Vancomycin can cause which two toxicities?

• A. Nephrotoxicity and Ototoxicity
• B. Hepatotoxicity and Neuropathy
• C. Hypothyroidism
• D. Skin rash

Answer: (A)

Vancomycin can damage the kidneys and the ears. Nephrotoxicity shows up as rising creatinine and decreased urine output, especially when trough levels are high or therapy is prolonged or used with other nephrotoxic drugs. Ototoxicity presents as tinnitus, dizziness, or hearing loss, typically sensorineural, and the risk increases with high trough levels, longer course, preexisting hearing loss, or concurrent loop diuretics. Monitoring renal function and vancomycin levels, adjusting dose for kidney function, and watching for early signs of hearing changes help prevent these toxicities. Other listed effects like hepatotoxicity, neuropathy, hypothyroidism, or simple skin rash are not the classic toxicities associated with vancomycin.