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Ethambutol
⚠️ Can cause retrobulbar / optic neuritis – risk increases with high doses and prolonged use.
📖 About
Always check the BNF link here.
- 💊 Used in combination therapy for tuberculosis.
- 🛑 Bacteriostatic agent (not bactericidal).
⚙️ Action
- 🔗 Inhibits mycobacterial arabinosyl transferases, enzymes essential for cell wall arabinogalactan synthesis.
- 🧱 Weakens mycobacterial cell wall.
🧪 Properties
- 🧠 Enters CSF if meninges are inflamed (e.g., TB meningitis).
💉 Indications
- 🏥 Tuberculosis – always given in combination with at least 3 other anti-TB drugs (to prevent resistance).
🔄 Interactions
- ⚠️ Aluminium-containing antacids ↓ absorption → avoid co-administration.
⚠️ Cautions
- 💧 Reduce dose in renal failure (renally cleared).
- 👀 Regular visual monitoring required during therapy.
⛔ Contraindications
- 🚫 Patients in whom visual monitoring is not possible (e.g., very young children).
- 🚫 History of optic neuritis / retrobulbar neuritis.
💥 Side Effects
- 👁️ Retrobulbar / optic neuritis → ↓ visual acuity, impaired red–green colour discrimination (reversible if drug stopped early).
- 🌡️ Hypersensitivity reactions (rare).
📊 Dose
- 💊 Standard: 15 mg/kg OD PO (usually combined with rifampicin, isoniazid, and pyrazinamide).
- 🧠 Higher doses may be used in TB meningitis (specialist advice).
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