Isotretinoin for moderate to severe acne: current recommendations

2021 ◽  
pp. 20-25
Author(s):  
L. S. Kruglova ◽  
N. V. Gryazeva ◽  
E. V. Sidorenko
Keyword(s):  
Vitamin A ◽  
Cumulative Dose ◽  
Adverse Reactions ◽  
Severe Acne ◽  
Daily Dose ◽  
Management Tactics

This article presents data on the pathogenesis of acne, the mechanisms of choosing therapy, the tactics of prescribing isotretinoin and further management of patients. Answers are given to important questions concerning the appointment of an adequate daily dose and the obligation to set of cumulative dose concerning the mandatory, the safety of drugs containing isotretinoin. In addition, the possibility of prescribing drugs based on vitamin A (retinol palmitate) in large doses in patients with acne and related adverse reactions is being discussed. The article is illustrated with three clinical examples of patients diagnosed with acne with a description of management tactics.

Isotretinoin Treatment of Severe Acne Affects the Endogenous Concentration of Vitamin A in Sebaceous Glands

1990 ◽  
Vol 94 (4) ◽  
pp. 496-498 ◽  
Author(s):  
Anders Vahlquist ◽  
Ola Rollman ◽  
Diana B Holland ◽  
William J Cunliffe
Keyword(s):  
Vitamin A ◽  
Sebaceous Glands ◽  
Severe Acne

High-dose vitamin A supplementation administered with vaccinations after 6 months of age: Sex-differential adverse reactions and morbidity

Vaccine ◽  
2013 ◽  
Vol 31 (31) ◽  
pp. 3191-3198 ◽  
Author(s):  
Ane Bærent Fisker ◽  
Carlito Bale ◽  
Mathias Jul Jørgensen ◽  
Ibriama Balde ◽  
Linda Hornshøj ◽  
...  
Keyword(s):  
Vitamin A ◽  
Adverse Reactions ◽  
High Dose ◽  
Vitamin A Supplementation ◽  
High Dose Vitamin

Adverse Reactions Induced by Minocycline: A Review of Literature

2021 ◽  
Vol 16 ◽  
Author(s):  
Maria Rose Dominic
Keyword(s):  
Adverse Reactions ◽  
Case Reports ◽  
English Literature ◽  
Pseudotumor Cerebri ◽  
Multiple Organ ◽  
Oral Antibiotic ◽  
First Line ◽  
Severe Acne ◽  
Acute Eosinophilic Pneumonia ◽  
Organ Systems

Background: Minocycline is a tetracycline antibiotic that is widely used to treat infections, and is a first-line oral antibiotic in the treatment of moderate to severe inflammatory acne. Although it has high efficacy, several adverse reactions, including life-threatening ones have been reported in association with its use. Objective: To identify all the potential adverse reactions due to minocycline and analyze them in terms of the number of cases reported so far, salient features, severity and clinical outcome. Methods: Comprehensive PubMed search of English and non-English literature for case reports of adverse reactions to minocycline. Results: A total of 550 cases were identified from over 200 publications. The major reported adverse events caused by minocycline are drug reaction with eosinophilia and systemic symptoms syndrome, autoimmune syndromes like hepatitis, lupus and vasculitis, acute eosinophilic pneumonia, pseudotumor cerebri, hyperpigmentation, serum sickness like reaction, Sweet’s syndrome and drug fever. Several other reactions involving multiple organ systems have also been reported. All of these show an overlap of clinical features and may be associated with multiple events causing considerable morbidity. Eight of these cases resulted in the death of the patients. Conclusion: In view of the evident potential of minocycline to cause long-lasting and severe adverse effects, significant morbidity and even mortality, it should be prescribed with caution in the first-line treatment for moderate to severe acne.

Once-Daily Dosing with Phenobarbital in Children with Seizure Disorders

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 824-827
Author(s):  
Anne G. Davis ◽  
Kelly D. Mutchie ◽  
Joel A. Thompson ◽  
Garth G. Myers
Keyword(s):  
Adverse Reactions ◽  
Pediatric Patients ◽  
Seizure Activity ◽  
Single Daily Dose ◽  
Daily Regimen ◽  
Serum Concentrations ◽  
Once Daily ◽  
Seizure Disorders ◽  
Daily Dose

In nine pediatric patients with seizure disorders, aged 8 months to 16½ years, a single daily dose of phenobarbital was as effective in maintaining therapeutic serum concentrations as twice-daily dosing. There were no adverse reactions to the once-daily regimen, and no seizure activity occurred during the study as a result of the change in dosing pattern.

