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http://www.meditalent.com/main2e3b.htm <-- visit for more pages is recommended
要聞 : 中國真菌病研究有重大突破 長征醫院此項研究獲國家科技進步二等獎
【本報訊】中國新生隱球菌以A、D型為主，缺乏C型；對隱球菌腦膜炎採用綜合分期治療新方法，可明顯提高治癒率。日前，由上海長征醫院皮膚科廖萬清教授與中國醫學科學院皮膚病研究所合作完成的《真菌病的基礎與臨床繫列研究》，獲得2000年度國家科技進步二等獎。這是迄今為止中國真菌病學研究獲得的最高獎勵。專家廖萬清教授針對中國農村地區頭癬流行，體股癬、手足癬患病率高的特點，通過兩次全中國性和18次區域性針對特定人群的流行病學研究，分析各種真菌病的患病率、致病菌及其變遷規律，先後發現10種新病原真菌及新病種，3種為國際首次發現，其中新生隱球菌上海變種採用廖氏命名，並被美國真菌菌種保藏中心(ATCC)收錄保藏。之後，又研製出複方酮素唑霜等新藥，並提出系列針對性防治措施，為中國在20世紀80年代基本消滅頭癬、基本控制其他癬病危害作出重要貢獻。
在此基礎上，課題組在國內首次建立了6種檢測病原真菌的實驗室診斷方法，將內臟器官深部真菌感染的實驗室診斷方法系列化，使內臟器官深部真菌感染的治癒率達到83.8%。20世紀80年代起，他們又開展對危害中國人民健康較大的念珠菌、隱球菌等致病真菌的免疫學、分子生物學研究，在國際上首次建立新生隱球菌大型標準菌及裴氏著色真菌DNA克隆庫，篩選獲得新生隱球菌、裴氏著色真菌的種、變種及血清型特異性探針，建立起隱球菌和念珠菌的分子流行病學研究方法。近5年來，廖萬清將上述研究成果應用於臨床，採用藥物綜合、降顱壓、電解質平衡、靜脈注射、鞘內注射及分兩期治療等方法，治療30餘例隱球菌性腦膜炎，治癒率達100%，病殘率、複發率為零。
據介紹，目前國際上隱球菌性腦膜炎的死亡率為40%－65%，病殘率為20%，複發率為20%－30%。有關專家認為，廖萬清所建立的隱球菌和念珠菌的分子流行病學研究方法，以及對隱球菌性腦膜炎的治療和在致病基因研究方面取得的突出成績，提高了中國真菌病的基礎研究水平，臨床診治技術處於國際領先。
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http://www.medicchina.com/cmedicchina/yongyaozhinan/guanzhuotc/xiyi/fuchanke/002.htm
克霉唑
Clotrimazole
[其他名稱] 三甲苯咪唑
[適應症] 本品作用于真菌細胞膜，抑制細胞膜脂類的合成，使細胞膜的通透性改變，使菌體細胞內的一些物質如鉀離子、磷酸、氨基酸等漏失，從而殺滅真菌。主要對表皮癬菌、毛發癬菌、曲菌、著色真菌和念珠菌等有較好的抗菌作用，對滴虫、部分細菌也有一定的殺滅作用。用于皮膚粘膜真菌感染.
[不良反應] 少數患者用本品制劑可發生局部過敏及刺激症狀，發生局部燒灼感、紅斑、刺感、起 、脫皮、瘙痒、 麻疹、接觸性皮炎。用于陰道內，曾有發生輕度燒灼感、紅斑及刺激症狀，稍有尿頻或皮疹，男方偶會感到陰莖或尿道有刺激感.
[注意事項] 婦女妊娠時，并不禁忌在皮膚上局部應用克霉唑，在中期、晚期妊娠時，也不禁止用其在陰道內給藥，但在妊娠早期不要使用。本品制劑不宜在眼部使用，用于眼周圍時，應特別注意.
[用法用量] 外用：1%～3%溶液或軟膏乳膏局部涂抹，將足量的溶液、乳膏軟膏覆蓋在病損及其周圍區域，每日2～3次
[劑型] 乳膏劑，軟膏，外用溶液。
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http://www.lamasbeauty.com/beauty/april03/dandruff_faq_print.htm
Nutritional Supplements
Supplementing the essential fatty acids is more important since these are usually lacking. Evening primrose oil is a good source of gamma linolenic acid (GLA), easily absorbed by the body.
B6 deficiencies also cause dandruff. To prevent imbalances, the entire B complex should be included. In addition, vitamins A and E are important for skin health.
Silica is also recommended for improving scalp health. It is available in capsules from a vegetable source and in a liquid gel form.
Daily Dosages
Most Important:
Evening primrose oil, two 500 mg capsules three times daily
Vitamin B complex, 50 mg twice daily with meals
Vitamin B6 or Pyridoxal-5-Phosphate, 50 mg twice daily
Helpful
Vitamin A, 10,000 IU (not during pregnancy)
Vitamin E, with mixed tocopherols, 400 IU
Silica, 1,000 mg, two 500 mg capsules daily
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Dandruff is one of the great levelers of life. It knows no class, creed or race. It affects everyone but not in equal measure. Some people have a very minute quantity of dandruff, while others spend their lifetimes trying to get rid of it. Dandruff has given rise to a whole multi-million dollar cleansing shampoo industry. Companies such as Unilever and P & G have spent millions of dollars in research and development to try to find an everlasting dandruff eradicator. Consumers keep on oscillating between products available in stores to various home remedies but at most both can provide temporary relief. There are several misconceptions regarding dandruff and unfortunately most people base their treatments on them.
Dandruff is the dry, white or grayish substance that appears in patches on the top of the head. They appear in the form of scales. Dandruff occurs when the scalp sheds dead epidermal (skin) cells in large clumps. Scalp cells replenish themselves in a pattern similar to that of hair, but more rapidly: The skin of the head renews itself about once a month. Dead scalp cells are constantly being pushed from the deepest layer of the epidermis to the skin's surface, where they gradually die. Usually the scalp sheds them in a nearly invisible way. But for reasons that are still unclear, cell turnover sometimes becomes unusually rapid, and dead cells are shed as the visible flakes called dandruff. This dandruff then falls on the shoulder and becomes visible to someone standing close by. Persons suffering from prolonged dandruff are said to have a dandruff ailment.
Dandruff is caused by a micro-organism called Pityrosporum-Ovale (now renamed Malassezia furfur), which are present in every body's scalp. The fungus is found naturally on the skin surface of both healthy people and those with dandruff. The fungus likes fat, and is consequently found most on skin areas with plenty of sebaceous glands: on the scalp, face and upper part of the body. Symptoms of dandruff manifest itself when exposed to dust; UV light, harsh chemical based shampoo, hair dyes etc. This results in the increase of the number of microbes, which causes unhealthy residue over the scalp, which leads to dandruff, which is the cause of unhealthy scalp results in unhealthy, lifeless hair and may also result in excessive loss of hair. But dandruff should not be mistaken for other more harmful conditions such as seborrheic dermatitis or psoriasis. These conditions cause itching and redness accompanied by dandruff. They can also lead to eczema.
People with oily scalps tend to suffer most from dandruff because an oily scalp supports the growth of yeast, which is crucial to the generation of scales. Causes of excessive dandruff could vary from hereditary reasons to tension and anxiety. Excessive usage of hairsprays, improper electric hair curlers, tight fitting hats and cold weather are the other known causes.
There are essentially two types of remedies for dandruff. A mild shampoo that contains a cytostatic agent, such as selenium sulfide or zinc pyrithione must be used. Cytostatic agents reduce the rate of growth and multiplication of cells on the top layer of skin on the scalp, which causes a noticeable decrease in visible dandruff within several weeks. Shampoos are to be avoided if there is a cut in the scalp. Nizoral is the only shampoo containing a patented active ingredient known as ketoconazole this ingredient is medically proven to be effective against Malassezia furfur. It has been recommended by doctors and pharmacists all over the world. If the dandruff is caused due to a nutrition deficiency then he/she must incorporate vitamins B6, B12, F and selenium in their diet.
There are a host of homemade treatments that can be recommended. Garlic and oil of oregano are excellent anti-dandruff agents. A fresh onion that is cut and applied to the scalp or the pouring of apple cider vinegar help in alleviating the condition by cleansing the scalp. Both of them have well-known antiseptic properties. Alternating hot and cold water on the head increases circulation to the scalp. Yoga headstands are also popular. But it is important to remember that dandruff cannot be eliminated; it can only be controlled.
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http://www.cfps.org.sg/sfp/19/194/articles/e194171.html
http://www.jrksiddha.com/products1.htm
DANO
Dano is recommended for regular use as a hair oil .
Laboratory studies have confirmed that Dano eradicates dandruff completly by its Fungicidal activity against Pityrosporum Ovale.
Application procedure
Apply DANO after bath
Keep hair free from moisture
Apply DANO over the scalp using finger ends
DANO is presented in easily absorbing and non sticky form
DANO is recommended for use as a regular hair oil
Wash hair regularly and clean the scalp with herbal hair care powders or formulations.
Dano is available in 100 ml pet bottles.
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coptis 黃連
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http://wolf.mind.net/SWSBM/Abstracts/Scutellaria-AB.txt
*****ANNALES PHARMACEUTIQUES FRANCAISES*****
Yang D Michel D Bevalot F Chaumont JP Millet-Clerc J
[Antifungal activity in vitro of Scutellaria baicalensis Georgi upon cutaneous
and ungual pathogenic fungi]
Activite antifongique in vitro de Scutellaria baicalensis Georgi vis- a-vis de
champignons pathogenes cutanes et ungueaux.
In: Ann Pharm Fr (1995) 53(3):138-41
ISSN: 0003-4509 (Published in French)
The root of Scutellaria baicalensis Georgi (Lamiaceae) is one of the traditional
drugs commonly used in the Far East. The extracts obtained by the successive
exhaustion in chloroform and in ethyl (n.乙基;四乙鉛) acetat present clear fungistatic
activities in vitro against to some cutaneous and ungual (a.爪的;有爪的) pathogenic (a.使生病的;成為病原的;病原性的) fungi, and
particularly upon strains of Candida albicans, Cryptococcus 隱球菌 neoformans and
Pityrosporum ovale. For each of these, its minimum inhibitory concentration is
determined. The ethyl acetat extract appears the most interesting because of its
efficiency and of its stability. An antifungal substance is found out as the
baicalein.
Registry Numbers:
491-67-8 (baicalein)
(Scutellarin 野黃芩; baicalein 黃芩素; 黃芩 元; Georgi; acetate n.醋酸鹽 ; fungistatin 製真菌素 )
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http://www.sundaylife.co.uk/features/story.jsp?story=466481
Troubled by skin infection
Q. I HAVE a recurrent fungal skin infection called pityriasis versicolor. I've seen a dermatologist about six times, over the last two years, and tried every combination of creams and tablets, none of which has helped. Are there any alternatives?
A. PITYRIASIS versicolor is a fungal skin infection due to a yeast, Pityrosporum.
It causes a fine, scaly rash on the skin with numerous round or oval patches that are initially pale pink or brown, before fading to leave white areas due to flaking off of outer skin cells.
As it is so widespread, it is usually treated with oral antifungal drugs such as itraconazole, for five to seven days which is usually effective.
However, the lesions may persist for some time, even after successful treatment because of loss of pigmentation (n.染色;著色;色素之形成), so it's possible your infection has already gone and the lesions will slowly fade.
The most effective alternative treatment for fungal skin infections is to apply neat tea tree oil twice a day.
Taking Olive leaf, grapefruit seed or Lapacho (Pau d'arco) extracts can also help.
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http://www.nutramed.com/skin/skinfungal.htm
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http://www.hoepharma.com.my/pd_aft_tolnaderm-c.html
ANTI FUNGAL TOPICAL
TOLNADERM CREAM
DESCRIPTION:
White opaque cream. Each gram contains 10mg of tolnaftate solubilised in a base containing polyethyiene glycol with butylated hydroxytoluene O.l%, methylparaben 0.16% and propyl paraben 0.03% as preservatives.
ACTIONS
Tolnaftate is effective in the treatment of the majority of cutaneous mycoses caused by Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum cants, Microsporum audouini, Microsporum gypseum, Epidermophyton floccosum andpityrosporum orbiculaire, but is ineffective against Candida or bacteria. Infections due to Trichophyton rubrum may relapse and a second course of treatment may be required.
PHARMACOLOGY
Tolnaftate inhibits the growth of Epidermophyton, Microsporum, Trichophyton spp., and Malassezia furfur, but it is not active against Candida spp. or bacteria.
INDICATIONS
The topical treatment of tinea pedis (athlete's foot), tinea cruris (jock itch) tinea corporis (body ringworm), tinea barbae (ringworm of the face and neck) and tinea manuum due to infection with Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum cants, Microsporum audouini, Epidermophyton floccosurn and tinea versicolor due to Pityrosporum orbiculaire. Tolnaderm Cream is indicated in tinea infections of the skin especially the non hairy areas of the body and including the groin. The vanishing cream base makes it cosmetically acceptable and there is no staining of the skin or clothing from the preparation. Tolnaderm Lotion, is nonaqueous and miscible with the exudates of fungal infections of the skin and penetrates into lesions without destruction of the epidermis. Toinaderm lotion is odourless, greaseless, and does notstain or discolour the skin, hair, nails or clothing. Tolnaftate preparations are not suitable for deep infections of the nailbed and hair follicles but may be applied concomittantly with a systemic agent.
CONTRAINDICATIONS
Hypersensitivity to tolnaftate or any component in the base.
ADVERSE EFFECTS
Skin reactions to toinaftate including irritation and pruritus may occur; contact dermatitis has been reported.
