User:Willy1018/沙盒1

Willy1018/沙盒1
Tretinoin2DACS.svg
系统(IUPAC)命名名称
(2E,4E,6E,8E)-3,7-Dimethyl-9-(2,6,6-trimethylcyclohexen-1-yl)nona-2,4,6,8-tetraenoic acid
临床数据
读音See pronunciation note
商品名Avita, Renova, Retin-a
Drugs.comMonograph
MedlinePlusa682437
医疗法规
妊娠分级
  • AU: X (高风险)
  • US: C (不排除有风险的可能)
给药途径Topical, by mouth
合法狀態
合法状态
药代动力学数据
蛋白结合度> 95%
生物半衰期0.5-2 hours
识别信息
CAS注册号302-79-4  ✓[cas]
ATC代码D10AD01 L01XX14
PubChemCID 444795
IUPHAR/BPS英语IUPHAR/BPS2644
DrugBankDB00755 ✓
ChemSpider392618 ✓
UNII5688UTC01R ✓
KEGGD00094 ✓
ChEBICHEBI:15367 ✓
ChEMBL英语ChEMBLCHEMBL38 ✓
化学信息
化学式C20H28O2
摩尔质量300.4412 g/mol
物理性质
熔点180 °C(356 °F)

Tretinoin is the 製藥 form of retinoic acid. One of several retinoids, it is the 羧酸

form of 維生素A and is also known as 全反式維甲酸 (ATRA). It is a first generation topical retinoid commonly used topically to treat acne vulgaris. It is also used orally to treat acute promyelocytic leukemia (APL). Its isomer, isotretinoin, is also an acne drug.

世界衛生組織基本藥物標準清單中,是人體中重要且必須的物質。[1]

醫療用途编辑

Skin disease编辑

Tretinoin is most commonly used to treat acne.[2] It is also used off-label to treat and reduce the appearance of stretch marks by increasing collagen production in the dermis.[3]

In topical form, this drug is pregnancy category C and should not be used by pregnant women.[2]

People using the topical form should not also use any cream or lotion that has a strong drying effect, contains alcohol, astringents, spices, lime, sulfur, resorcinol, or aspirin, as these may interact with tretinoin or exacerbate its side effects.[2]

Leukemia编辑

Tretinoin is used to induce remission in people with acute promyelocytic leukemia who have a mutation (the t(15;17) translocation 160 and/or the presence of the PML/RARα gene) and who don't respond to anthracyclines or can't take that class of drug. It is not used for maintenance therapy.[4][5][6]

In oral form, this drug is pregnancy category D and should not be used by pregnant women as it may harm the fetus.[4]

Side effects编辑

Skin disease use编辑

Topical tretinoin is only for use on skin and it should not be applied to eyes or mucosal tissues. Common side effects include skin irritation, redness, swelling, and blistering. Skin is more susceptible to sunburn.[2]

Leukemia use编辑

The oral form of the drug has boxed warnings concerning the risks of retinoic acid syndrome and leukocytosis.[4]

Other significant side effects include a risk of thrombosis, benign intracranial hypertension in children, high lipids (hypercholesterolemia and/or hypertriglyceridemia), and liver damage.[4]

There are many significant side effects from this drug that include malaise (66%), shivering (63%), hemorrhage (60%), infections (58%), peripheral edema (52%), pain (37%), chest discomfort (32%), edema (29%), disseminated intravascular coagulation (26%), weight increase (23%), injection site reactions (17%), anorexia (17%), weight decrease (17%), and myalgia (14%).[4]

Respiratory side effects usually signify retinoic acid syndrome, and include upper respiratory tract disorders (63%), dyspnea (60%), respiratory insufficiency (26%), pleural effusion (20%), pneumonia (14%), rales (14%), and expiratory wheezing (14%), and many others at less than 10%.[4]

大約 23% 人們, taking the drug have reported eararche or a feeling of fullness in their ears.[4]

Gastrointestinal disorders 包含流血 (34%)、腹痛 (31%)、 腹瀉(23%)、 便秘(17%)、 消化不良(14%)、 and swollen belly (11%) and many others at less than 10%.[4]

In the cardiovascular system, side effects include arrhythmias (23%), flushing (23%), hypotension (14%), hypertension (11%), phlebitis (11%), and cardiac failure (6%) and for 3% of patients: cardiac arrest, myocardial infarction, enlarged heart, heart murmur, ischemia, stroke, myocarditis, pericarditis, pulmonary hypertension, secondary cardiomyopathy.[4]

In the nervous system, side effects include dizziness (20%), paresthesias (17%), anxiety (17%), insomnia (14%), depression (14%), confusion (11%), and many others at less than 10% frequency.[4]

