Showing posts with label drugs. Show all posts
Showing posts with label drugs. Show all posts

Friday, August 17, 2012

[Drugs] Cooking With Pot


                        Cooking with Pot

     Many people after cleaning their grass throw away the seeds,
stems, and twigs.  I would highly recommend that you save these, as
there are many recipes for these odds and ends.  A tasty hot drink
that resembles tea can be made very simply by tying up all the
waste from your stash into a muslin ball or a piece of cheesecloth.

Use the quantity you have on hand, as the quantity will determine
the strength and potency. Now, drop the cheesecloth containing the
grass into a kettle of water, and bring the water to a boil.  Allow
the kettle to boil for a few minutes, and then remove it from the
flame and let it steep for another five minutes with the grass
still inside.  After this, the drink is ready.  Just add sugar and
lemon to taste.
     If you decide against growing pot, and want to eat your seeds,
there is an interesting recipe for "seed pancakes".  It is prepared
by lightly toasting a quarter cup of seeds in a large frying pan. 
Now, take the seeds from the frying pan and add them to a mixture
of one cup of pancake mix, one egg, a quarter cup of milk, and one
tablespoon of butter.  Beat this mixture until it is smooth and
creamy.  Heat a frying pan with a small amount of butter, then pour
in pancake batter.  Turn the pancakes as they start to look done,
or when the edges begin to turn brown.  Repeat procedure until all
batter is used.  Serve pancakes with butter, maple syrup, and
honey.
     For a stimulating drink (sounds like all the rest of the
cookbooks) place eight ounces milk, a few spoonfuls of sugar, a
tablespoon of malted milk, half a banana, and half a tablespoon
grass, and three betel muts in a blender.  Keep the blender working
full speed for a few minutes, then strain and serve.
     If you like candy, it's very simple to make some using pot. 
Take a quarter cup of powdered grass and add water until it equals
a full cup.  Mix this with four cups sugar and two and a half cups
corn syrup.  Now heat in a large pot to 310 degrees, and add red
food coloring and mint flavoring.  Remove the pot from the stove,
and allow the mixture to cool a little, before pouring it onto wax
paper.  When the candy's cool, cut it into squares and eat.
     One of the most common recipes for cooking with pot is
spaghetti.  This recipe doesn't take too much special preparation:
Just when you add your oregane, add at the same time a quarter cup
grass, and allow it to simmer with the sauce.  Be sure to use well
cleaned grass, unless you can get into eating twigs and stems. 
Another way of serving pot with spaghetti is to grind it up very
fine and mix it with some ground cheese.  Then sprinkle the cheese-
pot mixture over the sauce just before eating.
     Dessert is probably the most important stage of the meal,
since it will be the last thing your guests remember before they
pass out all over your table.  For an interesting dessert, grind a
quarter ounce of grass very finely, and add enough water so it
forms a paste.  Now separately dissolve one and a half cups sugar
into two cups milk.  Add to this your pot paste and one lemon rind
grated.  Beat in a half cup heavy cream, until the mixture is firm
and thick.  Now pour the mixture into ice cube trays and freeze. 
Just before you're ready to serve, rebeat the frozen mush until it
becomes light and fluffy.
     The following are some additional recipes for cooking with
pot:

                         Acapulco Green

3 ripe avocados                    3 tablespoons wine vinegar
1/2 cup chopped onions             2 teaspoons chili powder
1/2 cup chopped grass

Mix the vinegar, grass, and chili powder together and let the
mixture stand for one hour.  Then add avocados and onions and mash
all otgether.  It can be served with tacos or as a dip.

                            Pot Soup

1 can condensed beef broth         1/2 can water
3 tablespoons grass                3 tablespoons chopped watercress
3 tablespoons lemon juice

Combine all ingredients in a saucepan and bring to a boil over
medium heat.  Place in refrigerator for two to three hours, reheat,
and serve.

