Carbamazepine toxicity induced by lopinavir/ritonavir and nelfinavir.

Objective: To present a case of carbamazepine toxicity induced by lopinavir/ritonavir and nelfinavir.

Case Summary: A 50-year-old HIV-positive male developed excessive drowsiness secondary to carbamazepine when an antiretroviral regimen containing lopinavir/ritonavir was introduced. The carbamazepine serum concentration increased 46%.

Aminoglycoside ototoxicity.

Over the last 10 years new information has been published providing a better understanding of the risk factors, mechanism and prevention of aminoglycoside ototoxicity. The use of a higher dose and once-daily intravenous administration of aminoglycosides has shown clinical effectiveness with no increase in ototoxicity when compared to traditional regimens. An enhanced susceptibility to aminoglycoside cochlear toxicity has been linked to an A-to-G substitution in location 1555 of the mitochondrial ribosomal ribonucleic acid (RNA).

Ototoxicity induced by gentamicin and furosemide.

Objective: To present a case of ototoxicity induced by furosemide and once-daily gentamicin therapy.

Case Summary: A 60-year-old white woman presented to the hospital with community-acquired pneumonia and urinary tract infection. The antibiotic regimen included gentamicin and, after 5 doses, the patient reported profound bilateral hearing loss.