Side Effects of ethambutol: A Synthesis of Findings from 23 Studies

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Original Abstract of the Article

Major Research Findings

Ethambutol is a medication used to treat tuberculosis, but it can have serious side effects. 6 presents a case report of acute fatal autoimmune hemolytic anemia caused by ethambutol. 1 reports a case of optic neuropathy induced by ethambutol. 12 highlights that severe ethambutol toxicity can lead to irreversible vision loss.

Ethambutol works by interfering with the synthesis of the cell wall of the bacteria that causes tuberculosis. 22 introduces a new nanodelivery formulation of ethambutol, which could potentially reduce side effects and improve treatment effectiveness. However, due to its potential impact on the optic nerve and liver, the use of ethambutol needs to be closely monitored.

Reasons for Side Effects

Ethambutol is believed to cause side effects such as visual impairment by accumulating in optic nerve cells, hindering their function. 8 demonstrates how ethambutol accumulates within lysosomes, causing disruptions in their normal function. Lysosomes are responsible for breaking down cellular waste, so their impairment by ethambutol accumulation could lead to damage in optic nerve cells.

Common Side Effects

Visual Impairment

Ethambutol is known to cause optic neuropathy, which can manifest as decreased vision, color vision abnormalities, and narrowed field of vision. , 1 , and 12 report cases of visual impairment caused by ethambutol.

Liver Dysfunction

Ethambutol can potentially affect the liver, leading to liver dysfunction. 20 indicates that genetic variations in CYP enzymes may increase the risk of liver dysfunction from ethambutol.

Others

Ethambutol may also cause rarer side effects such as skin rash, fever, and gastrointestinal problems. 13 reports a case of hypersensitivity reaction to ethambutol.

Countermeasures for Side Effects

Countermeasures for Visual Impairment

To prevent visual impairment from ethambutol, regular eye exams are crucial. 19 recommends that patients receiving tuberculosis treatment undergo eye examinations at the beginning of treatment and at regular intervals during treatment. If any visual impairment symptoms occur, immediate medical attention is necessary.

Countermeasures for Liver Dysfunction

Regular liver function tests are essential for monitoring and potentially preventing liver dysfunction caused by ethambutol. If symptoms of liver dysfunction appear, immediate medical consultation is crucial.

Comparison between Studies

Commonalities between Studies

A common theme across various studies is that ethambutol carries the risk of side effects, including visual impairment. Additionally, the studies agree that the severity and manifestation of these side effects can vary greatly between individuals.

Differences between Studies

Studies show discrepancies in the occurrence rate and severity of ethambutol side effects. These variations are likely due to differences in the study populations, factors like age, gender, and treatment duration.

Notes on Applying the Research to Real Life

While ethambutol is a valuable treatment for tuberculosis, its potential for side effects, such as visual impairment, should be acknowledged. It's essential to understand these risks and strictly follow your doctor's instructions when taking ethambutol. Additionally, proactive measures like regular eye exams can aid in early detection of potential issues.

Limitations of Current Research

The research surrounding ethambutol's side effects remains incomplete. There's still much to be discovered about the rate of occurrence, severity, and underlying mechanisms of these side effects.

Directions for Future Research

To better understand the side effects of ethambutol, more in-depth research is needed. This includes elucidating the mechanisms by which these side effects develop, and ultimately, developing safer medications and treatments to minimize or eliminate these adverse effects.

Conclusion

Ethambutol is a medication effective in treating tuberculosis, but it carries the risk of side effects, including visual impairment. It's crucial to understand these risks, follow your doctor's instructions carefully, and be vigilant about early detection of potential issues.

Literature analysis of 23 papers
Positive Content
10
Neutral Content
4
Negative Content
9
Article Type
0
1
1
3
22
1.

Optic neuropathy induced by ethambutol: A rare case from Nepal.

Author: ShahSangam, AdhikariYagya Raj, PaudelSujan, SitaulaSanjeeta, KoiralaBipin, AryalSusan, PandeYubraj, KarkiRuchi

Vision problems

This case report describes a 42-year-old male who developed ethambutol-induced optic neuropathy after six weeks of ethambutol treatment. This highlights that ethambutol toxicity is rare in cases of new onset pulmonary tuberculosis where ethambutol has been administered for only 2 months.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

2.