                     Pork and Beans and Pot

1 can (1lb, 13 oz) can             1/2 cup light molasses
  pork and beans                   1/2 teaspoon hickory salt
1/2 half cup grass                 3 pineapple rings
4 slices bacon

Mix together in a casserole, cover top with pineapple and bacon,
bake at 350 degrees for about 45 minutes.  Serves about six.

                          The Meat Ball

1 lb. hamburger                    1/4 cup bread crumbs
1/4 cup chopped onions             3 tablespoons grass
1 can cream of mushroom soup       3 tablespoons India relish

Mix it all up and shape into meatballs.  Brown in frying pan and
drain.  Place in a casserole with soup and 1/2 cup water, cover and
cook over low heat for about thrity minutes.  Feeds about 4 people.

                         Spaghetti Sauce

1 can (6 oz.) tomato paste         1 can (6 oz.) water
2 tablespoons olive oil            1/2 clove minced garlic
1/2 cup chopped onions             1 bay leaf
1/2 cup chopped grass              1 pinch thyme
1 pinch pepper                     1/2 teaspoon salt

Mix in a large pot, cover and simmer with frequent stirring for two
hours.  Serve over spaghetti.

                            Pot Loaf

1 packet onion soup mix            2 lbs. ground beef
1 (16 oz) can whole peeled         1 egg
  tomatoes                         4 slices bread, crumbed
1/2 cup chopped grass

Mix all ingredients and shape into a loaf.  Bake for one hour in
400-degree oven.  Serves about six.

                         Chili Bean Pot

2 lbs. pinto beans                 1/2 clove garlic
1 lb. bacon, cut into two inch     1 cup chopped grass
  sections                         1/2 cup mushrooms
2 cups read wine                   4 tablespoons chili powder

Soak beans overnight in water.  In a large pot, pour boiling water
over beans and simmer for at least an hour, adding more water to
keep beans covered.  Now add all other ingredients and conitnue to
simmer for another three hours.  Salt to taste.  Serves about ten.

                          Bird Stuffing

5 cups rye bread crumbs            1/3 cup chopped onions
2 tablespoons poultry seasoning    3 tablespoons melted butter
1/2 cup each raisins and almonds   1/2 cup chopped grass
1/2 cup celery                     2 tablespoons red wine

Mix it all together, then stuff it in.

                            Apple Pot

4 apples (cored)                   4 cherries
1/2 cup brown sugar                1/3 cup chopped grass
1/4 cup water                      2 tablespoons cinnamon

Powder the grass in a blender, then mix grass with sugar water. 
Stuff apple cores with this paste.  Sprinkle apples with cinnamon,
and top with a cherry.  Bake for 25 minutes at 350 degrees.

                          Pot Brownies

1/2 cup flour                      1 egg (beaten)
3 tablespoons shortening           1 tablespoon water
2 tablespoons honey                1/2 cup grass
1 pinch salt                       1 square melted chocolate
1/4 teaspoon baking powder         1 teaspoon vanilla
1/2 cup sugar                      1/2 cup chopped nuts
2 tablespoons corn syrup

Sift flour, baking powder, and salt together.  Mix shortening,
sugar, honey, syrup and egg.  Then blend in chocolate and other
ingredients, mix well.  Spread in an eight-inch pan and bake for 20
minutes at 350 degrees.  If you are too lazy to cook, just add the
grass to any ready to make brownie mix.

                          Banana Bread

1/2 cup shortening                 1 cup mashed bananas
2 eggs                             2 cups sifted flour
1 teaspoon lemon juice             1/2 cup chopped grass
3 teaspoons baking powder          1/2 teaspoon salt
1 cup sugar                        1 cup chopped nuts

Mix the shortening and sugar, beat eggs, and add to mixture. 
Separately mix bananas with lemon juice and add to the first
mixture.  Sift flour, salt, and baking powder together, then mix
all ingredients together.  Bake for 1 1/4 hours at 375 degrees.

