Names and pronunciation
(e-tham′byoo-tole) Etibi , Myambutol
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Individual generic drug information
Extracted information for ethambutol only.
(e-tham′byoo-tole) Etibi , Myambutol
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Func. class.: Antitubercular
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Chem. class.: Diisopropylethylene diamide derivative
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ACTION: Inhibits RNA synthesis, decreases tubercle bacilli replication
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USES: Pulmonary TB as an adjunct, other mycobacterial infections
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Extracted information for ethambutol only.
CONTRAINDICATIONS: Children <13 yr, hypersensitivity, optic neuritis Precautions: Pregnancy, breastfeeding, renal disease, diabetic retinopathy, cata- racts, ocular defects, hepatic and hema- topoietic disorders
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SIDE EFFECTS CNS: Headache, confusion, fever, mal- aise, dizziness, disorientation, halluci- nations, peripheral neuropathy EENT: Blurred vision, optic neuritis, pho- tophobia, decreased visual acuity GI: Abdominal distress, anorexia, nau- sea, vomiting INTEG: Dermatitis, pruritus, toxic epider- mal necrolysis, erythema multiforme META: Elevated uric acid, acute gout, impaired hepatic function MISC: Thrombocytopenia, joint pain, anaphylaxis
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INTERACTIONS • Delayed absorption of ethambutol: aluminum salts, separate by 4 hr • Neurotoxicity: other neurotoxics NURSING CONSIDERATIONS
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Extracted information for ethambutol only.
DOSAGE AND ROUTES • Adult/child >13 yr: PO 15-25 mg/kg/ day as single dose (treatment naive) or 25 mg/kg daily (treatment experienced) Renal disease • Adult: PO CCr 10-50 mL/min, dose q24-36hr; CCr <10 mL/min, dose q48hr Retreatment • Adult: PO 25 mg/kg/day as single E dose × 2 mo with at least 1 other prod- uct, then decrease to 15 mg/kg/day as single dose, max 2.5 g/day • Child: PO 15 mg/kg/day
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Available forms: Tablets 100, 400 mg
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Administer: • With meals to decrease GI symptoms • Antiemetic if vomiting occurs • After C&S completed; monthly to de- tect resistance • 4 hr between this product and antacids
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Extracted information for ethambutol only.
Assess: • Hepatic studies weekly × 2 wk, then q2mo: ALT, AST, bilirubin; de- creased appetite, jaundice, dark urine, fatigue • Signs of anemia: Hct, Hb, fatigue • Mental status often: affect, mood, behavioral changes; psychosis may occur • C&S, including sputum, prior to treatment • Visual status: decreased acuity, altered color perception • Serious skin reactions: toxic epider- mal necrolysis • Pregnancy/breastfeeding: use only if benefit outweighs risk to fetus; product appears in breast milk
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Evaluate: • Therapeutic response: decreased symptoms of TB, decrease in acid-fast bacteria
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Patient and caregiver information: • To avoid alcohol products • That compliance with dosage sched- ule, duration is necessary • That scheduled appointments must be kept or relapse may occur • To report to prescriber any visual changes; rash; hot, swollen, painful joints; numbness, tingling of extremities
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Extracted information for ethambutol only.
PHARMACOKINETICS Peak 2-4 hr, half-life 3 hr, metabolized in liver, excreted in urine (unchanged product/inactive metabolites, unchanged product in feces)
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Filter the extracted dose blocks for this individual drug.
• Adult/child >13 yr: PO 15-25 mg/kg/ day as single dose (treatment naive) or 25 mg/kg daily (treatment experienced) Renal disease
Candidate age grouping · source page 527
• Adult: PO CCr 10-50 mL/min, dose q24-36hr; CCr <10 mL/min, dose q48hr Retreatment
Candidate age grouping · source page 527
• Adult: PO 25 mg/kg/day as single E dose × 2 mo with at least 1 other prod- uct, then decrease to 15 mg/kg/day as single dose, max 2.5 g/day
Candidate age grouping · source page 527
• Child: PO 15 mg/kg/day
Candidate age grouping · source page 527