What is the main side effect of Streptomycin?

Appeared in: Bihar CHO - 2021

Explanation

Streptomycin is an aminoglycoside antibiotic used in treating tuberculosis.
The primary and most significant adverse effect of aminoglycosides is toxicity to the eighth cranial nerve (vestibulocochlear nerve).
This toxicity, known as ototoxicity, can damage the cochlear portion, causing tinnitus and hearing loss, or the vestibular portion, causing vertigo and balance problems.
The damage can be permanent, making it a critical side effect to monitor.

Option A: Blood dyscrasias (abnormalities of blood cells) are not considered a main or common side effect of Streptomycin.
Option B: While many anti-TB drugs are hard on the liver, hepatotoxicity is the main concern for Isoniazid (INH), Rifampin, and Pyrazinamide.
Option C: Visual disturbance, specifically optic neuritis, is the characteristic main side effect of Ethambutol.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Adverse effects of anti-tubercular medications as background academic context rather than a clinical decision trigger.
A nurse's primary role is patient safety, which includes monitoring for drug toxicity.
For a patient on Streptomycin, the nurse must assess for early signs of ototoxicity, such as tinnitus, hearing difficulty, or complaints of dizziness and imbalance.
Baseline and periodic audiometry (hearing tests) and renal function tests (BUN, creatinine) are essential, as poor kidney function increases the risk of drug accumulation and toxicity.

How to Approach the Question

First, identify the keyword in the question stem: 'Streptomycin'.
This is a factual recall question that tests your knowledge of pharmacology.
Recall the drug class for Streptomycin, which is an aminoglycoside.
Remember the classic toxicities associated with aminoglycosides: ototoxicity (ear toxicity) and nephrotoxicity (kidney toxicity).
Scan the options provided. 'Ototoxicity' directly matches one of the known main side effects.
Mentally cross-check the other options: Hepatotoxicity is linked to INH/Rifampin/Pyrazinamide, and Visual Disturbance is linked to Ethambutol, confirming Ototoxicity is the correct choice for Streptomycin.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1836-1838

E6 Pharmacology Katzung 16e p. 1319-1321

Practise the full Bihar CHO - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.