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Use of Undiluted Tea-Tree Oil As a Cosmetic
Federal Institute for Risk Assessment (BfR) Use of undiluted tea-tree oil as a cosmetic Opinion of the Federal Insitute for Risk Assessment (BfR), 1th September 2003 Background Recently there has been an increasing amount of reports on contact-allergic eczema in con- junction with the use of tea-tree oil. Tea-tree oil is sold as a pure natural product, highly con- centrated and undiluted in cosmetics. Tea-tree oil is advertised as a universal remedy al- though there is no marketing authorisation as a pharmaceutical product. Concentrated tea-tree oil has been classified as harmful according to the self-classification of the International Fragrance Association (IFRA) and is labelled with R-phrases R 22 (harmful if swallowed) R 38 (irritating to skin) and R 65 (may cause lung damage if swallowed) as well as the symbol Xn (harmful) (IFRA Labelling Manual 1, 2001). These indications of health hazards are also part of the safety data sheets of raw material suppliers. At the 65th and 66th meetings of the Cosmetics Committee at the Federal Institute for Risk Assessment (BfR), health risks associated with the use of undiluted and highly concentrated tea-tree oil in cosmetic products were discussed extensively. Result Tea-tree oil is a mixture of various terpenes extracted from the Australian tea-tree. Undiluted tea-tree oil is a pure natural product. In the presence of atmospheric oxygen but also when exposed to light and higher temperatures, oxidation processes occur leading to the formation of peroxides, epoxides and endoperoxides which have a sensitising potency and may trigger allergic skin reactions. -
Suppression of Prostate Tumor Cell Growth by Stromal Cell Prostaglandin D Synthase–Derived Products
Research Article Suppression of Prostate Tumor Cell Growth by Stromal Cell Prostaglandin D Synthase–Derived Products Jeri Kim,1 Peiying Yang,2 Milind Suraokar,3 Anita L. Sabichi,3 Norma D. Llansa,3 Gabriela Mendoza,3 Vemparalla Subbarayan,3 Christopher J. Logothetis,1 Robert A. Newman,2 Scott M. Lippman,3 and David G. Menter3 Departments of 1Genitourinary Medical Oncology, 2Experimental Therapeutics, and 3Clinical Cancer Prevention, The University of Texas M.D. Anderson Cancer Center, Houston, Texas Abstract seminal fluid (10). Once PGD2 is made, it forms derivative Stromal-epithelial interactions and the bioactive molecules compounds, most of which can transactivate the peroxisome g g produced by these interactions maintain tissue homeostasis proliferator–activated receptor (PPAR ). One PGD2 derivative, 15-deoxy-D12,14-prostaglandin J (15-d-PGJ ), can slow the growth and influence carcinogenesis. Bioactive prostaglandins pro- 2 2 duced by prostaglandin synthases and secreted by the prostate and induce the partial differentiation of selected cancer cells (12). D12,14 into seminal plasma are thought to support reproduction, but Another PGD2 derivative, 15-deoxy- -PGD2 (15-d-PGD2), has g their endogenous effects on cancer formation remain unre- also been shown to stimulate PPAR transactivation in RAW 264.7 solved. No studies to date have examined prostaglandin cell macrophage cultures as effectively as 15-d-PGJ2 (13). L-PGDS enzyme production or prostaglandin metabolism in normal also binds tritiated testosterone and may play a role in androgen prostate stromal cells. Our results show that lipocalin-type transport (14). In castrated rats, testosterone proprionate induces prostaglandin D synthase (L-PGDS) and prostaglandin D L-PGDS synthesis in the epididymis (15). -
Outpatient Acne Care Guideline
