Drug Side Effects on Audiological and Vestibular Testing

By Robert M. DiSogra

This article is a part of the May/June 2017, Volume 29, Number 3, Audiology Today issue.

There are over 2,000 drugs and more than 400 side effects that could impact the accuracy of the audiometric or vestibular evaluation and the recommendations made for intervention and management (DiSogra, 2008, 2001).

During clinical trials, incidence figures of an adverse event (side effect) might be extremely low and reported as “rare” or “less frequent.” One person in 100 might report that their ears are ringing, however it could be reported as tinnitus, roaring, ear disturbances, or auditory hallucinations.

There is a wealth of drug information available on the internet, but it is incumbent on you to know what websites provide reliable, accurate, and up-to-date information especially reported adverse reactions or side effects.

Some websites that offer reliable drug information include (but not limited to): www.drugs.com, www.rxlist.com, www.earserv.com.drugs (audiology-specific side effects), and www.epocrates.com. The aforementioned websites do not represent an endorsement by the author or the American Academy of Audiology.

Audiology 101—The Case History

Typical case history questions to the patient are: “What medications are you currently taking?” “Why are you taking them?” “How long have you been taking them?” As simple as these questions are, it is the first step for possible problems.

A survey in the United States of a representative sampling of 2,206 community-dwelling adults (aged 62–85 years) was conducted by in-home interviews and use of medication logs between 2010 and 2011. At least one prescription medication was used by 87 percent of those surveyed. Five or more prescription medications were used by 36 percent, and 38 percent used over-the-counter medications (Qato, 2016). The Centers for Disease Control and Prevention (2016) estimated 75 percent of persons older than age 60 take two or more drugs, and those older than 90 take five or more medications.

In addition to pharmaceuticals, Kennedy (2005) reported that an estimated 38.2 million adults in the United States used herbs and/or supplements in 2002. Of interest is that only a third of the participants told their health-care provider about their herb or supplement use.

Medication side effects may influence an older patient’s understanding of your question(s) or test instructions and capacity to stay focused on the required task for a particular test. For example, some medications might have an obvious auditory side effect (e.g., tinnitus), might influence vestibular testing (e.g., oculomotor dysfunction), or have a cognitive side effect (e.g., confusion).