                       Sesame Seed Cookies

3 oz. ground roast sesame seeds    1/4 cup honey
3 tablespoons ground almonds       1/2 teaspoon ground ginger
1/4 teaspoon nutmeg                1/4 teaspoon cinnamon
1/4 oz. grass

Toast the grass until slighly brown and then crush it in a mortar. 
Mix crushed grass with all other ingredients, in a skillet.  Place
skillet over low flame and add 1 tablespoon of salt butter.  Allow
it to cook.  When cool, roll mixture into little balls and dip them
into the sesame seeds.

     If you happen to in the country at a place where pot is being
grown, here's one of the greates recipes you can try.  Pick a
medium-sized leaf off the marihuana plant and dip it into a cup of
drawn butter, add salt and eat.

I hope you enjoy these recipes which were taken from The Anarchist
Cookbook, by William Powell and no longer available at finer
bookstores anywhere.

Bon appetit!
Absalom


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[[category:Drugs]]

[Drugs] Chinese Checkers


HERBALISTHERBSCHINESEHEALTHMEDICINEDRUGONTARIOGOVERNMENT
CHINESE CHECKERS (Chinese Herbalists)

Chinese Checkers! 
-----------------

Last December saw new Government initiatives directed 
specifically towards imported Chinese medicines. The Oriental 
community, fearing restrictions on the use of their traditional 
medicinal herbs, organised a public meeting in Toronto, inviting
representatives from Health and Welfare Canada to explain the new
Government position.  

I could not resist attending this meeting myself and after 
hearing both sides speak, it seems that these remedies are now 
subject to the same Food and Drug regulations that all other 
herbal preparations have to deal with. Packaging must now be 
bi-(tri?)-lingual, and no claims may be made in regard to their 
medicinal effectiveness, unless of course the remedy has a 
Government approved Drug Identification Number (DIN).  

Unfortunately Health and Welfare Canada appear to have adopted 
the `let's see how difficult we can make it for them' approach, 
when it comes to issuing these DIN numbers. This was amply 
illustrated at the meeting, with many fully documented examples 
of importers and manufacturers bending over backwards to conform
to regulations, that seemed to change as frequently as the hair 
styles of the Government bureaucrats involved! 

As a service to our members the Society has available a full(?) 
list of the restricted Chinese herb products. The size of this 
list prohibits us from printing it here, so if you would like a 
copy, please write to us and we will mail one out to you. 

However, the importation and sale of non-proscribed Chinese herbs
in their natural form, i.e. roots, leaves, barks etc. is NOT 
affected. Dong quai (Chinese angelica), will still be available 
at your herb store. Although for how long is anyone's guess. Our
most useful and effective herbs are classed as restricted, with 
more joining the proscribed lists than ever before. How long 
before your chamomile tea becomes an illegal drug? Don't laugh, 
it's happening. Yet thousands of our citizens are addicted to the
legal botanic drug caffeine, with the prospect of any restriction
concerning its use, non existent. What on earth is going on here?

This Article is taken from The Herbalist, newsletter of the
Canadian Herbal Research Society. COPYRIGHT June 1988. 
Membership in the Society is $25.00 Canadian per year. You
receive four copies of the Journal each year and help to promote
herbalism and botanic medicine throughout Canada. 

THE SOCIETY HAS NO PAID OFFICIALS and is run entirely by
volunteers from among the membership. 

If you would like more info please write: 
Botanic Medicine Society. 
P.O. Box 82. Stn. A. 
Willowdale, Ont. CANADA. 
M2N 5S7. 
  
[[category:Drugs]]

[Drugs] Alert - Acetaminophen



ACETAMINOPHENMEDICATIONALCOHOLTYLENOLDATRILDRUGSMEDICINE 
ACETAMINOPHEN - MEDICATION ALERT (Mayo Clinic)


ACETAMINOPHEN - MEDICATION ALERT 
--------------------------------
Issued by the Mayo Clinics health newsletter!

