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Related to ethambutol hydrochloride: Pyrazinamide
Etibi (CA), Myambutol
Pharmacologic class: Synthetic antitubercular
Therapeutic class: Antitubercular, antileprotic
Pregnancy risk category B
Unknown. Thought to interfere with RNA synthesis of bacterial metabolites, decreasing mycobacterial replication.
Tablets: 100 mg, 400 mg
⊘Indications and dosages
➣ Adjunct in tuberculosis and atypical mycobacterial infection caused by Mycobacterium tuberculosis
Adults and adolescents: In patients who haven't received previous antitubercular therapy, 15 mg/kg P.O. daily. In patients who have received previous antitubercular therapy, 25 mg/kg P.O. daily, decreased after 60 days to 15 mg/kg daily.
• Renal impairment
• Hypersensitivity to drug
Use cautiously in:
• impaired renal or hepatic function, cataracts, optic neuritis, recurrent eye inflammation, diabetic retinopathy, gout
• pregnant patients
• children younger than age 13.
• Obtain specimens for culture and sensitivity testing, as necessary, before starting therapy and periodically throughout therapy.
• Give with food.
CNS: confusion, disorientation, malaise, dizziness, hallucinations, headache, peripheral neuritis
EENT: optic neuritis, blurred vision, decreased visual acuity, red-green color blindness, eye pain
GI: nausea, vomiting, abdominal pain, GI upset, anorexia
Hematologic: eosinophilia, thrombocytopenia
Hepatic: transient hepatic impairment
Metabolic: hyperuricemia, hypoglycemia
Musculoskeletal: joint pain, gouty arthritis
Respiratory: bloody sputum, pulmonary infiltrates
Skin: rash, pruritus, toxic epidermal necrolysis
Other: fever, anaphylactoid reactions
Drug-drug.Aluminum salts: delayed and reduced ethambutol absorption Other neurotoxic drugs: increased risk of neurotoxicity
Drug-diagnostic tests.Alanine aminotransferase, aspartate aminotransferase, bilirubin, uric acid: increased levels Glucose: decreased level
☞ Watch for serious adverse reactions, such as thrombocytopenia, respiratory problems, and anaphylactoid reactions.
• Monitor liver function tests, CBC, and blood urea nitrogen, creatinine glucose, and serum uric acid levels.
• Give analgesics for drug-induced pain, as prescribed.
• Observe for signs and symptoms of gout.
• Instruct patient to take with 8 oz of water. If stomach upset occurs, advise him to take with food.
• If patient must take antacids, advise him to take only aluminum-free antacids.
☞ Tell patient to immediately report easy bruising or bleeding, respiratory problems, or signs and symptoms of hypersensitivity reactions.
• Advise patient to report vision changes and to have annual eye exams. Reassure him that visual disturbances will subside within several weeks to months after drug is discontinued.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.