Notes in 3. Ethambutol & 4. Pyrazinamide

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Published	10/21/2024	Ethambutol is a {{c1::synthetic}}, {{c1::water-soluble}}, and {{c1::heat-stable}} drug used to treat tuberculosis
Published	10/21/2024	The typical dosage of ethambutol is {{c1::15-25 mg/kg}} once daily
Published	10/21/2024	The mechanism of action of ethambutol is being {{c1::bacteriostatic}} by inhibiting {{c1::mycobacterial arabinosyl transferases}}
Published	10/21/2024	Ethambutol achieves a blood level peak of {{c1::2-5 mcg/ml}} within {{c1::2-4 hours}} and is well absorbed from the gut
Published	10/21/2024	Metabolism of ethambutol occurs in the liver via {{c1::Alcohol dehydrogenase}}, leading to its breakdown into {{c1::Aldehyde}} and then {{c1::Dicarbox…
Published	10/21/2024	When the meninges are inflamed, ethambutol can cross the {{c1::Blood-Brain Barrier (BBB)}}
Published	10/21/2024	Ethambutol is excreted through feces {{c1::20% }} and urine {{c1::50%}} through predominantly in an unchanged form
Published	10/21/2024	Clinical use of ethambutol includes the {{c1::intensive phase}} of TB treatment and always in combination with other anti-TB drugs
Published	10/21/2024	For TB meningitis, a higher dosage of ethambutol might be used which is up to {{c1::50 mg/kg}}
Published	10/21/2024	Ethambutol is also used for treating {{c1::nontuberculous mycobacterial infections}} in combination with other drugs
Published	10/21/2024	The most common adverse effect of ethambutol is {{c1::retrobulbar neuritis}}
Published	10/21/2024	Retrobulbar neuritis can lead to {{c1::loss of visual acuity}} and {{c1::red-green color blindness (25mkd)}}
Published	10/21/2024	Ethambutol is usually contraindicated in {{c1::children}} too young to assess visual acuity and color discrimination
Published	10/21/2024	Ethambutol is widely distributed throughout the body, including the {{c1::kidneys, lungs and saliva}}
Published	10/21/2024	Due to its potential risk to the kidneys, {{c1::renal dose adjustments}} should be made when administering ethambutol
Published	10/21/2024	Unlike ethambutol, both {{c1::Isoniazid}} and {{c1::Rifampin}} do not require renal adjustments
Published	10/21/2024	Pyrazinamide is a drug that is {{c1::highly water soluble}} and is {{c1::inactive at neutral pH}}
Published	10/21/2024	The standard dosage of Pyrazinamide is {{c1::30-50 mg/kg}} thrice-weekly or twice-weeklyBUT for patients with creatinine clearance of <30 ml/min, t…
Published	10/21/2024	Pyrazinamide acts as a {{c1::bacteriostatic}} agent
Published	10/21/2024	Pyrazinamide is converted by {{c1::mycobacterial pyrazinamidase}} into its active form, pyrazinoic acid (PZA)
Published	10/21/2024	PZA disrupts {{c1::mycobacterial cell membrane metabolism}} and {{c1::transport function}}
Published	10/21/2024	Pyrazinamide is well absorbed from the GI tract and has a half-life of {{c1::8-11 hours}}
Published	10/21/2024	Pyrazinamide is mainly metabolized by the {{liver}} with its excretion primarily through the {{c1::kidneys}}
Published	10/21/2024	Clinically, Pyrazinamide is used as a front-line drug in TB treatment, particularly in conjunction with {{c1::isoniazid and rifampin}} in a short cour…
Published	10/21/2024	Pyrazinamide serves as a {{c1::sterilizing}} agent against residual intracellular organisms
Published	10/21/2024	Common adverse effects of Pyrazinamide include:{{c1::hepatotoxicity}} (in 1-5% of patients){{c1::nausea}}{{c1::vomiting}}{{c1::drug fever}}{{c1::photo…
Published	10/21/2024	Although Pyrazinamide can cause {{c1::hyperuricemia}}, it is not a reason to halt therapy if the patient is {{c1::asymptomatic}}
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