Outpatient Acne Care Guideline Severity Mild Moderate Severe < 20 comedones or < 20-100 comedones or 15-50 > 5 cysts, >100 comedones, or inflammatory lesions inflammatory lesions >50 inflammatory lesions Initial Treatment Initial Treatment Initial Treatment Benzoyl Peroxide (BP) or Topical Combination Therapy Combination Therapy Topical Retinoid Retinoid + BP Oral antibiotic or OR + (Retinoid + Antibiotic) + BP Topical retinoid Topical Combination Therapy or + BP + Antibiotic Retinoid + (BP + Antibiotic) or OR BP Retinoid + BP Oral antibiotic + topical retinoid + +/- or BP Topical antibiotic Retinoid + Antibiotic + BP or Topical Dapsone IF Inadequate Response IF Inadequate Response IF Inadequate Consider dermatology Response referral Change topical retinoid Consider changing oral concentrations, type and/or antibiotic formulation AND or Add BP or retinoid, if not already Change topiocal combination Consider isotretinoin prescribed therapy Consider hormone therapy or and/or (females) Change topical retinoid Add or change oral antibiotic concentrations, type and/or or formulation Consider isotretinoin Additional Considerations or Consider hormone therapy (females) Change topical comination Previous treatment/history Side effects therapy Costs Psychosocial impact Vehicle selection Active scarring Ease of use Regimen complexity Approved Evidence Based Medicine Committee 1-18-17 Reassess the appropriateness of Care Guidelines as condition changes. This guideline is a tool to aid clinical decision making. It is not a standard of care. The physician should deviate from the guideline when clinical judgment so indicates. GOAL: Pediatricians should initiate treatment for cases of “Mild” to “Severe” acne (see algorithms attached). Pediatricians should also counsel patients in order to maximize adherence to acne treatment regimens: 1. Realistic expectations. Patients should be counseled that topical therapies typically take up to 6-8 weeks to start seeing results. -
Formulary Drug Removals
July 2018 Formulary Drug Removals Below is a list of medicines by drug class that have been removed from your plan’s formulary. If you continue using one of the drugs listed below and identified as a Formulary Drug Removal, you may be required to pay the full cost. If you are currently using one of the formulary drug removals, ask your doctor to choose one of the generic or brand formulary options listed below. Category Formulary Drug Formulary Options Drug Class Removals Allergies BECONASE AQ flunisolide spray, fluticasone spray, mometasone spray, triamcinolone spray, Nasal Steroids / Combinations OMNARIS DYMISTA QNASL ZETONNA Anticonvulsants ZONEGRAN carbamazepine, carbamazepine ext-rel, divalproex sodium, divalproex sodium ext-rel, gabapentin, lamotrigine, lamotrigine ext-rel, levetiracetam, levetiracetam ext-rel, oxcarbazepine, phenobarbital, phenytoin, phenytoin sodium extended, tiagabine, topiramate, valproic acid, zonisamide, FYCOMPA, OXTELLAR XR, TROKENDI XR, VIMPAT Anti-infectives, Antibacterials E.E.S. GRANULES erythromycins Erythromycins / Macrolides ERYPED Anti-infectives, Antibacterials MINOCIN minocycline Tetracyclines DORYX doxycycline hyclate DORYX MPC MONODOX Anti-infectives, Antibacterials MACRODANTIN nitrofurantoin Miscellaneous Anti-infectives, Antivirals VALCYTE valganciclovir Cytomegalovirus * Anti-infectives, Antivirals MAVYRET EPCLUSA (genotypes 1, 2, 3, 4, 5, 6), HARVONI (genotypes 1, 4, 5, 6), VOSEVI 1 Hepatitis C * DAKLINZA EPCLUSA (genotypes 1, 2, 3, 4, 5, 6), HARVONI (genotypes 1, 4, 5, 6) OLYSIO TECHNIVIE -
Mechanisms of Action of Azelaic Acid 15% Gel: Assessing Its Broad Antioxidant and Comedolytic Effects Zoe Diana Draelos, MD
CCOSMETIOSMETICC CCONSULTATIONONSULTATION Mechanisms of Action of Azelaic Acid 15% Gel: Assessing Its Broad Antioxidant and Comedolytic Effects Zoe Diana Draelos, MD wo small studies were undertaken to investi- Dermatologic medications can have a similar versatility gate the ability of azelaic acid (AzA) 15% gel of action. For example, tetracyclines are used for their T to function as a comedolytic and as a topical antibacterial and anti-inflammatory qualities to treat antioxidant. The first study compared AzA 15% gel with acne. Sodium sulfacetamide and sulfur combinations are benzoyl peroxide (BPO) 5% gel as a comedolytic. Ten used for antibacterial, antifungal, and anti-inflammatory participants were randomized to apply AzA 15% gel on purposes for acne, seborrheic dermatitis, and rosacea. one shoulder and BPO 5% gel on the other shoulder One could argue that versatile ingredients can often be twice daily for 4 weeks, with a nontreated site on the more valuable than those that deliver a single, albeit central back serving as the control in all participants. powerful, effect. Comedone counts were obtainedCOS at baseline and week DERM4 An alternate dermatologic prescription that has mul- by examination of cyanoacrylate biopsies taken from tiple mechanisms of action is AzA 15% gel. Also known each site. The AzA 15% gel and BPO 5% gel produced as nonanedioic acid, AzA is a saturated dicarboxylic acid substantial decreases in mean comedones (12 to 0.9 and found naturally in wheat, rye, and barley. It is also pro- 14.9 to 1.6, respectively) from baseline to week 4 as duced by the yeast Pityrosporum ovale, a natural compo- compared with controlsDo (14.6 to 10.9). -