PRECAUTIONS/WARNINGS
It irritation occurs treatment should be discontinued. Keep away from the eyes and mucous membranes. lf there is no improvement within 10 days of use, treatment should be discontinued and a physician consulted. Not for ophthalmic use
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http://www.sinphar.com/medical/no33/medical_01.html
皮膚的黴菌感染
Skin fungal Infections
‧皮膚科／林仲醫師
常見的皮膚黴菌感染可分為皮癬菌感染、念珠菌感染、汗斑三大類。Three categories of common skin fungal infections are：
「黴菌」是甚麼生物？
Fungus（真菌、黴菌）是微生物中的一個大類，具有真正細胞核，產生孢子，不含葉綠素，以寄生或腐生方式攝取養分維生，目前已知的真菌種類有十萬種至二十五萬種，我們常聽到的黴菌、酵母菌、食用菇類（香菇、草菇、洋菇、木耳、金針菇）、靈芝、冬蟲夏草等皆屬於fungus。
Fungus依其所形成的菌落形態分為黴菌（霉菌）(mold)及酵母菌(yeast)兩大類，黴菌的體細胞為多細胞組成的絲狀體，稱為「菌絲體」，酵母菌的體細胞為單細胞，這是兩者之間最大的區別。但有些酵母菌也可產生假菌絲及真菌絲，有些黴菌則在自然界腐生或25℃培養時長出菌絲體，在活體內或37℃培養時呈酵母菌狀存在。
┌─ mold（黴菌、霉菌）─皮癬菌
Fungus（真菌、黴菌）┤
└─ yeast（酵母菌）─念珠菌、皮屑芽胞菌引
（起汗斑的黴菌）
由以上的分類可知「黴菌」的中文定義有狹義與廣義之分，狹義指「mold」，廣義指「fungus」。因此談到皮膚的「黴菌感染」時，一樣也有狹義及廣義之分，狹義的「皮膚黴菌感染」指的是皮癬菌感染，廣義的「皮膚黴菌感染」則不只皮癬菌感染，連念珠菌感染、汗斑也包括在內。其實包含皮癬菌感染、念珠菌感染、汗斑的廣義「皮膚黴菌感染」應稱為「皮膚真菌感染」較不會引起困擾，但此名詞在台灣不流行。另外也可知「fungus」應譯為「真菌」，只將「黴菌」一詞用來專指「mold」較妥。
由於「真菌」乃日本人創的新名詞，一般民眾鮮知，因此台灣醫界及民間少用「真菌」一詞，對於「fungus」或是「mold」都一樣使用「黴菌」這個傳統名詞，所以看到醫學文章講到「黴菌」時，應看清楚上下文來了解其究竟是指「fungus」還是「mold」。為了配合一般人的用法，本篇講義仍然稱「fungus」為「黴菌」。
一、皮癬菌感染
最常見的皮膚、指甲、頭髮的黴菌感染為dermatophyte（皮癬菌）引起的，皮癬菌分為三大類：Trichophyton（毛癬菌）、Microsporum （小芽孢菌）、Epidermophyton（表皮癬菌）。
皮癬菌只感染皮膚死掉的角質層，不侵犯人體的活組織，因為人類活體內有一種血清抑黴因子以及其它的免疫機轉，能抑制皮癬菌向內侵犯，偶而只在免疫有缺損的病人見到皮癬菌侵犯到人體深處。
感染皮癬菌的臨床表現：皮癬菌引起的皮膚病統稱為「tinea」或「ringworm」，西醫則翻譯為「癬」，更依下列原則進一步命名：
(1)依感染部位命名──頭癬、臉癬、鬚癬、體癬、股癬、手癬、足癬（香港腳）、甲癬（灰指甲、臭甲）等。
(2)依外觀命名──圓癬、花斑癬（中國大陸對於汗斑的稱呼）、禿瘡癬等，另外非西醫的病名如金錢癬（古代的病名）等。
其實西醫把「Tinea」翻譯為「癬」是個大錯誤，常引起醫護人員與病人的誤會！
我的皮膚病是不是長「癬」
古代中醫文獻裡的「癬」並不是特指一種皮膚病，而是包含很多種皮膚病：有從形狀命名的癬如「牛皮癬」（指皮膚病像牛頸子的皮，又厚又堅韌）、「金錢癬」（指皮膚病的外形圓圓的似銅錢）、「濕癬」（指抓了會流湯流水的皮膚病）、「乾癬」（指皮膚病的患處乾燥、抓了有白屑）、「松皮癬」（指皮膚病的外形似松樹的皮），有依發病時間命名的癬如「奶癬」（指於小孩哺乳期間所發生的皮膚病），有依病程命名的癬如「頑癬」（指頑固難醫的皮膚病），也有依感染源命名的癬如「疥癬」（由疥蟲感染所造成的皮膚病），這些「癬」病以現代醫學來說屬於很多不同類的疾病，並不是單一的病。
偏偏西醫借用「癬」這個字來稱呼黴菌感染的皮膚病，把一個廣義的字局限於狹隘的範圍，這是一個錯誤，常造成醫師及病人的誤會。如病人可能患慢性濕疹「頑癬」，但他卻自己去藥房買治療黴菌感染的藥膏來擦，只因為這種藥膏是治「癬」的！其實這兩種「癬」風馬牛不相及也，其治療結果可想而知！
由於錯誤已經鑄成了，無法改變，所以如講到「癬」，一定要知道是不是以前中醫或是一般民間所稱的「癬」，因這種「癬」無特殊意義，代表很多種皮膚病，反之西醫所說的「癬」則是代表黴菌感染。
二、念珠菌感染
念珠菌(Candida)為一種酵母菌(yeast)，主要由Candida albicans （白色念珠菌）致病。念珠菌在人類的口腔、陰道、腸胃道為正常的群落，當病人處於潮濕溫熱的環境，吃抗生素、類固醇、避孕藥，懷孕，免疫缺損等情況下，念珠菌即可以造成疾病。念珠菌常於黏膜及身體皺摺處造成皮膚病，常造成口腔的「鵝口瘡」(Thrush)、女性的外陰或陰道發炎、男性的龜頭及包皮發炎還有對磨疹、尿布疹、甲溝炎等。其臨床病灶的最重要特徵為主病灶的周圍出現衛星灶。
三、汗斑（變色糠疹、花斑癬）
汗斑為一種酵母菌「皮屑芽孢菌」(Pityrosporum orbiculare)造成的皮膚病，病灶的顏色可以由白色、淡紅色至棕色，因而有變色糠疹、花斑癬的稱呼。
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search by tricolsan spore - www.infectioncontroltoday.com/articles/321bpract.html
Date: September 19, 2003 01:49 PM
Author: Marilynn
Subject: Olive Leaf extract
I have had really good experiences with Olive Leaf. I use the Roex brand (roex.com) It is pharmaceutical grade and contains 17 to 22% oleuropean (depending on the time of year it is harvested) which is the active ingredient. I have looked for others, but only found ones that were 6% oleuopean - I am sure there are others, I just haven't hunted hard enough, but since I am satisfied with Roex, its okay. We keep it on hand and if taken every four hours at the very first sign of anything, generally stops it cold within a day. If you get something and it gets started, it will not stop it but will reduce the time you are miserable. My brother has Hepatitis C and we have been using the olive leaf (it has the ability to shred the protein covering on viruses) along with MG beta glucan from NSC (nsc24.com)(this one does not reaggregate in the intestines and it modulates the immune system), also a lot of other supplements aimed at the liver. He was keeping the viral load slowed down but still raising steadily each year until he added the olive leaf and beta glucan, which seems to have been the one two punch. His viral load is now reducing steadily for the last two years.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73457)
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Date: September 10, 2003 03:28 PM
Author: Denise
Subject: Olive leaf - BUMP UP!!
Here's the thread
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=71142)
--------------------------------------------------------------------------------
Date: September 18, 2003 11:05 PM
Author: Lyn
Subject: anti-bacterial, viral, fungal
In addition to olive leaf, I have found a good natural antiviral, bacterial & fungal to be Tea Tree Oil - readily available in Australia but I believe also available overseas. Green tea is also excellent - both internally and topically for minor infections and of course apple cider vinegar. In addition to taking a little internally - I also use it to wash with as I have very sensitive skin and have a bad reaction to soap. I have not had any problems since starting to use cider vinegar instead of soap. If your skin problem is sensitivity due to dryness and not an infection, then aloe vera jelly applied topically followed by a light application of blended cold pressed oils - e.g. wheat germ, macadamia, evening primrose,& a little lavender and calendula while skin is damp should help. Since using this regime which I developed by trial and error, I have received many compliments on my skin - I am in my 50's. Also take L-cysteine which boosts the immune system and is anti-bacterial and anti-viral.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73326)
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5. Dextrose-peptone-yeast extract Agar (DPYA)
Glucose (dextrose) 5.0 g
Peptone 1.0 g
Yeast extract 2.0 g
NH4NO3 1.0 g
K2HPO4 1.0 g
MgSO4.7H2O 0.5 g
FeCl3.6H2O 0.01 g
Oxgall 5.0 g
Sodium propionate 1.0 g
Chlortetracycline 30 mg
Streptomycin 30 mg
Agar 20 g
Distilled water 1000 ml
DPYA is an excellent medium for isolating fungi from soil and other natural substrates. The oxgall and sodium propionate restrict the growth of some rapidly spreading fungi, while the chlortetracycline and streptomycin discourage bacteria.
-----
http://www.nursingceu.com/NCEU/courses/handtwo/
Chloroxylenol
Chloroxylenol, also known as parachlorometaxylenol (PCMX), is a compound that has been used as a preservative in cosmetics and other products and as an active agent in antimicrobial soaps. It was developed in Europe in the late 1920s and has been used in the United States since the 1950s.
The antimicrobial activity of PCMX likely is attributable to inactivation of bacterial enzymes and alteration of bacterial cell walls. It has good in vitro activity against gram-positive organisms and fair activity against gram-negative bacteria, mycobacteria (leprosy, TB), and certain viruses. PCMX is less active against P. aeruginosa, but addition of ethylene-diaminetetraacetic acid (EDTA) increases its activity against Pseudomonas spp. and other pathogens.
A limited number of articles focusing on the efficacy of PCMX-containing preparations intended for use by HCWs have been published in the last 25 years, and the results of studies have sometimes been contradictory. The disparity between published studies may be associated with the various concentrations of PCMX included in the preparations evaluated and with other aspects of the formulations tested, including the presence or absence of EDTA. PCMX is not as rapidly active as chlorhexidine gluconate or iodophors, and its residual activity is less pronounced than that observed with chlorhexidine gluconate. In 1994, FDA TFM tentatively classified PCMX as a Category IIISE active agent (i.e., insufficient data are available to classify this agent as safe and effective).
The antimicrobial activity of PCMX is minimally affected by the presence of organic matter, but it is neutralized by nonionic surfactants. PCMX, which is absorbed through the skin, is usually well-tolerated, and allergic reactions associated with its use are uncommon. PCMX is available in concentrations of 0.3%-3.75%. In-use contamination of a PCMX-containing preparation has been reported.
Triclosan
Triclosan is a nonionic, colorless substance that was developed in the 1960s. It has been incorporated into soaps for use by HCWs and the public and into other consumer products. Concentrations of 0.2%-2% have antimicrobial activity. Triclosan enters bacterial cells and affects the cytoplasmic membrane and synthesis of RNA, fatty acids, and proteins.
Triclosan has a broad range of antimicrobial activity, but it is often bacteriostatic. Minimum inhibitory concentrations (MICs) range from 0.1 to 10 ug/mL, whereas minimum bactericidal concentrations are 25-500 ug/mL. Triclosan's activity against gram-positive organisms (including MRSA) is greater than against gram-negative bacilli, particularly P. aeruginosa. The agent possesses reasonable activity against mycobacteria and Candida spp., but it has limited activity against filamentous fungi. In 1994, FDA TFM tentatively classified triclosan <1.0% as a Category IIISE active agent (i.e., insufficient data exist to classify this agent as safe and effective for use as an antiseptic handwash). Further evaluation of this agent by the FDA is underway. Like chlorhexidine, triclosan has persistent activity on the skin. Its activity in hand-care products is affected by pH, the presence of surfactants, emollients, or humectants and by the ionic nature of the particular formulation. Triclosan's activity is not substantially affected by organic matter. The majority of formulations containing <2% triclosan are well-tolerated and seldom cause allergic reactions. Certain reports indicate that providing hospital personnel with a triclosan-containing preparation for hand antisepsis has led to decreased MRSA infections. Triclosan's lack of potent activity against gram-negative bacilli has resulted in occasional reports of contamination.
---------------------
http://217.60.75.10/labsafe/labsafe/biological/disinfectants/jjmdisinfectalt.html#chlorhex
CHARACTERISTICS
- FOR THE DIFFERENT TYPES OF DISINFECTANTS:
Alcohols-aldehydes-chlorhexidine-chlorine preparations-iodine preparations-oxydizing agents-phenolics-
quaternary ammonium compounds
Name: ALCOHOLS
Ethyl alcohol (ethanol) and isopropyl alcohols are the most frequently used alcohols.
Formula:
Ethanol: CH3CH2-OH Isopropanol: CH3-CH-OH
|
Inflammable. CH3
Effect:
Alcohols kill vegetative forms of bacteria (including TB) and fungi, but have no action on spores or
viruses (there might, however, be some effect on kappebærende vira).Their effect depend on
concentration and type of alcohol.
The following three solutions have similar effect:
Ethanol 70% , isopropanol 60% and n-propanol 40%
70-80% alcohol inactivates HIV and Hepatitis B in 2-10 minutes.
How does it work:
Alcohols precipitate proteins and solubilize lipids present in cell membranes.
It has a rapid action.
Contact time should preferably be 10-30 minutes.
Toxicity:
Ethanol is absorbant and astringent and dries out the skin. Propanoles are less absorbant, but they might penetrate the skin. The brief irritant action seen on the skin , when alcohol is applied in high concentrations, results from partial precipitaion of cellular proteins and from its dehydrating actions. If strong alcohol vapours are inhaled, the irritation causes reflex closure of glottis.