   This  Pain killer and alcohol can make a  lethal  combination: 
says the Mayo Clinic's newsletter.

    Acetaminophen  has  become a popular drug,  especially  since 
1955  when it first became available without prescription in  the 
United  States.  It  is  best known in  America  by  the  heavily 
advertised  brand names Tylenol and Datril.  Nevertheless,  it is 
present either alone or in a combination with other drugs in more 
than  200  over-the-counter formulations promoted for  relief  of 
pain, cough and colds. 

    In equivalent dosage,  acetaminophen is just as effective  as 
aspirin in relieving mild pain and reducing fever. In contrast to 
aspirin,  acetaminophen  does not irritate the stomach lining  or 
interfere  with  the  role  of  blood  platelets  in  controlling 
bleeding  from  small  blood  vessels.  Also,  it  has  not  been 
associated with Reye's syndrome. For these reasons, this drug has 
been  heavily  promoted  as a safe aspirin  substitute.           

     When  taken  in  recommended  amounts,  acetaminophen  is  a 
remarkably  safe medication.  Yet,  if ingested in large  amounts 
(for example,  either inadvertently or in a suicide attempt, this 
drug  can  cause  severe liver and kidney  damage.  Until  recent 
years,  acetaminophen poisoning has been infrequently  recognized 
in  America.  In contrast,  for reasons that are unclear,  deaths 
from overdosage often have been reported from the United  Kingdom 
(where the drug is called paracetamol).

 Alcohol and acetaminophen

     After excessive alcohol consumption,  many people experience 
abdominal  distress caused by inflammation of the stomach  lining 
(gastritis),  brought  on by the alcohol.  Aspirin also can cause 
gastritis.  Because  acetaminophen  does not  have  this  effect, 
people who drink heavily often use it in preference to aspirin.

     When  intoxicated,  people often behave  irrationally.  Drug 
overdoses are common.

     Now  there is some evidence that certain alcoholics may have 
a  particular sensitivity to the toxic effects of  acetaminophen. 
There are several recent reports of severe liver damage and death 
in  alcoholics  who  have  taken little  more  than  the  maximum 
recommended  dose of acetaminophen.  Although at present not  all 
experts agree about this possible risk,  we believe that  persons 
who  drink heavily should take acetaminophen with great  caution. 
Alcohol  also  may  interact  with a variety  of  other  commonly 
prescribed  drugs and lead to unexpected and sometimes  dangerous 
effects.   Our  recommendation  - don't  mix  alcohol  with   any 
medication   unless  you  have  discussed  the  risks  with  your 
physician.       

Mayo  Clinic Health Letter:  To subscribe  write 

Mayo Clinic Health Letter,  
Mayo Medical Resources, 
Rochester, Mn 
55905 

Telephone 1- 507-284-4577.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *


  
[[category:Drugs]]

[Drugs] Acne Treatment With Isotretinoin


ISOTRETINOINACCUTANEACNEPREGNANCYCYSTICFETALHEALTHMEDICINE 
ISOTRETINOIN (ACCUTANE) TREATMENT OF ACNE 


Isotretinoin (Accutane) treatment of acne  
-----------------------------------------

   It  has long been known that vitamin A has a regulatory effect 
on  growth and differentiation of epithelial  tissue.  Since  the 
1940's,  high  doses  of  vitamin  A have been  employed  in  the 
treatment of severe acne and various disorders of keratinization. 
Vitamin A's use, however, was limited by its side effects - liver 
toxicity and pseudotumor cerebri in particular.  In an attempt to 
find  a  drug  with a better therapeutic index  than  vitamin  A, 
several synthetic retinoids have been developed (1).