[Toxic retinopathies].

Author: KellnerUlrich, KellnerSimone, WeinitzSilke, FarmandGhazaleh

Retinopathy

This study discusses the toxic effects of various medications on the retina, the light-sensitive layer at the back of the eye. It highlights the importance of recognizing these side effects, which can mimic other eye diseases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : German

4.

Impact of the change in the antitubercular regimen from three to four drugs on cure and frequency of adverse reactions in tuberculosis patients from Brazil: A retrospective cohort study.

Author: ArriagaMaría B, TorresNinfa M C, AraujoNelia C N, CaldasSimone C C, AndradeBruno B, NettoEduardo M

TB cure rate
ADRs

This retrospective cohort study found that patients treated with the four-drug regimen (RHEZ) exhibited increased risk of ADRs compared to those who received the three-drug regimen (RHZ), especially in patients older than 30 years of age.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Ethambutol-Loaded Solid Lipid Nanoparticles as Dry Powder Inhalable Formulation for Tuberculosis Therapy.

Author: NematiElham, MokhtarzadehAhad, Panahi-AzarVahid, MohammadiAli, HamishehkarHamed, Mesgari-AbbasiMehran, Ezzati Nazhad DolatabadiJafar, de la GuardiaMiguel

Tuberculosis treatment

EMB-loaded SLN DPI, a new drug delivery system, has the potential to improve the treatment of tuberculosis by delivering ethambutol directly to the lungs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

A rare adverse reaction to ethambutol: drug-induced haemolytic anaemia.

Author: NicoliniA, PerazzoA, GattoP, PiroddiI M G, BarlasciniC, KaramichaliS, StradaP

Haemolytic anaemia

This case report describes a fatal autoimmune hemolytic anemia caused by ethambutol (EMB), an anti-tuberculosis drug.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

[Drug-induced toxicity and ophthalmology].

Author: SouteyrandGeorges, ChronopoulosArgyrios, ThumannGabriele

Preserved visual function
Drug toxicity
Visual impairment

Drug-induced ocular toxicity can affect various eye structures and requires careful monitoring to prevent visual impairment.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

8.

Ethambutol neutralizes lysosomes and causes lysosomal zinc accumulation.

Author: YamadaDaisuke, SaikiShinji, FuruyaNorihiko, IshikawaKei-Ichi, ImamichiYoko, KambeTaiho, FujimuraTsutomu, UenoTakashi, KoikeMasato, SumiyoshiKatsuhiko, HattoriNobutaka

Liver dysfunction
Retinal dysfunction

Ethambutol, a common tuberculosis drug, may impair autophagic flux by neutralizing lysosomes, potentially contributing to its side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Global Urine Metabolomics in Patients Treated with First-Line Tuberculosis Drugs and Identification of a Novel Metabolite of Ethambutol.

Author: DasMrinal Kumar, AryaRakesh, DebnathSanjita, DebnathRahul, LodhAnindita, BishwalSubasa Chandra, DasAnjan, NandaRanjan Kumar

Improved TB treatment
Drug resistance
Side effects

Metabolomics can be used to characterize the drug metabolism phenotype in tuberculosis patients, and may help identify novel drug metabolites.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Toxic optic neuropathies: an updated review.

Author: GrzybowskiAndrzej, ZülsdorffMagdalena, WilhelmHelmut, TonagelFelix

TON treatment

This review summarizes the current knowledge of toxic optic neuropathy (TON), a condition caused by damage to the optic nerve due to toxins. The review discusses various factors, including medications, metals, solvents, and nutritional deficiencies, that can contribute to TON.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

[Bitemporal hemianopia as presenting sign of severe ethambutol toxicity].

Author: Boulanger ScemamaE, TouitouV, Le HoangP

Optic neuropathy

A case report describes a patient who developed bilateral bitemporal hemianopia and central scotoma, which was ultimately attributed to ethambutol toxicity. The patient had been on ethambutol for 18 months for the treatment of Mycobacterium avium-related pneumonitis. This case highlights the importance of obtaining a detailed history to rule out drug toxicity as a cause of optic neuropathy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

13.