Effect on other materials:
Non-corrosive
May damage rubber, shellac and plastic
Interaction:
Synergistic effect together with iodine, chlorhexidin and quaternary ammonium compounds.
Alcohols are easily inactivated by organic material.
Use:
Hands, skin and instruments and surfaces: 60-70% ethanol.
In this case the effect is not enhanced with higher concentration, as it takes water to practice its effect
Name:ALDEHYDES
Formaldehyde (FA) and Glutaraldehyde (GA)
Pungent odour.
Effect:
Very effective against all kinds of germ; spores might take longer time and fungi might take higher concentrations.
Formaldehyde and glucoxal takes at least 2-4 hours (preferably 24 hours) to exert their effect; glutaraldehyde works a little faster.
Effect depends on temperature: FA has the best effect with high temperature and high humidity. There is no effect < 12ºC. GA can be used down to 5ºC with a longer action period.
pH dependent. FA works best in a neutral environnement, whereas GA has its optimum in a weak alkaline environnement (pH 7,5-8,5)
Not sensitive to organic matter, but it has difficuties in penetrating it.
How does it work:
Alkylating agents that react with the amine, sulfhydryl and carboxyl groups af protein and small organic molecules to kill microorganims.
Toxicity:
Even high dilutions is irritant to skin, eyes and airways; higher concentrations: cauterization.
All aldehydes may cause allergy, allergic asthma and allergic contactexema.
Large concentrations give strong irritation of mucous membranes in nose and eyes plus tear flux.
Effect on other materials:
Non-corrosive
Plastic and rubber might absorb considerable amountsà might be removed by rinsing it with clean water for 2 minutes.
Use:
FA: Instruments: 1-4%
GA: Instruments/equipment/glassware: 2%
Solutions should be freshly prepared
Name: CHLORHEXIDINE
Rapidly acting disinfectant.
Effect:
Chlorhexidine is efficient against both gram+ and gram- bacteria (but Pseudomonas, Proteus and Providencia might be resistant). No effect is seen on TB, spores and vira. The effect on fungi is variable.
The bactericidal effect is enhanced by alcohol.
pH dependant - optimum is ph 5,5-7,0 but it works in the range pH 5-8. pH-values lower than 5 vil give a destruction of chlorhexidine, whereas pH values above 8 vil cause a precipitation of the chlorhexidinebase.
In the presence of inorganic iones the heavily soluable chlorhexidinesalts wil precipitate, thus reducing the available amount.
It is inactivated by cork.
How does it work:
Toxicity:
Low toxicity, but when used frequently through a longer period of time, a few cases of contact dermatitis and fotosensibilisation have been observed.
Effect on other materials:
It is inactivated by cork.
Preparations for use do not damage metals or plastics.
Use:
Skin/hands: 0,5% or 1% dissolved in alcohol
Instruments: 0,5% dissolved in alcohol
Name: CHLORINE PREPARATIONS
Rapidly acting disinfectants after a period of induction. Organic chlorine compounds have a longer period of induction as do inorganic compounds (e.g. chloramine (氯亞明) T and sodium hypochlorite (n.次氯酸鹽) ).
1 gram chlorine/liter of water = 1 gram active chlorine pr. liter
Effect:
Very efficient with rapid action on bacteria, vira and most fungi.With higher concentration and/or longer time to effect, there is effect on TB, spores and the rest of the fungi.
Maximum effect at pH =7; at pH > 8-9 the effect is strongly reduced.
When pH is falling , the stability of the solution is reduced.
Some organic chlorine preparations may have effect in the range from pH 5-10.
The efficacy is strongly reduced by organic matter - when it reacts with protein chloramines are produced; they are bactericidal, but they work very slowly.
Contact time should be 10-60 minutes.
How does it work:
The effect is caused by the undissociated chlorundersyrling
Toxicity:
Chlorine preparations mixed with acid creates very toxic vapours.
Strong solutions of hypochlorite smell unpleasantly and are toxic - use thiosulfate as antidote.
Strong solutions of hypochlorite are caustic or strongy irritant to skin, eyes and mucous membranes, whereas solutions ready for use not are irritant.
When used through a longer period of time, chlorexema may arise.
Effect on other materials:
Very corrosive, especially to aluminium, but even stainless steel is damaged.
They have a bleaching effect.
Many plastics are resistent to chlorine preparations.
Interactions:
Chlorine preparations mixed with acid creates very toxic vapours.
Use:
Inorganic chlorine preparations:
Solutions for use are unstabile and should be freshly prepared/not more than 48 hours.
Rooms/tools: 200 mg - 10g active chlorine/liter
Organic chlorine preparations:
Hands: 1000-2500 mg active chlorine/liter
Instruments: 5000 mg active chlorine/liter
Name: IODINE PREPARATIONS
Iodine and iodophors. Rapid acting disinfectants.
Iodophors is an aqueous solution where iodine is "made soluble" by means of a detergent. There is an equilibrium (n.平衡;均衡;均勢)between free iodine and complex-bound iodine. As the free iodine is used, the equilibrium is displaced and bound iodine is liberated.
Iodine dissolves poorly in water but is readily soluble in alcohol.
Effect:
It is effective against all kinds of germs. Spores and TB, however, takes higher concentrations. The effect is enhanced when they are dissolved in alcohol.
The efficacy is reduced by organic matter. 5 % serum reduces the effect 4 - 20 times.
Efficient over a wide pH range, but it has maximum effect in an acid or neutral environment. Iodophor solutions retain good bactericidal activity in the prsence of organic matter as long as pH does not go higher than 4.
Iodophors has reduced effect at pH>8.
Iodophores: The solution is brown/yellow and will loose its colour as it is inactivated.
Contact time should be 10-30 minutes.
How does it work:
Iodine preparations reacts with hydroxyl groups and inactivates proteins.
Toxicity:
Iodine: Irritating to tissue. People, who are allergic to iodine might get contact-dermatitis.
When the skin is intact iodine is only slightly absorbed, whereas damaged skin might absorb large amounts.
Iodophors are less irritating. The solutions for use is untoxic and non-irritating - but has limited durability.
Effect on other materials:
Very corrosive to metals ( not stainless steel).
Very staining on plastic and textiles.
Rubber will crumble under long influence from iodine preparations
Interaction:
Iodine preparations should not be used together with quaternary ammonium compounds as it inactivates them.
Iodophors are rapudly inactivated by contact with metals, except from stainless steel. Furthermore they are inactivated by temperatures above 35 °C (sunlight) - this can by seen as the brown colour of the solution will be reduced or disappear by the inactivation.
Use:
Iodine: Skin: 0,5-5% dissolved in 80-90% alcohol
Iodophors: Skin: 1000 mg active iodine/l
Hands: 200-500 mg active iodine/l
Instruments: 500 mg active iodine/l
Name: OXYDIZING AGENTS
E.g. Hydrogen peroxide, Peracids and chlorine dioxide
Concentrated solutions - 30-35% hydrogen peroxide and 40 % peracid - are explosive.
Effect:
Hydrogen peroxide: effect on bacteria, vira and most fungi. At higher concentrations the rest of the fungi and spores are killed.
Peracids: Kills bacteria, fungi, spores and vira. It works more rapidly and with lower concentration than hydrogen peroxide.
Efficient at low temperatures. Effect is reduced by organic matter.
Chlorine dioxide: Very efficient against all germs (fungi takes longer time). It is activated by lowering pH, which gives a rapid action
How does it work:
Gives a lethal oxydation in the microorganisms.
Toxicity:
Concentrated solutions may cause serious cauterizations on skin, eyes and mucous membranes.
Inhalation may irritate the airways and might on sight result in cronical bronchitis.
Chlorine dioxide: Low toxicity. Concentrated solutions gives no skinirritation and only slight eyeirritation.
Effect on other materials:
Peracid is corrosive on metals (especially iron, brass and copper), but is less agressive than chlorine and iodine.
Chlorine dioxide is (almost) non-corrosive.
Use:
H2O2: 3-30 % aqueous solution
Peracid: 0,001-0,3% aqueous soulution
Chlorine dioxide: Instrument disinfection and gas sterilization of germ-free animal chambers
Name: PHENOLICS
Phenol (carbolic acid), cresols and synthetical phenolderivatives have all strong bactericidal effect.
Simple phenolics have a penetrating odor, whereas higher phenolics are odourless. They are heavily degradable.
Effect:
Simple phenolics: Best effect on gram- bacteria. With higher concentration and longer time to work there will be effect on TB.
Multiple phenolics are effective against gram+ (bacteriostatic) as well as gram- bacteria.
Variable effect on fungi. No effect on spores and vira.
Rate of action varies with concentration and type of phenolic compound.
Simple phenolics are effective in the presence of organic matter, whereas multiple phenolics may have a limited activity.
Phenolics are not very temperature- and time dependent.
Contact time should be 10-30 minutes. Phenolic compounds leaves on a residual film, which may be desirable on some surfaces, but unwanted in other connections, eg. in culture systems.
How does it work:
Phenolic compounds function by denaturing and coagulating the protein within the cells. In low concentrations, phenol disrupt the cell wall, allowing leakage of cellular constituents.
Toxicity:
It is easily absorbed through skin and mucous membranes, which gives a toxic action on the kidney and Central Nervous System.
Large amounts of phenolics might be absorbed in rubber and plastic.
Short skin contact with a solution for use will normally give no skin reaction.
Concentrated solution: Short contact will give skin irritation, whereas longer skin contact will give cauterizations.
Effect on other materials:
Low corrosiveness; aluminium might be affected with alkaline pH.
Large amounts og phenols might damage rubber and plastic.
Optical instruments might be damaged
Use:
Instruments: 3-5%
Name: QUATERNARY AMMONIUM COMPOUNDS
Cationic detergents with bactericidal effect.
Effect:
Effective against Gram+ bacteria and most gram- (Pseudomonas and Serratia might be resistent - Pseudomonas might even multiply in solutions for use) When used over a longer period, there can be a selection in favour of gram- bacteria.
There is some effect on fungi, but fungi with a lipoid-layer like Fusarium are difficult to affect. There is no sporocidal and virocidal effect, as well as no effect on TB is observed.
Efficiency is reduced in the presence of organic matter.
Quaternary ammonium compounds is adsorbed to rubber, cotton and other porous matters à concentration is reduced.
It is inactivated by low pH solutions, phospholipids, organic compounds and metal ions, and therefore there is limited effectiveness in soaps, detergents and hard water salts.
The bactericidal effect is enhanced by alcohol.
The best effect is seen in a weakly alkaline environnement.
Contact time should be 10-30 minutes.
How does it work:
They contain alkyl groups that interact with membrane lipids to disrupt the cytoplasmic membrane of bacteria.
Toxicity:
Solutions for use are untoxic.
Concentrated solutions irritates eyes, skin and mucous membranes.
There has been reports of a few cases of allergy.
Lethal dose is estimated to be 1-3 grams in the form of concentrated solution in humans.
Effect on other materials:
Slightly corrosive on aluminium and iron. The corrosive effect on iron may be neutralized by the addition of 0,5% sodiumnitrit.
Rubber may get "greasy" after longer influence.
Use:
Hands: 0,1%
Skin: 0,1-0,2% dissolved in alcohol
Instruments: 1-2%
Surfaces: 0,5%
Solutions <0,5 % should be freshly prepared
_________________________________________________________________________
Our recommendations:
To summ up the above, we will close this subject by giving some recommandations for disinfectants for use in the laboratory - where no special considerations are to be taken regarding microorganisms, materials etc.
For surfaces:
Alcohol - ethanol 70%
Some chlorine preparations
Peracids (Oxydizing agents)
For hands:
Hygienic handwash - ethanol 70%
For instruments:
a. As pretreatment prior to sterilisation:
Chlorine preparations
b. As the only treatment:
Chlorine preparations
Peracids (Oxydizing agents)
--------------------
www.windrug.com/pic/10/12/19/13/010.htm - 網頁紀錄
十一烯酸 undecylenic acid
【历史】 本品为消毒防腐药，是一种含11碳在不饱和脂肪酸，由卡夫特（krafft）于1877年由减压蒸馏蓖麻油制得，1937年正式生产，我国于1958年投产。中国、美国、英国、德国、法国、意大利、瑞士等国药典均有收载。
【其他名称】 undecenoic acid；undecap。
【性状与稳定性】 十一烯酸为淡黄色至黄色液体；色泽受光与空气影响，遇冷则变成乳白色结晶性团块，有特臭，几不溶于水，能与乙醇、氯仿、乙醚、挥发油或脂肪油任意混合。凝固点不低于21℃。
【药物作用】 本品能抑制真菌的繁殖。
【适应症状】 用于治疗头癣、股癣、足癣等皮肤真菌感染及真菌性阴道炎。对脚癣的疗效最好。
【不良反应与注意事项】 局部外用可引起接触性皮炎。本品为外用药不可内服，当浓度过大时对组织有刺激性。
【用法与用量】 外用。局部涂敷其制剂，须连用数周才能治愈。用于黏膜的浓度不宜大于1％，一日2～3次。
【限定剂型】 软膏剂、外用溶液剂。
【可供选用的上市制剂】
脚气灵软膏（复方十一烯酸锌软膏），生产，每10克中含十一烯酸0.5克，十一烯酸锌2克，锌具有收敛作用，这一作用有助于减轻炎症。
十一烯酸药水（内含酒精）。
脚气灵：软膏剂，天津药业公司生产。20％，每支10克，含十一烯酸锌2克，外用，涂敷患部，一日2～3次。置于密闭、干燥处贮存。含十一烯酸、氧化锌、甘油等。
湿气灵药粉：含十一烯酸、水杨酰苯胺、薄荷油、氧化锌、麝香草酚等。
新脚气灵：软膏剂，沈阳市兴齐制药厂生产。成分十一烯酸、十一烯酸锌、皮质激素，每支10克，外用，一日2～3次，除用于皮肤癣症外，还可以用于过敏皮炎和皮肤瘙痒等。
复方十一烯酸锌软膏：软膏剂，广州何济公制药厂生产。20％，每支10克，含十一烯酸锌2克，外用，用于头癣、足癣，洗净患部后涂敷，一日2～3次。密闭贮存。
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www.lamasbeauty.com/glossary/print_P.html - 網頁紀錄
Pityriasis Alba: Seborrheic dermatitis.