   One of these,  isotretinoin (13-cis-retinoic acid),  was first 
synthesized in 1955.  It was largely ignored until the results of 
the  first major clinical trial demonstrating its efficacy in the 
treatment  of severe recalcitrant cystic acne were  published  in 
1972 (2). in 1982, isotretinoin was approved in the United States 
for  that single indication only.  Its trade name is Accutane.  A 
major  feature  of  this drug is that  it  produces  a  prolonged 
remission  in patients with severe cystic acne,  many of whom had 
not  responded to other therapies.  The most striking  discovery, 
however,  is that the remission is often sustained for months  or 
years  after  the four- to five-month treatment course  has  been 
completed.

Transport and metabolism of vitamin A (retinol) and isotretinoin 

   Significant  differences  between vitamin A  and  isotretinoin 
with  regard to their transport and metabolism account for  their 
difference  in  toxicity  (3).  The  major source  of  vitamin  A 
(retinol)  is the conversion of dietary plant carotenoids in  the 
intestinal mucosa. Retinol is stored in the liver, which contains 
over  90%  of  body  stores.   Mobilization  from  the  liver  is 
accomplished  when  retinol  is bound  to  a  specific  transport 
protein,  retinol  binding protein,  that delivers it to tissues. 
Plasma  levels of vitamin A tend to remain constant despite  wide 
variations in diet. Extremely high dietary intake (eg. polar bear 
liver,   vitamin   A   tablets)  produces   hypervitaminosis   A. 
Hypervitaminosis  A results in greatly increased  hepatic  stores 
and subsequent toxicity.

   In contrast, isotretinoin binds to serum albumin. Isotretinoin 
is  readily  absorbed  orally and put into  circulation  via  the 
portal  system.  It  is  not significantly stored  in  any  organ 
system, and plasma levels vary with the amount ingested.

Mode of action of isotretinoin in the treatment of acne

   Acne is a disease of the pilosebaceous unit.  The pathogenesis 
of  acne is believed to include several factors.  Among them  are 
excessive sebum production, abnormal keratinization of follicular 
epithelium,    proliferation    of   'Propionibacterium   acnes', 
inflammation, and hormonal regulation of sebaceous glands.

   Isotreinoin affects several of these mechanisms, but its exact 
mode of action is not known.  Isotretinoin causes pronounced  but 
temporary inhibition of sebum production and atrophy of sebaceous 
glands  (4).  In  general,  after two weeks of  standard  therapy 
(1mg/kg/day),  sebum production is decreased by more than 50% and 
by  the  end of a four- to five- month treatment  period,  it  is 
reduced  by greater than 90%.  While there are some patients  who 
continue to have decreased sebum production months to years after 
cessation  of therapy,  the sebum production of the vast majority 
returns  to the baseline level within a few months.  Since  sebum 
production returns to normal in most patients,  this is obviously 
not  the sole mechanism for the prolonged remission of acne  seen 
in these individuals.  Many of these patients continue to improve 
even after therapy is discontinued (5).

   Some   investigators   believe  that   isotretinoin   inhibits 
follicular keratinization in patients with acne.  They  postulate 
that  this  prevents the formation of comedomes  (whiteheads  and 
blackheads), the precursors of inflammatory acne lesions.

   Isotretinoin  does decrease the quantity of  'Propionbacterium 
acnes' in treated patients.  This organism is normal flora within 
the  follicles.  Increased numbers of these bacteria in  patients 
with  acne  produce various chemotactic factors and enzymes  that 
may increase inflammation. The decreased number of these bacteria 
in  isotretinoin-treated  patients is thought to be a  result  of 
decreased sebum production,  producing a poor environment for the 
proliferation  of  this  organism.   Therefore,   the   decreased 
bacterial counts are thought to be secondary, and not the primary 
mechanism of action of Accutane.

Clinical side effects

   Mucocutaneous  side  effects  are  the  most  common  seen  in 
isotretinoin  treatment  (6).  More  than 90% of  people  treated 
experience  cheilitis,  usually  within the first  two  weeks  of 
treatment.  This is most easily treated with bland emolliation. A 
generalized xerosis is very common,  but frequently acne patients 
view  this  as a beneficial rather than  adverse  effect.  Should 
xerosis become problematic, the use of a noncomedogenic emollient 
lotion  can be employed.  Frequently patients develop nose bleeds 
and non-infectious conjunctivitis. Symptomatic treatment of these 
problems  is  all that is indicated.  Less than 30%  of  patients 
notice  temporary thinning of the hair.  Less than 10%  of  these 
have  clinically apparent hair loss,  and hair density returns to 
normal after treatment is discontinued. 