Hypersensitivity reaction and tolerance induction to ethambutol.

Author: CernadasJosefina Rodrigues, SantosNatacha, PintoClaudia, MotaPatricia Caetano, CastellsMariana

MAC infection
Adverse reactions

This case report describes a patient with Mycobacterium avium complex (MAC) infection who was successfully treated with ethambutol, a crucial component of their recovery. A modified desensitization protocol for ethambutol is presented.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

[Adverse ocular drug reactions of systemic antimicrobial agents].

Author: HuberM, StahlmannR

Intraocular inflammation
Neuropathies
Visual disturbances

Antimicrobial therapy can cause adverse ocular drug reactions. It is important for physicians and patients to be aware of potential symptoms and consequences as early detection can improve reversibility.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

15.

A 37-year-old woman presenting with impaired visual function during antituberculosis drug therapy: a case report.

Author: AyanniyiAbdulkabir A, AyanniyiRashidat O

Visual function recovery
Antituberculosis drug side effects
Visual impairment

Antituberculosis drug-induced impaired visual function can be reversed with early detection and attention.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Preparation and characterisation of ethambutol with β-cyclodextrin: a comprehensive molecular insight into host-guest interaction.

Author: GohSoen Qeng, ChanQiao Hui, AdnanRohana, RahimNurul Yani

Improved bioavailability
Drug resistance

इथाम्बुटोल (ETB) जस्ता पहिलो-लाइन औषधिहरूमा बढ्दो औषधि प्रतिरोधकताले क्षयरोग विरोधी औषधिहरूको लागि सुधारको विकास आवश्यक बनाएको छ। क्षयरोग विरोधी औषधिहरूको प्रतिरोधकता र साइड इफेक्टहरू रोक्नको लागि सक्रिय औषधीय घटक (API) को जैवउपलब्धता सुधार गर्ने नयाँ विधि अनुसन्धान गरिएको छ। यस अध्ययनमा, ETB को सुपरमोलिक्युलर वाहकको रूपमा β-साइक्लोडेक्सट्रिन (β-CD) प्रयोग गर्दै क्षयरोग विरोधी औषधि डेलिभरी सिस्टम तयार गरिएको छ। β-CD/ETB समावेशी परिसरको ठोस र तरल अवस्थामा समावेश व्यवहारको अनुसन्धान गरिएको छ।

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

[Exogenously induced retinopathies].

Author: KellnerUlrich, KellnerSimone, WeinitzSilke, FarmandGhazaleh

Retinal damage
Retinopathy

Exogenous retinopathies can be caused by various factors, including stimulants, systemic or ocular medications, vaccinations, and light or irradiation. The severity and duration of effects vary, with external stimulants being the most common cause of retinal damage.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : German

18.

Analysis of Adverse Drug Reactions to First-Line Anti-Tuberculosis Drugs Using the Korea Adverse Event Reporting System.

Author: ChungSoo Jie, ByeonSun-Ju, ChoiJeong-Hee

ADRs

This study investigated the clinical characteristics of adverse drug reactions to first-line anti-tuberculosis drugs in Korea using a nationwide database.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

The association between cytochrome P450 polymorphisms and anti-tuberculosis drug-induced liver injury: a systematic review and meta-analysis.

Author: LiuXingren, RenSong, ZhangJingwei, XuDalin, JiangFeifei, JiangPeidu, FengJing, DengFei

TB treatment
ATDILI

This study systematically reviewed and meta-analyzed the relationship between CYP polymorphism and susceptibility to anti-tuberculosis drug-induced liver injury.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

23.

Neuropsychiatric Effects of Antimicrobial Agents.

Author: ZareifopoulosNicholas, PanayiotakopoulosGeorge

CNS effects
Epileptogenic
Psychotomimetic
Stimulant
GABA antagonism
MAO inhibition
NMDA agonism

This review discusses the neuropsychiatric effects of antimicrobial drugs, emphasizing the importance of recognizing these effects to avoid misdiagnosis and ensure appropriate management. It highlights the mechanisms by which antimicrobials can interact with the nervous system and the potential for both adverse and beneficial effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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