Pityriasis Capitis: Dandruff.
Pityrosporum: Yeast that is a common inhabitant of the skin, usually starting at puberty. Not the yeast that causes vaginitis in women.
Pityrosporum Folliculitis: An acne-like rash composed of minute papules and pustules but no comedones (blackheads / whiteheads). It occurs most frequently on the forehead and sides of the face.
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http://web.uct.ac.za/depts/mmi/jmoodie/d01html.html#D01B
D01B ANTIFUNGALS FOR SYSTEMIC USE
Griseofulvin, certain azoles, and terbinafine are used systemically for serious or intractable dermatomycoses. Use should be restricted to the treatment of chronic infections not responding to topical measures.
Griseofulvin, an antifungal antibiotic, exerts an inhibitory action against common dermatophytes. It is inactive against yeasts and yeast-like fungi, including candida and pityrosporum species. It has no effect on fungi producing deep mycoses or on bacteria.
Terbinafine, an allylamine, is fungicidal against dermatophytes and some yeasts, but only fungistatic against C.albicans. Oral terbinafine is not effective in pityriasis versicolor.
Ketoconazole, fluconazole and itraconazole are effective for both yeast and dermatophyte infections. For full profiles, see section J02.
Intermittent therapy with itraconazole may be used for managing onychomycoses. As this agent is concentrated in the nail plate, it has been found that continuous therapy is not necessary. Ideally chemical or physical removal of the infected dystrophic nail plate should be used in conjunction with oral medication: itraconazole 200 mg/day, 1 week/month for 4 months.
Griseofulvin
(WHO essential agent)
Indications: Dermatophyte infections of the skin and appendages. Systemic administration is used for hair infections and failed topical management of all tinea infections.
Pharmacokinetics: Irregular absorption occurs over a prolonged period of time. It is deposited in keratinocytes and concentrated in the stratum corneum, nails and hair.
Absorbed drug is metabolised in the liver and excreted in urine. A large amount of an oral dose is excreted unchanged in faeces.
Precautions:
Contraindications: Liver failure; history of hypersensitivity to griseofulvin. Use with caution in systemic lupus erythematosus.
Drug interactions:
Alcohol: The effect of alcohol may be potentiated.
Antiepileptic agents: Effects of griseofulvin may be diminished.
Oral contraceptives: May result in contraceptive failure or breakthrough bleeding.
Warfarin: Anticoagulant effect may be reduced.
Pregnancy: Crosses the placenta; embryotoxic and teratogenic in animals. Avoid.
Lactation: Not known if excreted in breast milk; problems not documented.
Porphyria: Avoid
Geriatrics: Use with caution.
Paediatrics: Use is well established.
Adverse effects: Frequent - mild and transient headaches, skin rashes, GI disturbances, altered taste sensation and dry mouth.
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http://www.sim.fi/eng/products/System4/system4.html (Commercial page)
System 4
Very effective treatment for various scalp problems.
Countless users of System 4 have already found relief for conditions such as: dandruff, fungi, bacteria, yeast fungus, itching, psoriasis, atopic dermatitis, irritated skin, excessive secretion of sebaceous glands, hair loss or poor scalp microcirculation.
System 4 provides therapeutic synergy between shampoos and treatments. Not only do all the products provide individual benefits, but they also improve the effect of other System 4 products.
System 4 products include only dermatologically tested, safe raw materials.
The unique effect of System 4 is achieved using the following ingredients:
Climbazole is highly effective against one of the main causes of dandruff, the malassezia furfur fungus.
Piroctone olamine is effective against the pityrosporum fungus, another fungus causing dandruff.
Salicylic acid is an effective scalp and
keratosis exfoliater.
Undecylenic acid prevents excessive sebum secretion and calms irritated skin.
Rosemary stimulates hair growth.
----------------
http://www.nutramed.com/skin/skinfungal.htm
ANTIFUNGAL
Imidazoles are active against dermatophyte and candida and pityrosporum infections. They also inhibits growth of some gram-positive bacteria.
Canesten, clozole, lotremin, myco-hermal, 1% clotrimazole (cr or lotion)
Daktarin, 2% miconazole cr
Dermazole, pervaryl, 1% econazole nitrate cr
Exelderm, 1 % sulconazole nitrate cr
Mycospor, 1% bifonazole cr
Travogen, 1% isoconazole cr
Trosyd, 1% tioconazole cr
10.2 Allylamine are active against dermatophyte but less effective against candia and pityrosporum infections when compared with azole derivatives.
Exoderil : 1% Naftifine HCl cr
Lamisil : 1% Terbinafine cr
10.3 Polyenes are active against candida sp but not dermatophytes.
Fungizone : 3% amphotericin B cr
Mycostatin, : 100,000 u/gm Nystatin cr
Nadostine
10.4 Miscellaneous compounds including older products that are generally less active and more irritant and newer agents that do not fall into a particular class of drugs listed above.
- Tolnaftate active againsts dermatophytes and pityriasis versicolor but not candida & bacteria.
Aftate; Scholl; : containing 1% (cr/solution/powd spray)
Tinaderm
- Ciclopiroxolamine spectrum similar to imidazole.
Batrafen : containing 1% cr
- Undecylenic acid more irrtant, ususally as an ingredient of foot powders for prophylaxis or treatment of tinea pedis.
Dagra foot powder : Zn undecylenate (salicylic acid, boric acid, hexachlorophene)
Other including : Detrisol oint, egomycol solution, mycoderm cr/powd, mycota cr/powd/spray, tineafax oint/powd, benzoderm soap
- Haloprogin is active against dermatophyte, tinea versicolor and in vitro also against staphylococci, streptococci, and candida albicans.
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http://www.mesinc.com/education/monographs2/cme023/content/11.html
ITRACONAZOLE
Itraconazole is a synthetic triazole antifungal agent that inhibits the synthesis of ergosterol, an integral constituent of the cytoplasmic membrane of fungal cells. Specifically, it inhibits the cytochrome P450 (CYP 450)-dependent 14a-demethylase and leads to an accumulation of methylated sterols such as lanosterol and, thus, a defective cell membrane with altered permeability and function.40
Spectrum of Activity
Itraconazole has a broad spectrum of in vitro activity and a high affinity for keratinized tissues, which results in high concentrations of the drug in the nail plate.11 The therapeutic activity of itraconazole has been demonstrated against infections caused by dermatophytes, Candida sp, Pityrosporum infections, and nondermatophyte molds, such as Aspergillus sp, Fusarium sp, Alternia sp, and Scopulariopsis brevicaulis.16 Itraconazole may be considered the drug of first choice in mixed infections because of this wide spectrum of activity.
Clinical Efficacy
Numerous studies demonstrating the efficacy of itraconazole for the treatment of onychomycosis have been conducted in the US and Europe in doses ranging from 100 to 600 mg/day.41,42 Pulse therapy, consisting of two pulses of 200 mg itraconazole twice daily for 1 week separated by 3 weeks off treatment is the recommended treatment regimen for fingernail onychomycosis. The FDA-approved treatment regimen for toenail infections is 200 mg once daily for 12 weeks; however, clinical research has shown that three pulses of treatment (200 mg twice daily for 1 week per month for 3 consecutive months) are as effective as continuous therapy for the treatment of toenail onychomycosis, and this has become the standard of care.30,31
Pooled data (14 studies; 1389 patients)41 indicate that three pulses of itraconazole for the treatment of dermatophyte toenail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 58%, 82%, 77%, and 10%, respectively, 12 months after the start of therapy. Similarly, two pulses of itraconazole for the treatment of fingernail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 78%, 89%, 77%, and 4.9%, respectively, 9 months after the start of therapy
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www.aafp.org/afp/20031115/1963.html - 網頁紀錄
---------------
http://www.interpharmaplus.com/product.php?p=179
Product Information
Nizoral (Ketoconazole) cream Box with tube with 40 g
Active Ingredient:
Ketoconazol 2g
Directions:
NIZORAL Cream is indicated
in the treatment of the infections
in the skin:
membranes due to Trichophyton mentagrophytes,
Microsporum canis and Epidermophyton floccosum, like in the
treatment of the nea candidosis , vulvitis and
pitiriasis.
indicated in the treatment of the
seborreica dermatitis when the presence of Pityrosporum is
demonstrated makes oval.
Warning:
Cream is not for oftálmic use. In order to prevent the effect it
bounces after suspending a treatment prolonged with corticosteroides
topical, is recommendable to continue with the application of a
moderate topical corticoesteroide in the mornings and to apply to
NIZORAL * cream in, afternoon subsequent and gradually retiring the
therapy with steroids in a period of 2-3 weeks.
In Stock
Price: $19.99 Shipping: Click to see our rates
Handling: $0.00
---------
http://www.ecureme.com/emyhealth/Pediatrics/Cradle_Cap.asp
------------
http://archderm.ama-assn.org/cgi/content/abstract/112/3/350
Clinical evaluation of clotrimazole. A broad-spectrum antifungal agent
P. H. Spiekermann and M. D. Young
The efficacy and safety of the broad-spectrum, topically applied antifungal agent clotrimazole were evaluated in two double-blind, multicentric trials. Ten investigators reported on a total of 1,361 cases in which a 1% solution or a 1% cream formulation was compared with its respective vehicle. Clotrimazole was therapeutically effective, as confirmed by mycological cure (negative microscopy and culture) and clinical improvement, in tinea pedis, tinea cruris, tinea corporis, pityriasis versicolor, and cutaneous candidasis. Furthermore, species identification established the efficacy of clotrimazole against Trichophyton rubrum, T mentagrophytes, Epidermophyton floccosum, Microsporum canis, Malassezia furfur (Pityrosporum orbiculare), and Candida albicans. Safety was demonstrated by the low incidence of possibly drug-related adverse experiences, namely, 19 (2.7%) of 699 patients who were treated with clotrimazole, of whom four (0.6%) discontinued treatment.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
----------------
The PASCO antifungal susceptibility test system, developed in collaboration with a commercial company, is a broth microdilution assay which is faster and easier to use than the reference broth microdilution test performed according to the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A guidelines. Advantages of the PASCO system include the system's inclusion of quality-controlled, premade antifungal panels containing 10, twofold serial dilutions of drugs and a one-step inoculation system whereby all wells are simultaneously inoculated in a single step. For the prototype panel, we chose eight antifungal agents for in vitro testing (amphotericin B, flucytosine, fluconazole, ketoconazole, itraconazole, clotrimazole, miconazole, and terconazole) and compared the results with those of the NCCLS method for testing 74 yeast isolates (14 Candida albicans, 10 Candida glabrata, 10 Candida tropicalis, 10 Candida krusei, 10 Candida dubliniensis, 10 Candida parapsilosis, and 10 Cryptococcus neoformans isolates). The overall agreements between the methods were 91% for fluconazole, 89% for amphotericin B and ketoconazole, 85% for itraconazole, 80% for flucytosine, 77% for terconazole, 66% for miconazole, and 53% for clotrimazole. In contrast to the M27-A reference method, the PASCO method classified as resistant seven itraconazole-susceptible isolates (9%), two fluconazole-susceptible isolates (3%), and three flucytosine-susceptible isolates (4%), representing 12 major errors. In addition, it classified two fluconazole-resistant isolates (3%) and one flucytosine-resistant isolate (1%) as susceptible, representing three very major errors. Overall, the agreement between the methods was greater than or equal to 80% for four of the seven species tested (C. dubliniensis, C. glabrata, C. krusei, and C. neoformans). The lowest agreement between methods was observed for miconazole and clotrimazole and for C. krusei isolates tested against terconazole. When the data for miconazole and clotrimazole were removed from the analysis, agreement was 80% for all seven species tested. Therefore, the PASCO method is a suitable alternative procedure for the testing of the antifungal susceptibilities of the medically important Candida spp. and C. neoformans against a range of antifungal agents with the exceptions only of miconazole and clotrimazole and of terconazole against C. krusei isolates.
--------------
http://www.peacehealth.org/kbase/multum/d01236t1.htm
clotrimazole topical
Pronunciation: kloe TRIM a zole
Brand: Desenex AF Prescription Strength, Fungoid Solution, Lotrimin, Lotrimin AF, Lotrimin Jock Itch Powder, Mycelex, Mycelex OTC
What is the most important information I should know about clotrimazole topical?
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air to circulate to the affected area (occlusive dressings) unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).
Avoid getting this medication in your eyes, nose, or mouth.
What is clotrimazole topical?
Clotrimazole topical is an antifungal medication. Clotrimazole topical prevents fungus from growing on your skin.
Clotrimazole topical is used to treat skin infections such as athlete's foot, jock itch, ringworm, and yeast infections.
Clotrimazole topical may also be used for purposes other than those listed in this medication guide.
Who should not use clotrimazole topical?
Do not use clotrimazole topical if you have had an allergic reaction to it in the past.
Clotrimazole topical is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not use clotrimazole topical without first talking to your doctor if you are pregnant.
It is not known whether clotrimazole passes into breast milk. Do not use clotrimazole topical without first talking to your doctor if you are breast-feeding a baby.
How should I use clotrimazole topical?
Use clotrimazole topical exactly as directed by your doctor or follow the directions that accompany the package. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Wash your hands before and after using this medication, unless you are using it to treat a hand infection.
Clean and dry the affected area. Apply a small amount of the cream (usually twice daily) for 2 to 4 weeks.
Do not take this medication by mouth.
If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed by your doctor. A light cotton-gauze dressing may be used to protect clothing.
Avoid getting this medication in your eyes, nose, or mouth.