Comparing 2.5%, 5%, and 10% Benzoyl Peroxide on Inflammatory
Pharmacology and Therapeutics Comparing 2.5%, 5%, and 10% Benzoyi Peroxide on Inflammatory Acne Vulgaris OTTO H. MILLS, JR., PH.D., ALBERT M. KLICMAN, M.D., PH.D., PETER POCHI, M.D., AND HARRIET COMITE, M.D. From the Departments of Dermatology, University of Subjects, Materials, and Methods Pennsy/vania School of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Clinical Studies Boston, Massachusetts The same methods were used to conduct three double- blind studies. After giving informed consent, subjects with mild to moderately severe inflammatory acne vulgaris of the face (minimum of 10 inflammatory lesions) were assigned to one of the three treatment groups. A total of 153 subjects, 74 men and 79 women (average age of 20 years), participated ABSTRACT: A 2.5% formulation of benzoyi peroxide was in the three studies. In the first, 25 subjects used 2.5% ben- compared with its vehicle, and with a 5% and a 10% proprietary zoyi peroxide gel and 25, the gel vehicle for this formulation. benzoyi peroxide gel preparation in three double-blind studies In the second, 26 used the 2.5 gel and 27, a 5% gel. The involving 153 patients with mild to moderately severe acne third study consisted of 25 subjects who used the 2.5% gel vulgaris. The 2.5% benzoyi peroxide formulation was more and 25, a 10% benzoyi peroxide gel. The subjects received effective than its vehicle and equivalent to the 5% and 10% no medications for any reasor\s during \he 4-week period concentrations in reducing the number of inflammatory lesions prior to the start of the study. -
Long-Term Use of Spironolactone for Acne in Women: a Case Series of 403 Patients
Long-term use of spironolactone for acne in women: A case series of 403 patients Vaibhav Garg, BS,a JulianaK.Choi,MD,PhD,b William D. James, MD,b and John S. Barbieri, MD, MBAb Philadelphia, Pennsylvania Background: There are limited data regarding the long-term outcomes of spironolactone use for women with acne and its effect on truncal acne. Objective: To comprehensively describe outcomes of patients treated with spironolactone in routine clinical practice, including long-term outcomes. Methods: We performed a retrospective case series of 403 adult women treated for acne with spironolactone at an academic medical center between 2008 and 2019. Rates of objective, as assessed by Comprehensive Acne Severity Scale scores, and subjective acne clearance were evaluated, as well as rates of treatment discontinuation, dosage changes, and drug survival. Logistic regression was used to assess for association between incidence of menstrual adverse effects and combined oral contraceptive use. Results: As evaluated by Comprehensive Acne Severity Scale scores, at the first follow-up, 75.5%, 84.0%, and 80.2% of patients with available data had reduction or complete clearance of acne on the face, chest, and back, respectively. The mean drug survival was 470.7 days. Menstrual adverse effects were less common among those using combined oral contraception (odds ratio, 0.23; 95% confidence interval, 0.11-0.50). Limitations: This study was conducted at a single academic medical center. Conclusions: Spironolactone improves clinical outcomes and is well tolerated for many adult women with acne using it for an extended duration. ( J Am Acad Dermatol 2021;84:1348-55.) Key words: acne; acne vulgaris; birth control pill; combined oral contraceptive; comprehensive acne severity scale; oral antibiotics; outcomes; spironolactone. -
Aetna Formulary Exclusions Drug List