Nadolol and Propranolol in the Treatment of Hypertension: A Double-Blind Comparison

1980 ◽  
Vol 8 (3) ◽  
pp. 193-198 ◽  
Author(s):  
M M El Mehairy ◽  
MB Cairo ◽  
A Shaker ◽  
M Ramadan ◽  
S Hamza ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Statistical Significance ◽  
Randomized Study ◽  
Double Blind ◽  
Once Daily ◽  
Depressant Action ◽  
Daily Dose ◽  
Treatment Of Hypertension ◽  
Blind Comparison ◽  
Supine Systolic Blood Pressure

Nadolol and propranolol were compared in seventy-five hypertensive patients in a double-blind randomized study conducted at Ain-Shams Hospital. After an initial wash-out period of 5 weeks, including 3 weeks of placebo administration, forty-five patients were given nadolol once daily and thirty patients received propranolol four times per day for 12 weeks, followed by a tapering-off period of 2 weeks. Both beta-blocking agents were effective in controlling hypertension with final daily doses ranging from 80 to 320 mg. Of statistical significance, however, were the better responses of supine systolic blood pressure elicited by nadolol. The only adverse reactions that occurred in this series were slight weight gains in two patients treated with nadolol and moderate dizziness in one patient treated with propranolol. Nadolol was proved to be a safe antihypertensive drug, at least comparable to propranolol in efficacy, with the advantages of a once-daily dose and a lack of direct depressant action on the heart.

scholarly journals Pharmacogenetics of schizophrenia in real clinical practice: a clinical case

2018 ◽  
Vol 10 (4) ◽  
pp. 88-93 ◽  
Author(s):  
R. F. Nasyrova ◽  
N. A. Schnaider ◽  
K. O. Mironov ◽  
G. A. Shipulin ◽  
O. P. Dribnokhodova ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Clinical Case ◽  
Adverse Reactions ◽  
Clinical Effect ◽  
Antipsychotic Therapy ◽  
Wide Range ◽  
Daily Dose ◽  
Financial Expenditure ◽  
Genetically Determined ◽  
Positive And Negative Symptoms

Schizophrenia is a socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. The basic drugs in these patients are antipsychotics that are highly effective against the positive and negative symptoms of schizophrenia, but at the same time have a wide range of adverse reactions (ARs). The clinical effect and tolerability of antipsychotics are variable and depend on the characteristics of genetically determined mechanisms (transportation, biotransformation, and elimination).The paper describes a clinical case of a female patient with schizophrenia who has been noted to be unresponsive to antipsychotic therapy for some years after the onset of the disease. After pharmacogenetic testing, she was found to be homozygous for the nonfunctional allelic variant CYP2D6*4 (1934 G>A, rs3892097), which was the reason for the complete shutdown of isoenzyme 2D6 activity and the development of ARs in the use of initial doses of antipsychotic drugs, as well as for an increase in the severity of ARs with aggravation of psycho-producing symptoms with an even slow titration of the daily dose.

scholarly journals O31 Levetiracetam monitoring in breast-milk: high inter-individual variability

2019 ◽  
Vol 104 (6) ◽  
pp. e14.1-e14
Author(s):  
N Dinavitser ◽  
E Kohn ◽  
M Berlin ◽  
A Livne ◽  
R Keidar ◽  
...  
Keyword(s):  
Breast Milk ◽  
Adverse Reactions ◽  
Individual Variability ◽  
High Variability ◽  
Average Daily Dose ◽  
Anti Epileptic Drug ◽  
Daily Dose ◽  
Infant Dose ◽  
Pregnancy And Lactation ◽  
D 83

BackgroundAnti-epileptic drug therapy is a great challenge for the practitioners during pregnancy and lactation. Levetiracetam (LEV) is commonly prescribed to pregnant women, however, there are only few publications on its use during lactation with small number of participants.ObjectiveTo monitor LEV levels in breast-milk of epileptic mothers treated with LEV.MethodsBreastfeeding women treated with LEV during pregnancy and after delivery were recruited. Milk sample was collected before administration of the drug and other samples were collected at time points of 1,3,6,9, and 12 hours after drug administration. Breastmilk and blood LEV levels were measured using HPLC.ResultsFourteen breastfeeding women participated in the study: 9 infants were fully breastfed whereas 5 were partially breastfed. Maternal average daily dose of LEV was 2517 mg. Average infant´s age was 8 weeks (3–22w). Average infant´s weight 4368 gr (3300–7000 gr). Milk/Plasma LEV concentration ratio was 0.88 (0.23–1.1). Relative Infant Dose (RID) was 40% in partial breast feeding, and 61% in full breastfeeding. Estimated average daily dose that all infants received through milk was 158 mg/d (83–250 mg). The normalized dose for the average infant weight per day was 36 mg, which is 15% less than the maximal daily dose of LEV in infants (max. daily dose in infants 1–6 months in 42 mg/d). No adverse reactions were observed in the breastfeed infants.ConclusionsAlthough the RID of LEV were found to be high, no adverse reactions were observed in the infants; Nevertheless, further studies are needed to elucidate the high variability of LEV excretion into breastmilk.Disclosure(s)Nothing to disclose

scholarly journals Methotrexate at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with rheumatoid arthritis: a nationwide population-based cohort study