   Approximately  20% of patients on isotretinoin  have  musculo-
skeletal pains.  These tend to be minor, and are relieved by non-
steroidal  anti-inflammatory  agents.   More  worrisome  are  the 
skeletal abnormalities seen in patients on long term isotretinoin 
treatment for various keratinizing disorders (7).  These patients 
however  ,  were usually treated with higher doses of  2mg/kg/day 
for more than two years.  The ossification disorder seen in these 
patients   resembles  diffuse  idiopathic  skeletal   hypostosis. 
Children  being  treated for these disoreders had x-ray  findings 
suggesting premature closure of the epiphyses of the knees.

   More  recently,  in a small prospective study of  patients  on 
doses  of  2  mg/kg/day  of isotretinoin  for  the  treatment  of 
keratinizing   disorders,   radiologically  documented   skeletal 
changes  were  noted  after only 6-12 months  of  therapy.  These 
changes  consisted of slightly increased bone formation in  areas 
of  ligament  attachment.  It is not yet known  whether  this  is 
reversible.

   A  small number of patients may have a temporary flare of acne 
at the onset of treatment. Some clinincians feel that this can be 
minimized  by the administration of low dose prednisone  or  oral 
antibiotics. 

   Pseudotumor  cerebri  ( benign intracranial hypertension)  has 
occurred  in patients treated with  isotretinoin.  Patients  with 
headache,  nausea,  vomitting  or  visual disturbances should  be 
screened for papilledema.  The drug should be stopped immediately 
if papilledema is present. 

   Patients  with visual disturbances should also be checked  for 
corneal  opacities.  Corneal opacities occur more  frequently  in 
those   patients  receiving  higher  doses  of  isotretinoin  for 
keratinizing  disorders  but has also been reported  in  patients 
treated for cystic acne. The opacities resolve six to seven weeks 
after discontinuation of the drug. 

   There  have been rare reports of inflammatory bowel disease in 
patients  treated with isotretinoin.  Occasional patients  report 
fatigue or lassitude.

Laboratory abnormalities

   One  fourth  of  patients treated  with  isotretinoin  develop 
elevated  serum triglycerides during their  four- to  five- month 
course  of  treatment for acne.  Approximately one eighth have  a 
decrease  in  the  HDL  level and  one  sixteenth  have  elevated 
chloresterol.  These  changes  usually resolve after  therapy  is 
discontinued.  It  is  important to monitor blood lipids  at  the 
onset  of therapy and at intervals of two to four weeks until  it 
is seen that there are no significant changes.  Minor  elevations 
in  triglycerides are best treated by dietary maneuvres.  It   is 
not  known  what  role the lipid abnormalities may  play  in  the 
production  of coronary heart disease,  but the risk is currently 
thought  to  be low since abnormalities return  to  normal  after 
therapy  is stopped.  It is perhaps best that patients with  high 
triglyceride  elevations  be  treated with the  lowest  effective 
dosage of isotretinoin for a shorter period of time. Triglyceride 
elevations of greater than 500 mg/dL necessitate  discontinuation 
of  the drug,  as these patients are at risk for developing acute 
pancreatitis.  A few patients develop mild leukopenia, anemia, or 
thrombocytosis. Mild pyuria and liver function test abnormalities 
occasionally occur.  These changes appear to be reversible  after 
discontinuation  of  the  drug  and are  usually  not  clinically 
significant.

