the other anti-infectives, bacterial or fungal
superinfections and pseudomembranous colitis (see
Chap. 7) may occur with the use of these drugs. The
administration of the aminoglycosides may result in a
hypersensitivity reaction, which can range from mild to
severe and in some cases can be life threatening. Mild
hypersensitivity reactions may only require discontinu-ing
the drug, whereas the more serious reactions require
immediate treatment.

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