Store clotrimazole topical at room tempera
要聞 : 中國真菌病研究有重大突破 長征醫院此項研究獲國家科技進步二等獎
【本報訊】中國新生隱球菌以A、D型為主，缺乏C型；對隱球菌腦膜炎採用綜合分期治療新方法，可明顯提高治癒率。日前，由上海長征醫院皮膚科廖萬清教授與中國醫學科學院皮膚病研究所合作完成的《真菌病的基礎與臨床繫列研究》，獲得2000年度國家科技進步二等獎。這是迄今為止中國真菌病學研究獲得的最高獎勵。專家廖萬清教授針對中國農村地區頭癬流行，體股癬、手足癬患病率高的特點，通過兩次全中國性和18次區域性針對特定人群的流行病學研究，分析各種真菌病的患病率、致病菌及其變遷規律，先後發現10種新病原真菌及新病種，3種為國際首次發現，其中新生隱球菌上海變種採用廖氏命名，並被美國真菌菌種保藏中心(ATCC)收錄保藏。之後，又研製出複方酮素唑霜等新藥，並提出系列針對性防治措施，為中國在20世紀80年代基本消滅頭癬、基本控制其他癬病危害作出重要貢獻。
在此基礎上，課題組在國內首次建立了6種檢測病原真菌的實驗室診斷方法，將內臟器官深部真菌感染的實驗室診斷方法系列化，使內臟器官深部真菌感染的治癒率達到83.8%。20世紀80年代起，他們又開展對危害中國人民健康較大的念珠菌、隱球菌等致病真菌的免疫學、分子生物學研究，在國際上首次建立新生隱球菌大型標準菌及裴氏著色真菌DNA克隆庫，篩選獲得新生隱球菌、裴氏著色真菌的種、變種及血清型特異性探針，建立起隱球菌和念珠菌的分子流行病學研究方法。近5年來，廖萬清將上述研究成果應用於臨床，採用藥物綜合、降顱壓、電解質平衡、靜脈注射、鞘內注射及分兩期治療等方法，治療30餘例隱球菌性腦膜炎，治癒率達100%，病殘率、複發率為零。
據介紹，目前國際上隱球菌性腦膜炎的死亡率為40%－65%，病殘率為20%，複發率為20%－30%。有關專家認為，廖萬清所建立的隱球菌和念珠菌的分子流行病學研究方法，以及對隱球菌性腦膜炎的治療和在致病基因研究方面取得的突出成績，提高了中國真菌病的基礎研究水平，臨床診治技術處於國際領先。
----------
http://www.medicchina.com/cmedicchina/yongyaozhinan/guanzhuotc/xiyi/fuchanke/002.htm
克霉唑
Clotrimazole
[其他名稱] 三甲苯咪唑
[適應症] 本品作用于真菌細胞膜，抑制細胞膜脂類的合成，使細胞膜的通透性改變，使菌體細胞內的一些物質如鉀離子、磷酸、氨基酸等漏失，從而殺滅真菌。主要對表皮癬菌、毛發癬菌、曲菌、著色真菌和念珠菌等有較好的抗菌作用，對滴虫、部分細菌也有一定的殺滅作用。用于皮膚粘膜真菌感染.
[不良反應] 少數患者用本品制劑可發生局部過敏及刺激症狀，發生局部燒灼感、紅斑、刺感、起 、脫皮、瘙痒、 麻疹、接觸性皮炎。用于陰道內，曾有發生輕度燒灼感、紅斑及刺激症狀，稍有尿頻或皮疹，男方偶會感到陰莖或尿道有刺激感.
[注意事項] 婦女妊娠時，并不禁忌在皮膚上局部應用克霉唑，在中期、晚期妊娠時，也不禁止用其在陰道內給藥，但在妊娠早期不要使用。本品制劑不宜在眼部使用，用于眼周圍時，應特別注意.
[用法用量] 外用：1%～3%溶液或軟膏乳膏局部涂抹，將足量的溶液、乳膏軟膏覆蓋在病損及其周圍區域，每日2～3次
[劑型] 乳膏劑，軟膏，外用溶液。
---------
http://www.lamasbeauty.com/beauty/april03/dandruff_faq_print.htm
Nutritional Supplements
Supplementing the essential fatty acids is more important since these are usually lacking. Evening primrose oil is a good source of gamma linolenic acid (GLA), easily absorbed by the body.
B6 deficiencies also cause dandruff. To prevent imbalances, the entire B complex should be included. In addition, vitamins A and E are important for skin health.
Silica is also recommended for improving scalp health. It is available in capsules from a vegetable source and in a liquid gel form.
Daily Dosages
Most Important:
Evening primrose oil, two 500 mg capsules three times daily
Vitamin B complex, 50 mg twice daily with meals
Vitamin B6 or Pyridoxal-5-Phosphate, 50 mg twice daily
Helpful
Vitamin A, 10,000 IU (not during pregnancy)
Vitamin E, with mixed tocopherols, 400 IU
Silica, 1,000 mg, two 500 mg capsules daily
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Dandruff is one of the great levelers of life. It knows no class, creed or race. It affects everyone but not in equal measure. Some people have a very minute quantity of dandruff, while others spend their lifetimes trying to get rid of it. Dandruff has given rise to a whole multi-million dollar cleansing shampoo industry. Companies such as Unilever and P & G have spent millions of dollars in research and development to try to find an everlasting dandruff eradicator. Consumers keep on oscillating between products available in stores to various home remedies but at most both can provide temporary relief. There are several misconceptions regarding dandruff and unfortunately most people base their treatments on them.
Dandruff is the dry, white or grayish substance that appears in patches on the top of the head. They appear in the form of scales. Dandruff occurs when the scalp sheds dead epidermal (skin) cells in large clumps. Scalp cells replenish themselves in a pattern similar to that of hair, but more rapidly: The skin of the head renews itself about once a month. Dead scalp cells are constantly being pushed from the deepest layer of the epidermis to the skin's surface, where they gradually die. Usually the scalp sheds them in a nearly invisible way. But for reasons that are still unclear, cell turnover sometimes becomes unusually rapid, and dead cells are shed as the visible flakes called dandruff. This dandruff then falls on the shoulder and becomes visible to someone standing close by. Persons suffering from prolonged dandruff are said to have a dandruff ailment.
Dandruff is caused by a micro-organism called Pityrosporum-Ovale (now renamed Malassezia furfur), which are present in every body's scalp. The fungus is found naturally on the skin surface of both healthy people and those with dandruff. The fungus likes fat, and is consequently found most on skin areas with plenty of sebaceous glands: on the scalp, face and upper part of the body. Symptoms of dandruff manifest itself when exposed to dust; UV light, harsh chemical based shampoo, hair dyes etc. This results in the increase of the number of microbes, which causes unhealthy residue over the scalp, which leads to dandruff, which is the cause of unhealthy scalp results in unhealthy, lifeless hair and may also result in excessive loss of hair. But dandruff should not be mistaken for other more harmful conditions such as seborrheic dermatitis or psoriasis. These conditions cause itching and redness accompanied by dandruff. They can also lead to eczema.
People with oily scalps tend to suffer most from dandruff because an oily scalp supports the growth of yeast, which is crucial to the generation of scales. Causes of excessive dandruff could vary from hereditary reasons to tension and anxiety. Excessive usage of hairsprays, improper electric hair curlers, tight fitting hats and cold weather are the other known causes.
There are essentially two types of remedies for dandruff. A mild shampoo that contains a cytostatic agent, such as selenium sulfide or zinc pyrithione must be used. Cytostatic agents reduce the rate of growth and multiplication of cells on the top layer of skin on the scalp, which causes a noticeable decrease in visible dandruff within several weeks. Shampoos are to be avoided if there is a cut in the scalp. Nizoral is the only shampoo containing a patented active ingredient known as ketoconazole this ingredient is medically proven to be effective against Malassezia furfur. It has been recommended by doctors and pharmacists all over the world. If the dandruff is caused due to a nutrition deficiency then he/she must incorporate vitamins B6, B12, F and selenium in their diet.
There are a host of homemade treatments that can be recommended. Garlic and oil of oregano are excellent anti-dandruff agents. A fresh onion that is cut and applied to the scalp or the pouring of apple cider vinegar help in alleviating the condition by cleansing the scalp. Both of them have well-known antiseptic properties. Alternating hot and cold water on the head increases circulation to the scalp. Yoga headstands are also popular. But it is important to remember that dandruff cannot be eliminated; it can only be controlled.
---------------
---
http://www.cfps.org.sg/sfp/19/194/articles/e194171.html
http://www.jrksiddha.com/products1.htm
DANO
Dano is recommended for regular use as a hair oil .
Laboratory studies have confirmed that Dano eradicates dandruff completly by its Fungicidal activity against Pityrosporum Ovale.
Application procedure
Apply DANO after bath
Keep hair free from moisture
Apply DANO over the scalp using finger ends
DANO is presented in easily absorbing and non sticky form
DANO is recommended for use as a regular hair oil
Wash hair regularly and clean the scalp with herbal hair care powders or formulations.
Dano is available in 100 ml pet bottles.
-------
coptis 黃連
------------------
http://wolf.mind.net/SWSBM/Abstracts/Scutellaria-AB.txt
*****ANNALES PHARMACEUTIQUES FRANCAISES*****
Yang D Michel D Bevalot F Chaumont JP Millet-Clerc J
[Antifungal activity in vitro of Scutellaria baicalensis Georgi upon cutaneous
and ungual pathogenic fungi]
Activite antifongique in vitro de Scutellaria baicalensis Georgi vis- a-vis de
champignons pathogenes cutanes et ungueaux.
In: Ann Pharm Fr (1995) 53(3):138-41
ISSN: 0003-4509 (Published in French)
The root of Scutellaria baicalensis Georgi (Lamiaceae) is one of the traditional
drugs commonly used in the Far East. The extracts obtained by the successive
exhaustion in chloroform and in ethyl (n.乙基;四乙鉛) acetat present clear fungistatic
activities in vitro against to some cutaneous and ungual (a.爪的;有爪的) pathogenic (a.使生病的;成為病原的;病原性的) fungi, and
particularly upon strains of Candida albicans, Cryptococcus 隱球菌 neoformans and
Pityrosporum ovale. For each of these, its minimum inhibitory concentration is
determined. The ethyl acetat extract appears the most interesting because of its
efficiency and of its stability. An antifungal substance is found out as the
baicalein.
Registry Numbers:
491-67-8 (baicalein)
(Scutellarin 野黃芩; baicalein 黃芩素; 黃芩 元; Georgi; acetate n.醋酸鹽 ; fungistatin 製真菌素 )
--------------
http://www.sundaylife.co.uk/features/story.jsp?story=466481
Troubled by skin infection
Q. I HAVE a recurrent fungal skin infection called pityriasis versicolor. I've seen a dermatologist about six times, over the last two years, and tried every combination of creams and tablets, none of which has helped. Are there any alternatives?
A. PITYRIASIS versicolor is a fungal skin infection due to a yeast, Pityrosporum.
It causes a fine, scaly rash on the skin with numerous round or oval patches that are initially pale pink or brown, before fading to leave white areas due to flaking off of outer skin cells.
As it is so widespread, it is usually treated with oral antifungal drugs such as itraconazole, for five to seven days which is usually effective.
However, the lesions may persist for some time, even after successful treatment because of loss of pigmentation (n.染色;著色;色素之形成), so it's possible your infection has already gone and the lesions will slowly fade.
The most effective alternative treatment for fungal skin infections is to apply neat tea tree oil twice a day.
Taking Olive leaf, grapefruit seed or Lapacho (Pau d'arco) extracts can also help.
--------------
http://www.nutramed.com/skin/skinfungal.htm
--------
http://www.hoepharma.com.my/pd_aft_tolnaderm-c.html
ANTI FUNGAL TOPICAL
TOLNADERM CREAM
DESCRIPTION:
White opaque cream. Each gram contains 10mg of tolnaftate solubilised in a base containing polyethyiene glycol with butylated hydroxytoluene O.l%, methylparaben 0.16% and propyl paraben 0.03% as preservatives.
ACTIONS
Tolnaftate is effective in the treatment of the majority of cutaneous mycoses caused by Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum cants, Microsporum audouini, Microsporum gypseum, Epidermophyton floccosum andpityrosporum orbiculaire, but is ineffective against Candida or bacteria. Infections due to Trichophyton rubrum may relapse and a second course of treatment may be required.
PHARMACOLOGY
Tolnaftate inhibits the growth of Epidermophyton, Microsporum, Trichophyton spp., and Malassezia furfur, but it is not active against Candida spp. or bacteria.
INDICATIONS
The topical treatment of tinea pedis (athlete's foot), tinea cruris (jock itch) tinea corporis (body ringworm), tinea barbae (ringworm of the face and neck) and tinea manuum due to infection with Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum cants, Microsporum audouini, Epidermophyton floccosurn and tinea versicolor due to Pityrosporum orbiculaire. Tolnaderm Cream is indicated in tinea infections of the skin especially the non hairy areas of the body and including the groin. The vanishing cream base makes it cosmetically acceptable and there is no staining of the skin or clothing from the preparation. Tolnaderm Lotion, is nonaqueous and miscible with the exudates of fungal infections of the skin and penetrates into lesions without destruction of the epidermis. Toinaderm lotion is odourless, greaseless, and does notstain or discolour the skin, hair, nails or clothing. Tolnaftate preparations are not suitable for deep infections of the nailbed and hair follicles but may be applied concomittantly with a systemic agent.
CONTRAINDICATIONS
Hypersensitivity to tolnaftate or any component in the base.
ADVERSE EFFECTS
Skin reactions to toinaftate including irritation and pruritus may occur; contact dermatitis has been reported.