Covered and non-covered drugs Drugs not covered – and their covered alternatives 2020 Advanced Control Plan – Aetna Formulary Exclusions Drug List 05.03.525.1B (7/20) Below is a list of medications that will not be covered without a Key prior authorization for medical necessity. If you continue using one of these drugs without prior approval, you may be required UPPERCASE Brand-name medicine to pay the full cost. Ask your doctor to choose one of the generic lowercase italics Generic medicine or brand formulary options listed below. Preferred Options For Excluded Medications1 Excluded drug name(s) Preferred option(s) ABILIFY aripiprazole, clozapine, olanzapine, quetiapine, quetiapine ext-rel, risperidone, ziprasidone, VRAYLAR ABSORICA isotretinoin ACANYA adapalene, benzoyl peroxide, clindamycin gel (except NDC^ 68682046275), clindamycin solution, clindamycin-benzoyl peroxide, erythromycin solution, erythromycin-benzoyl peroxide, tretinoin, EPIDUO, ONEXTON, TAZORAC ACIPHEX, esomeprazole, lansoprazole, omeprazole, pantoprazole, DEXILANT ACIPHEX SPRINKLE ACTICLATE doxycycline hyclate capsule, doxycycline hyclate tablet (except doxycycline hyclate tablet 50 mg [NDC^ 72143021160 only], 75 mg, 150 mg), minocycline, tetracycline ACTOS pioglitazone ACUVAIL bromfenac, diclofenac, ketorolac, PROLENSA acyclovir cream acyclovir (except acyclovir cream), valacyclovir ADCIRCA sildenafil, tadalafil ADZENYS XR-ODT amphetamine-dextroamphetamine mixed salts ext-rel†, dexmethylphenidate ext-rel, dextroamphetamine ext-rel, methylphenidate ext-rel†, MYDAYIS, -
Lipocalin-Type Prostaglandin D Synthase Regulates Light-Induced Phase Advance of the Central Circadian Rhythm in Mice
ARTICLE https://doi.org/10.1038/s42003-020-01281-w OPEN Lipocalin-type prostaglandin D synthase regulates light-induced phase advance of the central circadian rhythm in mice Chihiro Kawaguchi et al.# 1234567890():,; We previously showed that mice lacking pituitary adenylate cyclase-activating polypeptide (PACAP) exhibit attenuated light-induced phase shift. To explore the underlying mechan- isms, we performed gene expression analysis of laser capture microdissected suprachias- matic nuclei (SCNs) and found that lipocalin-type prostaglandin (PG) D synthase (L-PGDS) is involved in the impaired response to light stimulation in the late subjective night in PACAP- deficient mice. L-PGDS-deficient mice also showed impaired light-induced phase advance, but normal phase delay and nonvisual light responses. Then, we examined the receptors involved in the response and observed that mice deficient for type 2 PGD2 receptor DP2/ CRTH2 (chemoattractant receptor homologous molecule expressed on Th2 cells) show impaired light-induced phase advance. Concordant results were observed using the selective DP2/CRTH2 antagonist CAY10471. These results indicate that L-PGDS is involved in a mechanism of light-induced phase advance via DP2/CRTH2 signaling. #A list of authors and their affiliations appears at the end of the paper. COMMUNICATIONS BIOLOGY | (2020) 3:557 | https://doi.org/10.1038/s42003-020-01281-w | www.nature.com/commsbio 1 ARTICLE COMMUNICATIONS BIOLOGY | https://doi.org/10.1038/s42003-020-01281-w he mammalian circadian clock system comprises the genes (Fig. 1a). Of these 593 genes, we specifically analyzed genes endogenous master pacemaker located within the supra- that were upregulated (>1.7-fold change) or downregulated (>0.6- T −/− chiasmatic nucleus (SCN) in the hypothalamus and coor- fold change) by light stimulation in PACAP and wild-type mice. -
Rosuvastatin and Atorvastatin Are Ligands of the Human Constitutive Androstane Receptor/Retinoid X Receptor a Complex S
Supplemental material to this article can be found at: http://dmd.aspetjournals.org/content/suppl/2017/05/23/dmd.117.075523.DC1 1521-009X/45/8/974–976$25.00 https://doi.org/10.1124/dmd.117.075523 DRUG METABOLISM AND DISPOSITION Drug Metab Dispos 45:974–976, August 2017 Copyright ª 2017 by The American Society for Pharmacology and Experimental Therapeutics Short Communication Rosuvastatin and Atorvastatin Are Ligands of the Human Constitutive Androstane Receptor/Retinoid X Receptor a Complex s Received February 21, 2017; accepted May 17, 2017 ABSTRACT Statins are well known lipid lowering agents that inhibit the enzyme models of CAR/RXRa-LBD were constructed by ligand-based and – 