In the urinary system, side effects include renal insufficiency (11%) and several others at less than 10% frequency.[4]

Mechanism of action编辑

For its use in cancer, its mechanism of action is unknown, but on a cellular level, laboratory test show that tretinoin forces APL cells to differentiate and stops them from proliferating; in people there is evidence that it forces the primary cancerous promyelocytes to differentiate into their final form, allowing normal cells to take over the bone marrow.[4]

For its use in acne, the mechanism is unknown, but again on a cellular level there is evidence that it decreases the ability of epithelial cells in hair follicles to stick together, leading to fewer blackheads; it also seems to make the epithelial cells divide faster, causing the blackheads to be pushed out.[2]

歷史编辑

Tretinoin was co-developed for its use in acne by James Fulton and Albert Kligman when they were at University of Pennsylvania in the late 1960s.[7][8] The University of Pennsylvania held the patent for Retin-A, which it licensed to pharmaceutical companies.[8]

辭源编辑

The origin of the name tretinoin is uncertain,[9][10] although several sources agree (one with probability,[9] one with asserted certainty[11]) that it probably comes from trans- + retinoic [acid] + -in, which is plausible given that tretinoin is the all-trans isomer of retinoic acid. The name isotretinoin is the same root tretinoin plus the prefix iso-. Regarding pronunciation, the following variants apply equally to both tretinoin and isotretinoin. Given that retinoic is pronounced /ˌrɛt[不支援的輸入]ˈn[不支援的輸入]k/,[10][11][12][13] it is natural that /ˌtrɛt[不支援的輸入]ˈn[不支援的輸入]n/ is a commonly heard pronunciation. Dictionary transcriptions also include /ˌtr[不支援的輸入]ˈtɪn[不支援的輸入]n/ (trə-TIN-oh-in)[10][12] and /ˈtrɛt[不支援的輸入]nɔɪn/.[11][13]

研究编辑

Tretinoin has been explored as a treatment for hair loss, potentially as a way to increase the ability of minoxidil to penetrate the scalp, but the evidence is weak and contradictory.[14][15]

參見编辑

References编辑

  1. ^ www.who.int (PDF). 
  2. ^ 2.0 2.1 2.2 2.3 2.4 Topical Cream Gel Liquid Label
  3. ^ Arthur W. Perry. Straight talk about cosmetic surgery. Yale University Press. 2007: 63. ISBN 978-0-300-12104-9. 
  4. ^ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 Oral Label
  5. ^ Huang M, Ye Y, Chen S, Chai J, Lu J, Zhoa L, Gu L, Wang Z. Use of all-trans retinoic acid in the treatment of acute promyelocytic leukemia (PDF). Blood. 1988, 72 (2): 567–72. PMID 3165295. 
  6. ^ Castaigne S, Chomienne C, Daniel M, Ballerini P, Berger R, Fenaux P, Degos L. All-trans retinoic acid as a differentiation therapy for acute promyelocytic leukemia. I. Clinical results (PDF). Blood. 1990, 76 (9): 1704–9. PMID 2224119. 
  7. ^ Vivant Pharmaceuticals, LLC Press Release. July 10, 2013, Vivant Skin Care Co-founder James E. Fulton, MD, Loses Colon Cancer Battle
  8. ^ 8.0 8.1 Denis Gellene for the New York Times. Feb 22, 2010. Dr. Albert M. Kligman, Dermatologist, Dies at 93
  9. ^ 9.0 9.1 Merriam-Webster, Merriam-Webster's Unabridged Dictionary, Merriam-Webster. 
  10. ^ 10.0 10.1 10.2 Oxford Dictionaries, Oxford Dictionaries Online, Oxford University Press. 
  11. ^ 11.0 11.1 11.2 Houghton Mifflin Harcourt, The American Heritage Dictionary of the English Language, Houghton Mifflin Harcourt. 
  12. ^ 12.0 12.1 Merriam-Webster, Merriam-Webster's Medical Dictionary, Merriam-Webster. 
  13. ^ 13.0 13.1 Elsevier, Dorland's Illustrated Medical Dictionary, Elsevier. 
  14. ^ Ralph M. Trüeb. The Difficult Hair Loss Patient: Guide to Successful Management of Alopecia and Related Conditions. Springer, 2015. ISBN 9783319197012 Pg. 95
  15. ^ Rogers, N; Avram, M. Medical treatments for male and female pattern hair loss.. Journal of the American Academy of Dermatology. October 2008, 59 (4): 547–566. PMID 18793935. doi:10.1016/j.jaad.2008.07.001. 

External links编辑

Template:Chemotherapeutic agents

Template:Nuclear receptor ligands