PRECAUTIONS/WARNINGS
It irritation occurs treatment should be discontinued. Keep away from the eyes and mucous membranes. lf there is no improvement within 10 days of use, treatment should be discontinued and a physician consulted. Not for ophthalmic use
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http://www.sinphar.com/medical/no33/medical_01.html
皮膚的黴菌感染
Skin fungal Infections
‧皮膚科／林仲醫師
常見的皮膚黴菌感染可分為皮癬菌感染、念珠菌感染、汗斑三大類。Three categories of common skin fungal infections are：
「黴菌」是甚麼生物？
Fungus（真菌、黴菌）是微生物中的一個大類，具有真正細胞核，產生孢子，不含葉綠素，以寄生或腐生方式攝取養分維生，目前已知的真菌種類有十萬種至二十五萬種，我們常聽到的黴菌、酵母菌、食用菇類（香菇、草菇、洋菇、木耳、金針菇）、靈芝、冬蟲夏草等皆屬於fungus。
Fungus依其所形成的菌落形態分為黴菌（霉菌）(mold)及酵母菌(yeast)兩大類，黴菌的體細胞為多細胞組成的絲狀體，稱為「菌絲體」，酵母菌的體細胞為單細胞，這是兩者之間最大的區別。但有些酵母菌也可產生假菌絲及真菌絲，有些黴菌則在自然界腐生或25℃培養時長出菌絲體，在活體內或37℃培養時呈酵母菌狀存在。
┌─ mold（黴菌、霉菌）─皮癬菌
Fungus（真菌、黴菌）┤
└─ yeast（酵母菌）─念珠菌、皮屑芽胞菌引
（起汗斑的黴菌）
由以上的分類可知「黴菌」的中文定義有狹義與廣義之分，狹義指「mold」，廣義指「fungus」。因此談到皮膚的「黴菌感染」時，一樣也有狹義及廣義之分，狹義的「皮膚黴菌感染」指的是皮癬菌感染，廣義的「皮膚黴菌感染」則不只皮癬菌感染，連念珠菌感染、汗斑也包括在內。其實包含皮癬菌感染、念珠菌感染、汗斑的廣義「皮膚黴菌感染」應稱為「皮膚真菌感染」較不會引起困擾，但此名詞在台灣不流行。另外也可知「fungus」應譯為「真菌」，只將「黴菌」一詞用來專指「mold」較妥。
由於「真菌」乃日本人創的新名詞，一般民眾鮮知，因此台灣醫界及民間少用「真菌」一詞，對於「fungus」或是「mold」都一樣使用「黴菌」這個傳統名詞，所以看到醫學文章講到「黴菌」時，應看清楚上下文來了解其究竟是指「fungus」還是「mold」。為了配合一般人的用法，本篇講義仍然稱「fungus」為「黴菌」。
一、皮癬菌感染
最常見的皮膚、指甲、頭髮的黴菌感染為dermatophyte（皮癬菌）引起的，皮癬菌分為三大類：Trichophyton（毛癬菌）、Microsporum （小芽孢菌）、Epidermophyton（表皮癬菌）。
皮癬菌只感染皮膚死掉的角質層，不侵犯人體的活組織，因為人類活體內有一種血清抑黴因子以及其它的免疫機轉，能抑制皮癬菌向內侵犯，偶而只在免疫有缺損的病人見到皮癬菌侵犯到人體深處。
感染皮癬菌的臨床表現：皮癬菌引起的皮膚病統稱為「tinea」或「ringworm」，西醫則翻譯為「癬」，更依下列原則進一步命名：
(1)依感染部位命名──頭癬、臉癬、鬚癬、體癬、股癬、手癬、足癬（香港腳）、甲癬（灰指甲、臭甲）等。
(2)依外觀命名──圓癬、花斑癬（中國大陸對於汗斑的稱呼）、禿瘡癬等，另外非西醫的病名如金錢癬（古代的病名）等。
其實西醫把「Tinea」翻譯為「癬」是個大錯誤，常引起醫護人員與病人的誤會！
我的皮膚病是不是長「癬」
古代中醫文獻裡的「癬」並不是特指一種皮膚病，而是包含很多種皮膚病：有從形狀命名的癬如「牛皮癬」（指皮膚病像牛頸子的皮，又厚又堅韌）、「金錢癬」（指皮膚病的外形圓圓的似銅錢）、「濕癬」（指抓了會流湯流水的皮膚病）、「乾癬」（指皮膚病的患處乾燥、抓了有白屑）、「松皮癬」（指皮膚病的外形似松樹的皮），有依發病時間命名的癬如「奶癬」（指於小孩哺乳期間所發生的皮膚病），有依病程命名的癬如「頑癬」（指頑固難醫的皮膚病），也有依感染源命名的癬如「疥癬」（由疥蟲感染所造成的皮膚病），這些「癬」病以現代醫學來說屬於很多不同類的疾病，並不是單一的病。
偏偏西醫借用「癬」這個字來稱呼黴菌感染的皮膚病，把一個廣義的字局限於狹隘的範圍，這是一個錯誤，常造成醫師及病人的誤會。如病人可能患慢性濕疹「頑癬」，但他卻自己去藥房買治療黴菌感染的藥膏來擦，只因為這種藥膏是治「癬」的！其實這兩種「癬」風馬牛不相及也，其治療結果可想而知！
由於錯誤已經鑄成了，無法改變，所以如講到「癬」，一定要知道是不是以前中醫或是一般民間所稱的「癬」，因這種「癬」無特殊意義，代表很多種皮膚病，反之西醫所說的「癬」則是代表黴菌感染。
二、念珠菌感染
念珠菌(Candida)為一種酵母菌(yeast)，主要由Candida albicans （白色念珠菌）致病。念珠菌在人類的口腔、陰道、腸胃道為正常的群落，當病人處於潮濕溫熱的環境，吃抗生素、類固醇、避孕藥，懷孕，免疫缺損等情況下，念珠菌即可以造成疾病。念珠菌常於黏膜及身體皺摺處造成皮膚病，常造成口腔的「鵝口瘡」(Thrush)、女性的外陰或陰道發炎、男性的龜頭及包皮發炎還有對磨疹、尿布疹、甲溝炎等。其臨床病灶的最重要特徵為主病灶的周圍出現衛星灶。
三、汗斑（變色糠疹、花斑癬）
汗斑為一種酵母菌「皮屑芽孢菌」(Pityrosporum orbiculare)造成的皮膚病，病灶的顏色可以由白色、淡紅色至棕色，因而有變色糠疹、花斑癬的稱呼。
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search by tricolsan spore - www.infectioncontroltoday.com/articles/321bpract.html
Date: September 19, 2003 01:49 PM
Author: Marilynn
Subject: Olive Leaf extract
I have had really good experiences with Olive Leaf. I use the Roex brand (roex.com) It is pharmaceutical grade and contains 17 to 22% oleuropean (depending on the time of year it is harvested) which is the active ingredient. I have looked for others, but only found ones that were 6% oleuopean - I am sure there are others, I just haven't hunted hard enough, but since I am satisfied with Roex, its okay. We keep it on hand and if taken every four hours at the very first sign of anything, generally stops it cold within a day. If you get something and it gets started, it will not stop it but will reduce the time you are miserable. My brother has Hepatitis C and we have been using the olive leaf (it has the ability to shred the protein covering on viruses) along with MG beta glucan from NSC (nsc24.com)(this one does not reaggregate in the intestines and it modulates the immune system), also a lot of other supplements aimed at the liver. He was keeping the viral load slowed down but still raising steadily each year until he added the olive leaf and beta glucan, which seems to have been the one two punch. His viral load is now reducing steadily for the last two years.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73457)
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Date: September 10, 2003 03:28 PM
Author: Denise
Subject: Olive leaf - BUMP UP!!
Here's the thread
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=71142)
--------------------------------------------------------------------------------
Date: September 18, 2003 11:05 PM
Author: Lyn
Subject: anti-bacterial, viral, fungal
In addition to olive leaf, I have found a good natural antiviral, bacterial & fungal to be Tea Tree Oil - readily available in Australia but I believe also available overseas. Green tea is also excellent - both internally and topically for minor infections and of course apple cider vinegar. In addition to taking a little internally - I also use it to wash with as I have very sensitive skin and have a bad reaction to soap. I have not had any problems since starting to use cider vinegar instead of soap. If your skin problem is sensitivity due to dryness and not an infection, then aloe vera jelly applied topically followed by a light application of blended cold pressed oils - e.g. wheat germ, macadamia, evening primrose,& a little lavender and calendula while skin is damp should help. Since using this regime which I developed by trial and error, I have received many compliments on my skin - I am in my 50's. Also take L-cysteine which boosts the immune system and is anti-bacterial and anti-viral.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73326)
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5. Dextrose-peptone-yeast extract Agar (DPYA)
Glucose (dextrose) 5.0 g
Peptone 1.0 g
Yeast extract 2.0 g
NH4NO3 1.0 g
K2HPO4 1.0 g
MgSO4.7H2O 0.5 g
FeCl3.6H2O 0.01 g
Oxgall 5.0 g
Sodium propionate 1.0 g
Chlortetracycline 30 mg
Streptomycin 30 mg
Agar 20 g
Distilled water 1000 ml
DPYA is an excellent medium for isolating fungi from soil and other natural substrates. The oxgall and sodium propionate restrict the growth of some rapidly spreading fungi, while the chlortetracycline and streptomycin discourage bacteria.
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http://www.nursingceu.com/NCEU/courses/handtwo/
Chloroxylenol
Chloroxylenol, also known as parachlorometaxylenol (PCMX), is a compound that has been used as a preservative in cosmetics and other products and as an active agent in antimicrobial soaps. It was developed in Europe in the late 1920s and has been used in the United States since the 1950s.
The antimicrobial activity of PCMX likely is attributable to inactivation of bacterial enzymes and alteration of bacterial cell walls. It has good in vitro activity against gram-positive organisms and fair activity against gram-negative bacteria, mycobacteria (leprosy, TB), and certain viruses. PCMX is less active against P. aeruginosa, but addition of ethylene-diaminetetraacetic acid (EDTA) increases its activity against Pseudomonas spp. and other pathogens.
A limited number of articles focusing on the efficacy of PCMX-containing preparations intended for use by HCWs have been published in the last 25 years, and the results of studies have sometimes been contradictory. The disparity between published studies may be associated with the various concentrations of PCMX included in the preparations evaluated and with other aspects of the formulations tested, including the presence or absence of EDTA. PCMX is not as rapidly active as chlorhexidine gluconate or iodophors, and its residual activity is less pronounced than that observed with chlorhexidine gluconate. In 1994, FDA TFM tentatively classified PCMX as a Category IIISE active agent (i.e., insufficient data are available to classify this agent as safe and effective).
The antimicrobial activity of PCMX is minimally affected by the presence of organic matter, but it is neutralized by nonionic surfactants. PCMX, which is absorbed through the skin, is usually well-tolerated, and allergic reactions associated with its use are uncommon. PCMX is available in concentrations of 0.3%-3.75%. In-use contamination of a PCMX-containing preparation has been reported.
Triclosan
Triclosan is a nonionic, colorless substance that was developed in the 1960s. It has been incorporated into soaps for use by HCWs and the public and into other consumer products. Concentrations of 0.2%-2% have antimicrobial activity. Triclosan enters bacterial cells and affects the cytoplasmic membrane and synthesis of RNA, fatty acids, and proteins.
Triclosan has a broad range of antimicrobial activity, but it is often bacteriostatic. Minimum inhibitory concentrations (MICs) range from 0.1 to 10 ug/mL, whereas minimum bactericidal concentrations are 25-500 ug/mL. Triclosan's activity against gram-positive organisms (including MRSA) is greater than against gram-negative bacilli, particularly P. aeruginosa. The agent possesses reasonable activity against mycobacteria and Candida spp., but it has limited activity against filamentous fungi. In 1994, FDA TFM tentatively classified triclosan <1.0% as a Category IIISE active agent (i.e., insufficient data exist to classify this agent as safe and effective for use as an antiseptic handwash). Further evaluation of this agent by the FDA is underway. Like chlorhexidine, triclosan has persistent activity on the skin. Its activity in hand-care products is affected by pH, the presence of surfactants, emollients, or humectants and by the ionic nature of the particular formulation. Triclosan's activity is not substantially affected by organic matter. The majority of formulations containing <2% triclosan are well-tolerated and seldom cause allergic reactions. Certain reports indicate that providing hospital personnel with a triclosan-containing preparation for hand antisepsis has led to decreased MRSA infections. Triclosan's lack of potent activity against gram-negative bacilli has resulted in occasional reports of contamination.
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http://217.60.75.10/labsafe/labsafe/biological/disinfectants/jjmdisinfectalt.html#chlorhex
CHARACTERISTICS
- FOR THE DIFFERENT TYPES OF DISINFECTANTS:
Alcohols-aldehydes-chlorhexidine-chlorine preparations-iodine preparations-oxydizing agents-phenolics-
quaternary ammonium compounds
Name: ALCOHOLS
Ethyl alcohol (ethanol) and isopropyl alcohols are the most frequently used alcohols.
Formula:
Ethanol: CH3CH2-OH Isopropanol: CH3-CH-OH
|
Inflammable. CH3
Effect:
Alcohols kill vegetative forms of bacteria (including TB) and fungi, but have no action on spores or
viruses (there might, however, be some effect on kappebærende vira).Their effect depend on
concentration and type of alcohol.
The following three solutions have similar effect:
Ethanol 70% , isopropanol 60% and n-propanol 40%
70-80% alcohol inactivates HIV and Hepatitis B in 2-10 minutes.
How does it work:
Alcohols precipitate proteins and solubilize lipids present in cell membranes.
It has a rapid action.
Contact time should preferably be 10-30 minutes.
Toxicity:
Ethanol is absorbant and astringent and dries out the skin. Propanoles are less absorbant, but they might penetrate the skin. The brief irritant action seen on the skin , when alcohol is applied in high concentrations, results from partial precipitaion of cellular proteins and from its dehydrating actions. If strong alcohol vapours are inhaled, the irritation causes reflex closure of glottis.