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098122
Author(s):  
Wuu-Tsun Perng ◽  
Yao-Min Hung ◽  
Renin Chang ◽  
Cheng-Li Lin ◽  
Jeng-Yuan Chiou ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cancer Risk ◽  
Cumulative Dose ◽  
Lower Risk ◽  
Dose Group ◽  
Population Based ◽  
Defined Daily Dose ◽  
User Group ◽  
Daily Dose ◽  
New Onset

Background: We investigated whether taking methotrexate (MTX) is associated with a lower risk of new-onset cancers in patients with rheumatoid arthritis (RA). Methods: We conducted a 12-year retrospective cohort study from a population-based National Health Insurance Research Database in Taiwan. A total of 21,699 patients with newly diagnosed RA were enrolled during 2000–2009. The overall cancer rate was compared between 10,352 new users of MTX and 11,347 non-users. We used the WHO Defined Daily Dose (DDD) as a tool to assess drug exposure. Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of disease after controlling for demographics and other comorbidities. Results: After adjusting for age, sex, cancer-related comorbidities, and RA-combined medication, the HR of cancer risk was 0.87 (95% CI = 0.74–1.02) for the MTX user group compared with the MTX non-user group. The cumulative incidence of cancer in the MTX non-user group was significantly higher than that of the MTX user group (log-rank test p < 0.001). In the low accumulative dose group [cumulative dose <1125 mg, cumulative defined daily dose (cDDD) <450], the HR of cancer risk for MTX users was 1.20 (95% CI = 1.01–1.42) compared with the MTX-non-user group. However, the adjusted HR of cancer risk was reduced to 0.66 (95% CI = 0.49–0.87) in MTX middle-dose users (cumulative dose 1125–2250 mg, cDDD: 450–899) and 0.33 (95% CI = 0.23–0.48) for the MTX high-dose group (cumulative dose ⩾2250 mg, cDDD ⩾900), respectively ( p for trend < 0.0001). Conclusion: MTX at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with RA.

scholarly journals Pharmacoepidemiology of Furosemide in the Neonatal Intensive Care Unit

Neonatology ◽  
2020 ◽  
pp. 1-5
Author(s):  
Elizabeth J. Thompson ◽  
Daniel K. Benjamin ◽  
Rachel G. Greenberg ◽  
Karan R. Kumar ◽  
Kanecia O. Zimmerman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Cumulative Dose ◽  
Neonatal Intensive Care ◽  
Total Duration ◽  
Maximum Daily Dose ◽  
Daily Dose ◽  
Median Cumulative Dose ◽  
Short Courses

<b><i>Background:</i></b> Furosemide is commonly used off-label in the neonatal intensive care unit (NICU), but current dosing practices vary widely. <b><i>Objectives:</i></b> To describe dosing practices including route, dose, and duration of exposure to furosemide in a large number of community and tertiary NICUs across North America. <b><i>Method:</i></b> Using the Pediatrix Medical Group Clinical Data Warehouse, we identified infants who received ≥1 dose of furosemide between 1997 and 2016. We excluded infants with incomplete dosing data. We calculated average daily furosemide dose, cumulative dose, total days of exposure, and maximum daily dose. We compared dosing between infants born at &#x3c;32 weeks gestational age (GA) and ≥32 weeks GA. <b><i>Results:</i></b> A total of 18,572 infants had complete dosing data. The median (interquartile value) postnatal age at first exposure was 11 days (4, 26), the median maximum daily dose was 1.0 mg/kg (0.97, 1.6), the median average daily dose was 1.0 mg/kg (0.88, 1.1), and the median cumulative dose was 2.0 mg/kg (1.0, 4.5). The median total duration of exposure was 2 days (1, 4). A total of 177 (1%) infants received <i>≥</i>4 mg/kg/day of furosemide. Infants born &#x3c;32 weeks GA were an older age at initial furosemide exposure compared to those born ≥32 weeks GA: 19 versus 4 days, <i>p</i> &#x3c; 0.001. <b><i>Conclusions:</i></b> Most infants received short courses of furosemide within the labeled dosing parameters. Further studies are needed to assess the safety and efficacy of furosemide in the NICU.

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