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Related Concept Videos

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...

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Related Experiment Video

Updated: Jun 23, 2026

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
08:38

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Published on: April 18, 2019

Horizontal head impulse test detects gentamicin vestibulotoxicity.

K P Weber1, S T Aw, M J Todd

  • 1Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia.

Neurology
|April 22, 2009
PubMed
Summary

Gentamicin can cause bilateral vestibular loss (BVL). Head impulse testing (HIT) effectively detects this, revealing significant saccade abnormalities in patients with gentamicin vestibulotoxicity (GVT), aiding early diagnosis.

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Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
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Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity

Published on: March 16, 2018

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Last Updated: Jun 23, 2026

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
08:38

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Published on: April 18, 2019

Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
09:52

Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity

Published on: March 16, 2018

Area of Science:

  • Oto-neurology
  • Vestibular neurophysiology
  • Clinical audiology

Background:

  • Gentamicin, an antibiotic, can induce bilateral vestibular loss (BVL) through ototoxicity.
  • This toxicity affects vestibular hair cells, leading to impaired balance and eye movement control.

Purpose of the Study:

  • To quantify horizontal vestibulo-ocular reflex (VOR) gain deficits in patients with gentamicin vestibulotoxicity (GVT) using a graded head impulse test (HIT).
  • To compare HIT findings with standard caloric and rotational testing.
  • To characterize HIT catch-up saccade patterns for clinical application.

Main Methods:

  • Horizontal head impulse testing (HIT) with graded accelerations (750–6,000 degrees/sec²) was performed.
  • Measurements utilized binocular dual search coils in 14 GVT patients, 14 normal subjects, and one control with surgical BVL.

Main Results:

  • Patients exhibited symmetric HIT gain deficits, ranging from mild to complete BVL, even at low accelerations.
  • HIT gain correlated strongly with caloric testing (rho = 0.85) and moderately with rotational testing (rho = 0.55).
  • GVT patients showed significantly larger cumulative overt saccade amplitudes and fewer covert saccades compared to unilateral deafferentation patients.

Conclusions:

  • Head impulse testing (HIT) is valuable for early bedside detection of gentamicin vestibulotoxicity (GVT).
  • The presence of large overt saccades in most GVT patients, even with partial bilateral vestibular loss (BVL), facilitates diagnosis.
  • Covert saccades are less frequent in GVT patients, potentially masking the extent of BVL but can still be present in total BVL.