Effect on other materials:
Non-corrosive
May damage rubber, shellac and plastic
Interaction:
Synergistic effect together with iodine, chlorhexidin and quaternary ammonium compounds.
Alcohols are easily inactivated by organic material.
Use:
Hands, skin and instruments and surfaces: 60-70% ethanol.
In this case the effect is not enhanced with higher concentration, as it takes water to practice its effect
Name:ALDEHYDES
Formaldehyde (FA) and Glutaraldehyde (GA)
Pungent odour.
Effect:
Very effective against all kinds of germ; spores might take longer time and fungi might take higher concentrations.
Formaldehyde and glucoxal takes at least 2-4 hours (preferably 24 hours) to exert their effect; glutaraldehyde works a little faster.
Effect depends on temperature: FA has the best effect with high temperature and high humidity. There is no effect < 12ºC. GA can be used down to 5ºC with a longer action period.
pH dependent. FA works best in a neutral environnement, whereas GA has its optimum in a weak alkaline environnement (pH 7,5-8,5)
Not sensitive to organic matter, but it has difficuties in penetrating it.
How does it work:
Alkylating agents that react with the amine, sulfhydryl and carboxyl groups af protein and small organic molecules to kill microorganims.
Toxicity:
Even high dilutions is irritant to skin, eyes and airways; higher concentrations: cauterization.
All aldehydes may cause allergy, allergic asthma and allergic contactexema.
Large concentrations give strong irritation of mucous membranes in nose and eyes plus tear flux.
Effect on other materials:
Non-corrosive
Plastic and rubber might absorb considerable amountsà might be removed by rinsing it with clean water for 2 minutes.
Use:
FA: Instruments: 1-4%
GA: Instruments/equipment/glassware: 2%
Solutions should be freshly prepared
Name: CHLORHEXIDINE
Rapidly acting disinfectant.
Effect:
Chlorhexidine is efficient against both gram+ and gram- bacteria (but Pseudomonas, Proteus and Providencia might be resistant). No effect is seen on TB, spores and vira. The effect on fungi is variable.
The bactericidal effect is enhanced by alcohol.
pH dependant - optimum is ph 5,5-7,0 but it works in the range pH 5-8. pH-values lower than 5 vil give a destruction of chlorhexidine, whereas pH values above 8 vil cause a precipitation of the chlorhexidinebase.
In the presence of inorganic iones the heavily soluable chlorhexidinesalts wil precipitate, thus reducing the available amount.
It is inactivated by cork.
How does it work:
Toxicity:
Low toxicity, but when used frequently through a longer period of time, a few cases of contact dermatitis and fotosensibilisation have been observed.
Effect on other materials:
It is inactivated by cork.
Preparations for use do not damage metals or plastics.
Use:
Skin/hands: 0,5% or 1% dissolved in alcohol
Instruments: 0,5% dissolved in alcohol
Name: CHLORINE PREPARATIONS
Rapidly acting disinfectants after a period of induction. Organic chlorine compounds have a longer period of induction as do inorganic compounds (e.g. chloramine (氯亞明) T and sodium hypochlorite (n.次氯酸鹽) ).
1 gram chlorine/liter of water = 1 gram active chlorine pr. liter
Effect:
Very efficient with rapid action on bacteria, vira and most fungi.With higher concentration and/or longer time to effect, there is effect on TB, spores and the rest of the fungi.
Maximum effect at pH =7; at pH > 8-9 the effect is strongly reduced.
When pH is falling , the stability of the solution is reduced.
Some organic chlorine preparations may have effect in the range from pH 5-10.
The efficacy is strongly reduced by organic matter - when it reacts with protein chloramines are produced; they are bactericidal, but they work very slowly.
Contact time should be 10-60 minutes.
How does it work:
The effect is caused by the undissociated chlorundersyrling
Toxicity:
Chlorine preparations mixed with acid creates very toxic vapours.
Strong solutions of hypochlorite smell unpleasantly and are toxic - use thiosulfate as antidote.
Strong solutions of hypochlorite are caustic or strongy irritant to skin, eyes and mucous membranes, whereas solutions ready for use not are irritant.
When used through a longer period of time, chlorexema may arise.
Effect on other materials:
Very corrosive, especially to aluminium, but even stainless steel is damaged.
They have a bleaching effect.
Many plastics are resistent to chlorine preparations.
Interactions:
Chlorine preparations mixed with acid creates very toxic vapours.
Use:
Inorganic chlorine preparations:
Solutions for use are unstabile and should be freshly prepared/not more than 48 hours.
Rooms/tools: 200 mg - 10g active chlorine/liter
Organic chlorine preparations:
Hands: 1000-2500 mg active chlorine/liter
Instruments: 5000 mg active chlorine/liter
Name: IODINE PREPARATIONS
Iodine and iodophors. Rapid acting disinfectants.
Iodophors is an aqueous solution where iodine is "made soluble" by means of a detergent. There is an equilibrium (n.平衡;均衡;均勢)between free iodine and complex-bound iodine. As the free iodine is used, the equilibrium is displaced and bound iodine is liberated.
Iodine dissolves poorly in water but is readily soluble in alcohol.
Effect:
It is effective against all kinds of germs. Spores and TB, however, takes higher concentrations. The effect is enhanced when they are dissolved in alcohol.
The efficacy is reduced by organic matter. 5 % serum reduces the effect 4 - 20 times.
Efficient over a wide pH range, but it has maximum effect in an acid or neutral environment. Iodophor solutions retain good bactericidal activity in the prsence of organic matter as long as pH does not go higher than 4.
Iodophors has reduced effect at pH>8.
Iodophores: The solution is brown/yellow and will loose its colour as it is inactivated.
Contact time should be 10-30 minutes.
How does it work:
Iodine preparations reacts with hydroxyl groups and inactivates proteins.
Toxicity:
Iodine: Irritating to tissue. People, who are allergic to iodine might get contact-dermatitis.
When the skin is intact iodine is only slightly absorbed, whereas damaged skin might absorb large amounts.
Iodophors are less irritating. The solutions for use is untoxic and non-irritating - but has limited durability.
Effect on other materials:
Very corrosive to metals ( not stainless steel).
Very staining on plastic and textiles.
Rubber will crumble under long influence from iodine preparations
Interaction:
Iodine preparations should not be used together with quaternary ammonium compounds as it inactivates them.
Iodophors are rapudly inactivated by contact with metals, except from stainless steel. Furthermore they are inactivated by temperatures above 35 °C (sunlight) - this can by seen as the brown colour of the solution will be reduced or disappear by the inactivation.
Use:
Iodine: Skin: 0,5-5% dissolved in 80-90% alcohol
Iodophors: Skin: 1000 mg active iodine/l
Hands: 200-500 mg active iodine/l
Instruments: 500 mg active iodine/l
Name: OXYDIZING AGENTS
E.g. Hydrogen peroxide, Peracids and chlorine dioxide
Concentrated solutions - 30-35% hydrogen peroxide and 40 % peracid - are explosive.
Effect:
Hydrogen peroxide: effect on bacteria, vira and most fungi. At higher concentrations the rest of the fungi and spores are killed.
Peracids: Kills bacteria, fungi, spores and vira. It works more rapidly and with lower concentration than hydrogen peroxide.
Efficient at low temperatures. Effect is reduced by organic matter.
Chlorine dioxide: Very efficient against all germs (fungi takes longer time). It is activated by lowering pH, which gives a rapid action
How does it work:
Gives a lethal oxydation in the microorganisms.
Toxicity:
Concentrated solutions may cause serious cauterizations on skin, eyes and mucous membranes.
Inhalation may irritate the airways and might on sight result in cronical bronchitis.
Chlorine dioxide: Low toxicity. Concentrated solutions gives no skinirritation and only slight eyeirritation.
Effect on other materials:
Peracid is corrosive on metals (especially iron, brass and copper), but is less agressive than chlorine and iodine.
Chlorine dioxide is (almost) non-corrosive.
Use:
H2O2: 3-30 % aqueous solution
Peracid: 0,001-0,3% aqueous soulution
Chlorine dioxide: Instrument disinfection and gas sterilization of germ-free animal chambers
Name: PHENOLICS
Phenol (carbolic acid), cresols and synthetical phenolderivatives have all strong bactericidal effect.
Simple phenolics have a penetrating odor, whereas higher phenolics are odourless. They are heavily degradable.
Effect:
Simple phenolics: Best effect on gram- bacteria. With higher concentration and longer time to work there will be effect on TB.
Multiple phenolics are effective against gram+ (bacteriostatic) as well as gram- bacteria.
Variable effect on fungi. No effect on spores and vira.
Rate of action varies with concentration and type of phenolic compound.
Simple phenolics are effective in the presence of organic matter, whereas multiple phenolics may have a limited activity.
Phenolics are not very temperature- and time dependent.
Contact time should be 10-30 minutes. Phenolic compounds leaves on a residual film, which may be desirable on some surfaces, but unwanted in other connections, eg. in culture systems.
How does it work:
Phenolic compounds function by denaturing and coagulating the protein within the cells. In low concentrations, phenol disrupt the cell wall, allowing leakage of cellular constituents.
Toxicity:
It is easily absorbed through skin and mucous membranes, which gives a toxic action on the kidney and Central Nervous System.
Large amounts of phenolics might be absorbed in rubber and plastic.
Short skin contact with a solution for use will normally give no skin reaction.
Concentrated solution: Short contact will give skin irritation, whereas longer skin contact will give cauterizations.
Effect on other materials:
Low corrosiveness; aluminium might be affected with alkaline pH.
Large amounts og phenols might damage rubber and plastic.
Optical instruments might be damaged
Use:
Instruments: 3-5%
Name: QUATERNARY AMMONIUM COMPOUNDS
Cationic detergents with bactericidal effect.
Effect:
Effective against Gram+ bacteria and most gram- (Pseudomonas and Serratia might be resistent - Pseudomonas might even multiply in solutions for use) When used over a longer period, there can be a selection in favour of gram- bacteria.
There is some effect on fungi, but fungi with a lipoid-layer like Fusarium are difficult to affect. There is no sporocidal and virocidal effect, as well as no effect on TB is observed.
Efficiency is reduced in the presence of organic matter.
Quaternary ammonium compounds is adsorbed to rubber, cotton and other porous matters à concentration is reduced.
It is inactivated by low pH solutions, phospholipids, organic compounds and metal ions, and therefore there is limited effectiveness in soaps, detergents and hard water salts.
The bactericidal effect is enhanced by alcohol.
The best effect is seen in a weakly alkaline environnement.
Contact time should be 10-30 minutes.
How does it work:
They contain alkyl groups that interact with membrane lipids to disrupt the cytoplasmic membrane of bacteria.
Toxicity:
Solutions for use are untoxic.
Concentrated solutions irritates eyes, skin and mucous membranes.
There has been reports of a few cases of allergy.
Lethal dose is estimated to be 1-3 grams in the form of concentrated solution in humans.
Effect on other materials:
Slightly corrosive on aluminium and iron. The corrosive effect on iron may be neutralized by the addition of 0,5% sodiumnitrit.
Rubber may get "greasy" after longer influence.
Use:
Hands: 0,1%
Skin: 0,1-0,2% dissolved in alcohol
Instruments: 1-2%
Surfaces: 0,5%
Solutions <0,5 % should be freshly prepared
_________________________________________________________________________
Our recommendations:
To summ up the above, we will close this subject by giving some recommandations for disinfectants for use in the laboratory - where no special considerations are to be taken regarding microorganisms, materials etc.
For surfaces:
Alcohol - ethanol 70%
Some chlorine preparations
Peracids (Oxydizing agents)
For hands:
Hygienic handwash - ethanol 70%
For instruments:
a. As pretreatment prior to sterilisation:
Chlorine preparations
b. As the only treatment:
Chlorine preparations
Peracids (Oxydizing agents)
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www.windrug.com/pic/10/12/19/13/010.htm - 網頁紀錄
十一烯酸 undecylenic acid
【历史】 本品为消毒防腐药，是一种含11碳在不饱和脂肪酸，由卡夫特（krafft）于1877年由减压蒸馏蓖麻油制得，1937年正式生产，我国于1958年投产。中国、美国、英国、德国、法国、意大利、瑞士等国药典均有收载。
【其他名称】 undecenoic acid；undecap。
【性状与稳定性】 十一烯酸为淡黄色至黄色液体；色泽受光与空气影响，遇冷则变成乳白色结晶性团块，有特臭，几不溶于水，能与乙醇、氯仿、乙醚、挥发油或脂肪油任意混合。凝固点不低于21℃。
【药物作用】 本品能抑制真菌的繁殖。
【适应症状】 用于治疗头癣、股癣、足癣等皮肤真菌感染及真菌性阴道炎。对脚癣的疗效最好。
【不良反应与注意事项】 局部外用可引起接触性皮炎。本品为外用药不可内服，当浓度过大时对组织有刺激性。
【用法与用量】 外用。局部涂敷其制剂，须连用数周才能治愈。用于黏膜的浓度不宜大于1％，一日2～3次。
【限定剂型】 软膏剂、外用溶液剂。
【可供选用的上市制剂】
脚气灵软膏（复方十一烯酸锌软膏），生产，每10克中含十一烯酸0.5克，十一烯酸锌2克，锌具有收敛作用，这一作用有助于减轻炎症。
十一烯酸药水（内含酒精）。
脚气灵：软膏剂，天津药业公司生产。20％，每支10克，含十一烯酸锌2克，外用，涂敷患部，一日2～3次。置于密闭、干燥处贮存。含十一烯酸、氧化锌、甘油等。
湿气灵药粉：含十一烯酸、水杨酰苯胺、薄荷油、氧化锌、麝香草酚等。
新脚气灵：软膏剂，沈阳市兴齐制药厂生产。成分十一烯酸、十一烯酸锌、皮质激素，每支10克，外用，一日2～3次，除用于皮肤癣症外，还可以用于过敏皮炎和皮肤瘙痒等。
复方十一烯酸锌软膏：软膏剂，广州何济公制药厂生产。20％，每支10克，含十一烯酸锌2克，外用，用于头癣、足癣，洗净患部后涂敷，一日2～3次。密闭贮存。
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www.lamasbeauty.com/glossary/print_P.html - 網頁紀錄
Pityriasis Alba: Seborrheic dermatitis.
