Q: 44 years old female is in cardiac ICU due to shortness of breath secondary to her underlying pulmonary hypertension and right ventricular (RV) dysfunction. She complains of sudden hearing loss. Which of the following drug can be a probable cause?
A) milrinone
B) inhaled Nitric Oxide (iNO)
C) sildenafil
D) hydralazine
E) lisinopril
Answer: C
A less known side effect of Phosphodiesterase-5 inhibitors (PD-5 I) such as sildenafil, vardenafil, and tadalafil is sudden hearing loss. This hearing loss is usually one-sided and occurs within the first 24 hours of initiation. In about two-thirds of patients, it can be permanent.
All other choices in the above question have no profile of this side effect so far.
#pharmacology
#pulmonary
#hemodynamics
References:
1. Thakur JS, Thakur S, Sharma DR, et al. Hearing loss with phosphodiesterase-5 inhibitors: a prospective and objective analysis with tadalafil. Laryngoscope 2013; 123:1527.
2. Khan AS, Sheikh Z, Khan S, et al. Viagra deafness--sensorineural hearing loss and phosphodiesterase-5 inhibitors. Laryngoscope 2011; 121:1049.
3. Maddox PT, Saunders J, Chandrasekhar SS. Sudden hearing loss from PDE-5 inhibitors: A possible cellular stress etiology. Laryngoscope 2009; 119:1586.
No comments:
Post a Comment