์ํ๋ถํจ
์ํ๋ถํจ์ ํฉ์ฑ ์ ๊ท ์ฑ ํญ๋ง์ด์ฝ๋ฐํ ๋ฆฌ์ ์ฝ๋ฌผ๋ก, ์ฃผ๋ก ๋ค์ ๋ณ์ฉ ์๋ฒ('์นตํ ์ผ ์๋ฒ')์ ์ผ๋ถ๋ก ์ฌ์ฉ๋์ด ๋์น์ฑ ๋ง์ด์ฝ๋ฐํ ๋ฆฌ์ ๊ฐ์ผ(๊ฒฐํต๊ท , ์๊ฒฐํต๊ท , ์กฐ๋ฅํ ๊ฒฐํต๊ท ๋ณตํฉ์ฒด ๋ฑ)์ ์น๋ฃํฉ๋๋ค. **์์์ ์ง์ฃผ:** ๋จ๊ณ์ ๋ด์ฑ ๋ฐํ์ ๋ฐฉ์งํ๊ธฐ ์ํด ๋จ๋ ์๋ฒ์ ์๊ฒฉํ ๊ธ์ง๋ฉ๋๋ค. ์ผ๋ฐ์ ์ผ๋ก ๋ฆฌํํ, ์ด์๋์์ง๋ ๋ฑ์ ์ฝ๋ฌผ๊ณผ ๋ณ์ฉํฉ๋๋ค. > **์ค์ํ ๊ณต์ค ๋ณด๊ฑด ์ฃผ์์ฌํญ:** ์ธ์๊ณตํต๊ฐ์ผ์ ์ฌ๊ฐํ ์ ์ฌ์ ์ํ์ฑ, ํนํ ๊ฐ์ ๋ด ๋ฉด์ญ ์ ํ์์๊ฒ ๋ฏธ์น๋ ์ํ ๋๋ฌธ์ ์์ํ์์ ์ด๋ฌํ ๊ฐ์ผ์ ์น๋ฃํ๋ ๊ฒ์ ๋ ผ๋์ ์ฌ์ง๊ฐ ๋ง์ต๋๋ค.
์์ฉ ๊ธฐ์ : Ethambutol is active only against actively dividing mycobacteria. Mechanistically, it inhibits the enzyme **arabinosyl transferase** โ disrupts the synthesis of arabinogalactan โ prevents the incorporation of **mycolic acid** into the mycobacterial cell wall. This disruption increases cell wall permeability, which allows other antimycobacterial drugs (like rifampin or isoniazid) to penetrate the cell more effectively. It also interferes with RNA synthesis. It has no appreciable activity against other non-mycobacterial bacteria or fungi.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Treatment of feline tuberculosis (resistant cases) ยท 15 mg/kg PO once daily ยท PO ยท once daily ยท Not specified ยท Considered if resistance develops to initial therapy. Used in combination with rifampin and isoniazid.
- Treatment of M. avium infections in caged birds (Protocol 1) ยท 20 mg/kg PO q12h ยท PO ยท q12h ยท 6-12 months ยท Used with Ciprofloxacin/Enrofloxacin, Clofazimine, and Cycloserine.
- Treatment of M. avium infections in caged birds (Protocol 2) ยท 30 mg/kg PO once daily ยท PO ยท once daily ยท 6-12 months ยท Used with Clofazimine and Rifampin.
- Treatment of M. avium infections in caged birds (Protocol 3) ยท 30 mg/kg PO once daily ยท PO ยท once daily ยท 6-12 months ยท Used with Ciprofloxacin/Enrofloxacin and Rifampin/Rifabutin.
- Avian mycobacteriosis ยท 30-85 mg/kg PO once daily ยท PO ยท once daily ยท 9-12 months ยท Used with Rifabutin, Clarithromycin, and Enrofloxacin.
- Treatment of disseminated M. tuberculosis ยท 10-25 mg/kg PO once daily ยท PO ยท once daily ยท More than 9 months ยท Used in combination with rifampin (5-10 mg/kg PO q12-24h) and isoniazid (10-20 mg/kg PO once daily). May also add pyrazinamide (ineffective for M. bovis).
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Patients with a history of prior hypersensitivity reactions to ethambutol
์ด์๋ฐ์
- Optic neuritis (decreased visual acuity, usually reversible)
- CNS degenerative changes (with prolonged use)
- Myocardial toxicity (at high doses)
- Depigmentation of the tapetum lucidum
- Bacterial or fungal overgrowth (due to prolonged multi-drug antimicrobial therapy)
์ฝ๋ฌผ ์ํธ์์ฉ
- Aluminum-containing antacids ยท Can reduce oral absorption of ethambutol; separate dosing by at least 4 hours if both are necessary
๋ชจ๋ํฐ๋ง
- Clinical efficacy
- Visual function (periodic monitoring with long-term therapy)
- Liver function
- Renal function
- CBC
- Monitor for fungal or bacterial overgrowth infections
๊ณผ์ฉ๋
Very limited veterinary information exists. In humans, acute overdoses of >10 grams have caused **optic neuritis**. Other adverse effects noted with human overdoses include CNS effects (confusion, visual hallucinations), abdominal pain, nausea, fever, and headache. Treatment is supportive.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.