Pityriasis Capitis: Dandruff.
Pityrosporum: Yeast that is a common inhabitant of the skin, usually starting at puberty. Not the yeast that causes vaginitis in women.
Pityrosporum Folliculitis: An acne-like rash composed of minute papules and pustules but no comedones (blackheads / whiteheads). It occurs most frequently on the forehead and sides of the face.
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http://web.uct.ac.za/depts/mmi/jmoodie/d01html.html#D01B
D01B ANTIFUNGALS FOR SYSTEMIC USE
Griseofulvin, certain azoles, and terbinafine are used systemically for serious or intractable dermatomycoses. Use should be restricted to the treatment of chronic infections not responding to topical measures.
Griseofulvin, an antifungal antibiotic, exerts an inhibitory action against common dermatophytes. It is inactive against yeasts and yeast-like fungi, including candida and pityrosporum species. It has no effect on fungi producing deep mycoses or on bacteria.
Terbinafine, an allylamine, is fungicidal against dermatophytes and some yeasts, but only fungistatic against C.albicans. Oral terbinafine is not effective in pityriasis versicolor.
Ketoconazole, fluconazole and itraconazole are effective for both yeast and dermatophyte infections. For full profiles, see section J02.
Intermittent therapy with itraconazole may be used for managing onychomycoses. As this agent is concentrated in the nail plate, it has been found that continuous therapy is not necessary. Ideally chemical or physical removal of the infected dystrophic nail plate should be used in conjunction with oral medication: itraconazole 200 mg/day, 1 week/month for 4 months.
Griseofulvin
(WHO essential agent)
Indications: Dermatophyte infections of the skin and appendages. Systemic administration is used for hair infections and failed topical management of all tinea infections.
Pharmacokinetics: Irregular absorption occurs over a prolonged period of time. It is deposited in keratinocytes and concentrated in the stratum corneum, nails and hair.
Absorbed drug is metabolised in the liver and excreted in urine. A large amount of an oral dose is excreted unchanged in faeces.
Precautions:
Contraindications: Liver failure; history of hypersensitivity to griseofulvin. Use with caution in systemic lupus erythematosus.
Drug interactions:
Alcohol: The effect of alcohol may be potentiated.
Antiepileptic agents: Effects of griseofulvin may be diminished.
Oral contraceptives: May result in contraceptive failure or breakthrough bleeding.
Warfarin: Anticoagulant effect may be reduced.
Pregnancy: Crosses the placenta; embryotoxic and teratogenic in animals. Avoid.
Lactation: Not known if excreted in breast milk; problems not documented.
Porphyria: Avoid
Geriatrics: Use with caution.
Paediatrics: Use is well established.
Adverse effects: Frequent - mild and transient headaches, skin rashes, GI disturbances, altered taste sensation and dry mouth.
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http://www.sim.fi/eng/products/System4/system4.html (Commercial page)
System 4
Very effective treatment for various scalp problems.
Countless users of System 4 have already found relief for conditions such as: dandruff, fungi, bacteria, yeast fungus, itching, psoriasis, atopic dermatitis, irritated skin, excessive secretion of sebaceous glands, hair loss or poor scalp microcirculation.
System 4 provides therapeutic synergy between shampoos and treatments. Not only do all the products provide individual benefits, but they also improve the effect of other System 4 products.
System 4 products include only dermatologically tested, safe raw materials.
The unique effect of System 4 is achieved using the following ingredients:
Climbazole is highly effective against one of the main causes of dandruff, the malassezia furfur fungus.
Piroctone olamine is effective against the pityrosporum fungus, another fungus causing dandruff.
Salicylic acid is an effective scalp and
keratosis exfoliater.
Undecylenic acid prevents excessive sebum secretion and calms irritated skin.
Rosemary stimulates hair growth.
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http://www.nutramed.com/skin/skinfungal.htm
ANTIFUNGAL
Imidazoles are active against dermatophyte and candida and pityrosporum infections. They also inhibits growth of some gram-positive bacteria.
Canesten, clozole, lotremin, myco-hermal, 1% clotrimazole (cr or lotion)
Daktarin, 2% miconazole cr
Dermazole, pervaryl, 1% econazole nitrate cr
Exelderm, 1 % sulconazole nitrate cr
Mycospor, 1% bifonazole cr
Travogen, 1% isoconazole cr
Trosyd, 1% tioconazole cr
10.2 Allylamine are active against dermatophyte but less effective against candia and pityrosporum infections when compared with azole derivatives.
Exoderil : 1% Naftifine HCl cr
Lamisil : 1% Terbinafine cr
10.3 Polyenes are active against candida sp but not dermatophytes.
Fungizone : 3% amphotericin B cr
Mycostatin, : 100,000 u/gm Nystatin cr
Nadostine
10.4 Miscellaneous compounds including older products that are generally less active and more irritant and newer agents that do not fall into a particular class of drugs listed above.
- Tolnaftate active againsts dermatophytes and pityriasis versicolor but not candida & bacteria.
Aftate; Scholl; : containing 1% (cr/solution/powd spray)
Tinaderm
- Ciclopiroxolamine spectrum similar to imidazole.
Batrafen : containing 1% cr
- Undecylenic acid more irrtant, ususally as an ingredient of foot powders for prophylaxis or treatment of tinea pedis.
Dagra foot powder : Zn undecylenate (salicylic acid, boric acid, hexachlorophene)
Other including : Detrisol oint, egomycol solution, mycoderm cr/powd, mycota cr/powd/spray, tineafax oint/powd, benzoderm soap
- Haloprogin is active against dermatophyte, tinea versicolor and in vitro also against staphylococci, streptococci, and candida albicans.
------------------
http://www.mesinc.com/education/monographs2/cme023/content/11.html
ITRACONAZOLE
Itraconazole is a synthetic triazole antifungal agent that inhibits the synthesis of ergosterol, an integral constituent of the cytoplasmic membrane of fungal cells. Specifically, it inhibits the cytochrome P450 (CYP 450)-dependent 14a-demethylase and leads to an accumulation of methylated sterols such as lanosterol and, thus, a defective cell membrane with altered permeability and function.40
Spectrum of Activity
Itraconazole has a broad spectrum of in vitro activity and a high affinity for keratinized tissues, which results in high concentrations of the drug in the nail plate.11 The therapeutic activity of itraconazole has been demonstrated against infections caused by dermatophytes, Candida sp, Pityrosporum infections, and nondermatophyte molds, such as Aspergillus sp, Fusarium sp, Alternia sp, and Scopulariopsis brevicaulis.16 Itraconazole may be considered the drug of first choice in mixed infections because of this wide spectrum of activity.
Clinical Efficacy
Numerous studies demonstrating the efficacy of itraconazole for the treatment of onychomycosis have been conducted in the US and Europe in doses ranging from 100 to 600 mg/day.41,42 Pulse therapy, consisting of two pulses of 200 mg itraconazole twice daily for 1 week separated by 3 weeks off treatment is the recommended treatment regimen for fingernail onychomycosis. The FDA-approved treatment regimen for toenail infections is 200 mg once daily for 12 weeks; however, clinical research has shown that three pulses of treatment (200 mg twice daily for 1 week per month for 3 consecutive months) are as effective as continuous therapy for the treatment of toenail onychomycosis, and this has become the standard of care.30,31
Pooled data (14 studies; 1389 patients)41 indicate that three pulses of itraconazole for the treatment of dermatophyte toenail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 58%, 82%, 77%, and 10%, respectively, 12 months after the start of therapy. Similarly, two pulses of itraconazole for the treatment of fingernail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 78%, 89%, 77%, and 4.9%, respectively, 9 months after the start of therapy
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www.aafp.org/afp/20031115/1963.html - 網頁紀錄
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http://www.interpharmaplus.com/product.php?p=179
Product Information
Nizoral (Ketoconazole) cream Box with tube with 40 g
Active Ingredient:
Ketoconazol 2g
Directions:
NIZORAL Cream is indicated
in the treatment of the infections
in the skin:
membranes due to Trichophyton mentagrophytes,
Microsporum canis and Epidermophyton floccosum, like in the
treatment of the nea candidosis , vulvitis and
pitiriasis.
indicated in the treatment of the
seborreica dermatitis when the presence of Pityrosporum is
demonstrated makes oval.
Warning:
Cream is not for oftálmic use. In order to prevent the effect it
bounces after suspending a treatment prolonged with corticosteroides
topical, is recommendable to continue with the application of a
moderate topical corticoesteroide in the mornings and to apply to
NIZORAL * cream in, afternoon subsequent and gradually retiring the
therapy with steroids in a period of 2-3 weeks.
In Stock
Price: $19.99 Shipping: Click to see our rates
Handling: $0.00
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http://www.ecureme.com/emyhealth/Pediatrics/Cradle_Cap.asp
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http://archderm.ama-assn.org/cgi/content/abstract/112/3/350
Clinical evaluation of clotrimazole. A broad-spectrum antifungal agent
P. H. Spiekermann and M. D. Young
The efficacy and safety of the broad-spectrum, topically applied antifungal agent clotrimazole were evaluated in two double-blind, multicentric trials. Ten investigators reported on a total of 1,361 cases in which a 1% solution or a 1% cream formulation was compared with its respective vehicle. Clotrimazole was therapeutically effective, as confirmed by mycological cure (negative microscopy and culture) and clinical improvement, in tinea pedis, tinea cruris, tinea corporis, pityriasis versicolor, and cutaneous candidasis. Furthermore, species identification established the efficacy of clotrimazole against Trichophyton rubrum, T mentagrophytes, Epidermophyton floccosum, Microsporum canis, Malassezia furfur (Pityrosporum orbiculare), and Candida albicans. Safety was demonstrated by the low incidence of possibly drug-related adverse experiences, namely, 19 (2.7%) of 699 patients who were treated with clotrimazole, of whom four (0.6%) discontinued treatment.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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The PASCO antifungal susceptibility test system, developed in collaboration with a commercial company, is a broth microdilution assay which is faster and easier to use than the reference broth microdilution test performed according to the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A guidelines. Advantages of the PASCO system include the system's inclusion of quality-controlled, premade antifungal panels containing 10, twofold serial dilutions of drugs and a one-step inoculation system whereby all wells are simultaneously inoculated in a single step. For the prototype panel, we chose eight antifungal agents for in vitro testing (amphotericin B, flucytosine, fluconazole, ketoconazole, itraconazole, clotrimazole, miconazole, and terconazole) and compared the results with those of the NCCLS method for testing 74 yeast isolates (14 Candida albicans, 10 Candida glabrata, 10 Candida tropicalis, 10 Candida krusei, 10 Candida dubliniensis, 10 Candida parapsilosis, and 10 Cryptococcus neoformans isolates). The overall agreements between the methods were 91% for fluconazole, 89% for amphotericin B and ketoconazole, 85% for itraconazole, 80% for flucytosine, 77% for terconazole, 66% for miconazole, and 53% for clotrimazole. In contrast to the M27-A reference method, the PASCO method classified as resistant seven itraconazole-susceptible isolates (9%), two fluconazole-susceptible isolates (3%), and three flucytosine-susceptible isolates (4%), representing 12 major errors. In addition, it classified two fluconazole-resistant isolates (3%) and one flucytosine-resistant isolate (1%) as susceptible, representing three very major errors. Overall, the agreement between the methods was greater than or equal to 80% for four of the seven species tested (C. dubliniensis, C. glabrata, C. krusei, and C. neoformans). The lowest agreement between methods was observed for miconazole and clotrimazole and for C. krusei isolates tested against terconazole. When the data for miconazole and clotrimazole were removed from the analysis, agreement was 80% for all seven species tested. Therefore, the PASCO method is a suitable alternative procedure for the testing of the antifungal susceptibilities of the medically important Candida spp. and C. neoformans against a range of antifungal agents with the exceptions only of miconazole and clotrimazole and of terconazole against C. krusei isolates.
--------------
http://www.peacehealth.org/kbase/multum/d01236t1.htm
clotrimazole topical
Pronunciation: kloe TRIM a zole
Brand: Desenex AF Prescription Strength, Fungoid Solution, Lotrimin, Lotrimin AF, Lotrimin Jock Itch Powder, Mycelex, Mycelex OTC
What is the most important information I should know about clotrimazole topical?
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air to circulate to the affected area (occlusive dressings) unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).
Avoid getting this medication in your eyes, nose, or mouth.
What is clotrimazole topical?
Clotrimazole topical is an antifungal medication. Clotrimazole topical prevents fungus from growing on your skin.
Clotrimazole topical is used to treat skin infections such as athlete's foot, jock itch, ringworm, and yeast infections.
Clotrimazole topical may also be used for purposes other than those listed in this medication guide.
Who should not use clotrimazole topical?
Do not use clotrimazole topical if you have had an allergic reaction to it in the past.
Clotrimazole topical is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not use clotrimazole topical without first talking to your doctor if you are pregnant.
It is not known whether clotrimazole passes into breast milk. Do not use clotrimazole topical without first talking to your doctor if you are breast-feeding a baby.
How should I use clotrimazole topical?
Use clotrimazole topical exactly as directed by your doctor or follow the directions that accompany the package. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Wash your hands before and after using this medication, unless you are using it to treat a hand infection.
Clean and dry the affected area. Apply a small amount of the cream (usually twice daily) for 2 to 4 weeks.
Do not take this medication by mouth.
If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed by your doctor. A light cotton-gauze dressing may be used to protect clothing.
Avoid getting this medication in your eyes, nose, or mouth.
Store clotrimazole topical at room tempera
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