▁of ▁the ▁population ▁who ▁receives ▁am in og ly cos ides ▁experience ▁damage ▁to ▁their ▁inner ▁ear . ▁The ▁common ▁sympt oms ▁of ▁inner ▁ear ▁damage ▁include ▁t inn it us , ▁hearing ▁loss , ▁vert igo , ▁trouble ▁with ▁coord ination , ▁and ▁d izz iness . ▁Chron ic ▁use ▁of ▁gent am ic in ▁can ▁affect ▁two ▁areas ▁of ▁the ▁ears . ▁First , ▁damage ▁of ▁the ▁inner ▁ear ▁hair ▁cells ▁can ▁result ▁in ▁irre vers ible ▁hearing ▁loss . ▁Second , ▁damage ▁to ▁the ▁inner ▁ear ▁vest ib ular ▁appar atus ▁can ▁lead ▁to ▁balance ▁problems . ▁To ▁reduce ▁the ▁risk ▁of ▁o tot ox icity ▁during ▁treatment , ▁it ▁is ▁recommended ▁to ▁stay ▁hyd r ated . ▁ ▁Fact ors ▁that ▁increase ▁the ▁risk ▁of ▁inner ▁ear ▁damage ▁include : ▁ ▁In cre ased ▁age ▁ ▁High ▁blood ▁u ric ▁acid ▁levels ▁ ▁Kid ney ▁d ys function ▁ ▁Liver ▁d ys function ▁▁ ▁High er ▁dos es ▁▁ ▁Long ▁courses ▁of ▁ther apy ▁ ▁Also ▁taking ▁strong ▁di ure t ics ▁( e . g ., ▁fu ros em ide ) ▁ ▁Mechan ism ▁of ▁action ▁Gent am ic in ▁is ▁a ▁b acter ic idal ▁ant ib i otic ▁that ▁works ▁by ▁binding ▁the ▁ 3 0 S ▁sub unit ▁of ▁the ▁b acter ial ▁rib os ome , ▁neg atively ▁impact ing ▁protein ▁synth esis . ▁The ▁primary ▁mechanism ▁of ▁action ▁is ▁generally ▁accepted ▁to ▁work ▁through ▁ab l ating ▁the ▁ability ▁of ▁the ▁rib os