Isotretinoin and pregnancy

   The   most  serious  side  effect  of  isotretinoin   is   its 
teratogenicity.  The  drug  should not be used by women  who  are 
pregnant  or those who plan to become pregnant during  treatment. 
Contraception is recommended for women taking the drug, beginning 
one month before treatment,  and continuing until one month after 
discontinuation of treatment.  Many physicians obtain a pregnancy 
test within two weeks prior to starting therapy. 

   Reported    fetal    abnormalities   include    hydrocephalus, 
microcephalus,  abnormalities  of the external  ear  (micropinna, 
small  or  absent external auditory  canals),  Micropthalmia  and 
cardiovascular  abnormalities.  These abnormalities have  occured 
only  in  children  born to mothers exposed to  the  drug  during 
pregnancy.

   The   package  insert  recommends  that  patients  who  become 
pregnant  discuss  with  their  physician  the  desirability   of 
continuing the pregnancy.  Since the half-life of isotretinoin is 
less than one to three days, it is believed that there is no risk 
of  teratogenicity  during  subsequent pregnancies  occurring  at 
least one month after treatment has been stopped.

   While  no reproduction studies have been performed  on  humans 
taking  isotretinoin,  studies in rats have not revealed impaired 
fertility. No significant changes have been seen in the number or 
mobility of spermatazoa of human males receiving isotretinoin. As 
it is not known whether isotretinoin is secreted into milk, it is 
inadvisable to treat nursing mothers with the drug.

Dosage and administration

   Isotretinoin  is  presently approved by the FDA only  for  the 
treatment of severe recalcitrant nodulocystic acne. While dosages 
of 0.1,  0.5,  and 1.0 mg/kg/day orally seem equally effective in 
inducing  a remission of acne,  there is a  significantly  higher 
relapse rate in patients rate in patients treated at lower doses. 
As  the goal of isotretinoin therapy is not only the clearing  of 
active disease but the indefinite maintenance of clearing,  it is 
recommended  that patients be treated with 1 mg/kg/day for  16-20 
weeks. Extensive truncal lesions, which do not respond as quickly 
or  completely as facial lesions,  may require dosages of 1.5-2.0 
mg/kg/day. Isotretinoin is supplied in 10,20, and 20 mg capsules. 
Most patients are treated with 40 mg twice daily. Patients should 
be  advised not to ingest any vitamin A supplements during  their 
treatment course.

Other indications

   Isotretinoin has also been shown to be effective for a variety 
of  other skin disorders,  but it is not yet approved by the  FDA 
for  these indications.  These include several variants of  acne: 
hidradenitis   suppurativa,   gram  negative  folliculitis,   and 
rosacea.

   Retinoids also have an antineoplastic effect. Several patients 
with  the  basal  cell nervus  syndrome,  an  autosomal  dominant 
disorder   in   which  patients  develop  multiple   basal   cell 
carcinomas, have been treated. Isotretinoin resulted in reduction 
in  tumor  sizes,  but  usually did not  completely  destroy  the 
tumors.  Retinoids  are  also being studied for  possible  future 
roles  in cancer prevention.  Isotretinoin and other retinoids  ( 
especially etretinate,  an aromatic retinoid not yet available in 
the  US) have been used to treat a wide variety  of  keratinizing 
skin  disorders,   such  as  psoriasis,  keratosis  follicularis, 
ichthyosis,  pityriasis rubra pilaris, and others (8). Discussion 
of  this is beyond the scope of this paper.  Although the drug is 
very effective for several of these disorders,  the major problem 
is  that  long-term  treatment  is  required  for  these  chronic 
diseases,   and  long-term  safety  of  retinoids  has  not  been 
established.

Conclusion 

   Isotretinoin   (Accutane)  is  an  exceedingly  useful   drug, 
producing dramatic prolonged remissions after four to five  weeks 
in  most patients with severe nodulocystic acne.  Because of  its 
side effects, teratogenicity, and cost (about $600 for a four- to 
five- month course of treatment), the drug should be reserved for 
the less than 1% of patients with severe acne.

  
[[category:Drugs]]