Ethambutol

Ethambutol
Names
Other names
(2S,2’S)-2,2’-(Ethane-1,2-diyldiimino)dibutan-1-ol[1]
Identifiers
74-55-5 YesY
3D model (Jmol) Interactive image
ChEBI CHEBI:4877 YesY
ChEMBL ChEMBL44884 YesY
ChemSpider 13433 YesY
DrugBank DB00330 YesY
ECHA InfoCard 100.000.737
EC Number 200-810-26
KEGG D07925 YesY
MeSH Ethambutol
PubChem 14052
UNII 8G167061QZ YesY
Properties
C10H24N2O2
Molar mass 204.31 g·mol−1
Appearance White crystals
Odor Odourless
log P −0.291
Pharmacology
J04AK02 (WHO)
  • B
Oral
Pharmacokinetics:
20–30%
Hepatic
3–4 hours
Renal
Related compounds
Related compounds
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
Infobox references

Ethambutol (commonly abbreviated EMB or simply E) is a medication primarily used to treat tuberculosis.[2] It is usually given in combination with other tuberculosis drugs, such as isoniazid, rifampicin and pyrazinamide. It may also be used to treat Mycobacterium avium complex, and Mycobacterium kansasii.[3]

It can cause problems with vision, liver problems and allergies among other side effects.[3] It is pregnancy category C in the United States due to concerns with eye issues and category A in Australia meaning that they did not find evidence of harm after being taken by many pregnant women.[3][4] It is reasonable to use during breast feeding if required.[3]

It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[5] It is sold under the trade names Myambutol and Servambutol.

Medical uses

Ethambutol is used along with other medications to treat a number of infections including: tuberculosis, Mycobacterium avium complex, and Mycobacterium kansasii.[3]

Adverse effects

Mechanism of action

Ethambutol is bacteriostatic against actively growing TB bacilli. It works by obstructing the formation of cell wall. Mycolic acids attach to the 5'-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyl transferase. Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.

Pharmacokinetics

It is well absorbed from the gastrointestinal tract and well distributed in body tissues and fluids. 50% is excreted unchanged in urine.

References

  1. "ethambutol (CHEBI:4877)". Chemical Entities of Biological Interest. UK: European Bioinformatics Institute. 18 August 2010. Main. Retrieved 26 April 2012.
  2. Yendapally R, Lee RE (March 2008). "Design, synthesis, and evaluation of novel ethambutol analogues". Bioorg. Med. Chem. Lett. 18 (5): 1607–11. doi:10.1016/j.bmcl.2008.01.065. PMC 2276401Freely accessible. PMID 18242089.
  3. 1 2 3 4 5 "Ethambutol Hydrochloride". The American Society of Health-System Pharmacists. Retrieved 24 April 2014.
  4. "Prescribing medicines in pregnancy database". Australian Government. 3 March 2014. Retrieved 22 April 2014.
  5. "WHO Model List of Essential Medicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
  6. Lim SA (April 2006). "Ethambutol-associated optic neuropathy" (PDF). Ann. Acad. Med. Singap. 35 (4): 274–8. PMID 16710500.
  7. Tripathi, K D (August 2015). Essentials of MEDICAL PHARMACOLOGY (Seventh ed.). India: JAYPEE BROTHERS MEDICAL PUBLISHERS. p. 769. ISBN 978-93-5025-937-5.
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