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase. They also structure-based in silico modeling. Experiments and computational Downloaded from activate drug metabolism but their exact receptor-mediated action modeling show that atorvastatin and rosuvastatin bind to the human has not been proven so far. We tested whether atorvastatin and CAR/RXRa-LBD heterodimer, suggesting both can modulate the rosuvastatin are direct ligands of human constitutive androstane activity of CAR through direct interaction with the LBD of this receptor (CAR). We measured binding activities of atorvastatin and receptor. We confirm that atorvastatin and rosuvastatin are direct rosuvastatin to the human constitutive androstane receptor/retinoid ligands of CAR. The clinical consequences of CAR activation by X receptor a ligand-binding domain (CAR/RXRa-LBD) heterodimer statins are in their potential drug-drug interactions, and changes in dmd.aspetjournals.org with surface plasmon resonance (SPR). Additionally, three-dimensional glucose and energy metabolism. -
Estonian Statistics on Medicines 2016 1/41
Estonian Statistics on Medicines 2016 ATC code ATC group / Active substance (rout of admin.) Quantity sold Unit DDD Unit DDD/1000/ day A ALIMENTARY TRACT AND METABOLISM 167,8985 A01 STOMATOLOGICAL PREPARATIONS 0,0738 A01A STOMATOLOGICAL PREPARATIONS 0,0738 A01AB Antiinfectives and antiseptics for local oral treatment 0,0738 A01AB09 Miconazole (O) 7088 g 0,2 g 0,0738 A01AB12 Hexetidine (O) 1951200 ml A01AB81 Neomycin+ Benzocaine (dental) 30200 pieces A01AB82 Demeclocycline+ Triamcinolone (dental) 680 g A01AC Corticosteroids for local oral treatment A01AC81 Dexamethasone+ Thymol (dental) 3094 ml A01AD Other agents for local oral treatment A01AD80 Lidocaine+ Cetylpyridinium chloride (gingival) 227150 g A01AD81 Lidocaine+ Cetrimide (O) 30900 g A01AD82 Choline salicylate (O) 864720 pieces A01AD83 Lidocaine+ Chamomille extract (O) 370080 g A01AD90 Lidocaine+ Paraformaldehyde (dental) 405 g A02 DRUGS FOR ACID RELATED DISORDERS 47,1312 A02A ANTACIDS 1,0133 Combinations and complexes of aluminium, calcium and A02AD 1,0133 magnesium compounds A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 811120 pieces 10 pieces 0,1689 A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 3101974 ml 50 ml 0,1292 A02AD83 Calcium carbonate+ Magnesium carbonate (O) 3434232 pieces 10 pieces 0,7152 DRUGS FOR PEPTIC ULCER AND GASTRO- A02B 46,1179 OESOPHAGEAL REFLUX DISEASE (GORD) A02BA H2-receptor antagonists 2,3855 A02BA02 Ranitidine (O) 340327,5 g 0,3 g 2,3624 A02BA02 Ranitidine (P) 3318,25 g 0,3 g 0,0230 A02BC Proton pump inhibitors 43,7324 A02BC01 Omeprazole -
MINOCYCLINE for Acne
This policy statement is approved by Halton, Knowsley, Liverpool, South Sefton, Southport and Formby, St Helens, Warrington, and Wirral CCGs Ha Kn Li SS SF SH Wa Wi MINOCYCLINE for acne The Pan Mersey Area Prescribing Committee does not recommend the prescribing of MINOCYCLINE for acne. BLACK The NHS England document ‘Items which should not routinely be prescribed in primary care: Guidance for CCGs’ contains the following advice.1 Recommendation Advise CCGs that prescribers in primary care should not initiate minocycline for any new patient with acne. Advice CCGs to support prescribers in de-prescribing minocycline in all patients with acne and, where appropriate, ensure the availability of relevant services to facilitate this change. Exceptions and further No routine exceptions have been identified. recommendations Category Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns. Annual spend in Pan £13,796 Mersey area (Epact Jan. 2020) Background and Minocycline is a tetracycline antibiotic that can be used for many indications but is Rationale mainly used in primary care for acne. Minocycline is mainly used for acne however there are various safety risks associated with its use. NICE CKS advises Minocycline is not recommended for use in acne as it is associated with an increased risk of adverse effects such as drug induced lupus, skin pigmentation and hepatitis. A PrescQIPP CIC review found there is no evidence to support the use of one tetracycline over another in terms of efficacy for the treatment of acne vulgaris and alternative once daily products are available2.