Instruct: Given a question, retrieve relevant documents that can help answer the question.
Query: Is accutane Vitamin A?
Isotretinoin, also known as 13-cis-retinoic acid (and colloquially referred to by its former brand name Accutane or Roaccutane), is a medication primarily used to treat severe acne. Rarely, it is also used to prevent certain skin cancers (squamous-cell carcinoma), and in the treatment of other cancers. It is used to treat harlequin-type ichthyosis, a usually lethal skin disease, and lamellar ichthyosis. It is a retinoid, meaning it is related to vitamin A, and is found in small quantities naturally in the body. Its isomer, tretinoin, is also an acne drug.
Corticosteroids (cortisone), accutane (isotretinoin) and other vitamin A derivatives, barbiturates, certain antibiotics, propofol, volatile anesthetics, non-depolarizing muscle relaxants, some local anesthetics, statins, fibrates, glitazones, beta blockers, biguanides, amiodarone, some chemotherapies, some neuroleptics, nucleoside reverse transcriptase inhibitors and various other drugs.
A vitamin is an organic molecule (or related set of molecules) that is an essential micronutrient that an organism needs in small quantities for the proper functioning of its metabolism. Essential nutrients cannot be synthesized in the organism, either at all or not in sufficient quantities, and therefore must be obtained through the diet. Vitamin C can be synthesized by some species but not by others; it is not a vitamin in the first instance but is in the second. The term "vitamin" does not include the three other groups of essential nutrients: minerals, essential fatty acids, and essential amino acids. Most vitamins are not single molecules, but groups of related molecules called vitamers. For example, vitamin E consists of four tocopherols and four tocotrienols. The thirteen vitamins required by human metabolism are: vitamin A (retinols and carotenoids), vitamin B (thiamine), vitamin B (riboflavin), vitamin B (niacin), vitamin B (pantothenic acid), vitamin B (pyridoxine), vitamin B (biotin), vitamin B (folic acid or folate), vitamin B (cobalamins), vitamin C (ascorbic acid), vitamin D (calciferols), vitamin E (tocopherols and tocotrienols), and vitamin K (quinones).
Bremner's brain imaging studies showed smaller volume of the hippocampus in people with Post traumatic stress disorder related to childhood abuse or Vietnam combat; he was the first to publish that relationship. These studies and others resulted in him being one of the most highly cited researchers in the field of Post traumatic stress disorder.
Bremner's research used PET brain imaging to show a decrease in frontal lobe brain function in acne patients treated with Accutane (isotretinoin). He was an expert witness in litigation related to the relationship between Accutane and suicide and depression, including the case of Charles J. Bishop, which he describes in the narrative non-fiction book, "The Goose That Laid the Golden Egg".
Vitamin D deficiencies are often caused by decreased exposure of the skin to sunlight. People with a darker pigment of skin or increased amounts of melanin in their skin may have decreased production of Vitamin D. Melanin absorbs ultraviolet B radiation from the sun and reduces vitamin D production. Sunscreen can also reduce vitamin D production. Medications may speed up the metabolism of vitamin D, causing a deficiency. Some types of liver diseases and kidney diseases can decrease vitamin D production leading to a deficiency. The liver is required to transform vitamin D into 25-hydroxyvitamin D. This is an inactive metabolite of vitamin D but is a necessary precursor (building block) to create the active form of vitamin D.
Severe acne usually indicates the necessity of prescription medication to treat the pimples. Prescription medications used to treat acne and pimples include isotretinoin, which is a retinoid. Historically, antibiotics such as tetracyclines and erythromycin were prescribed. While they were more effective than topical applications of benzoyl peroxide, the bacteria eventually grew resistant to the antibiotics and the treatments became less and less effective. Also, antibiotics had more side effects than topical applications, such as stomach cramps and severe discoloration of teeth. Common antibiotics prescribed as of 2001 by dermatologists included doxycycline and minocycline. For more severe cases of acne dermatologists might recommend accutane, a retinoid that is the most potent of acne treatments. However, accutane can cause various side effects including vomiting, diarrhea, and birth defects if taken during pregnancy.
Vitamins and minerals are required for normal metabolism but which the body cannot manufacture itself and which must therefore come from external sources. Vitamins come from several sources including fresh fruit and vegetables (Vitamin C), carrots, liver (Vitamin A), cereal bran, bread, liver (B vitamins), fish liver oil (Vitamin D) and fresh green vegetables (Vitamin K). Many minerals are also essential in small quantities including iron, calcium, magnesium, sodium chloride and sulfur; and in very small quantities copper, zinc and selenium. The micronutrients, minerals, and vitamins in fruit and vegetables may be destroyed or eluted by cooking. Vitamin C is especially prone to oxidation during cooking and may be completely destroyed by protracted cooking. The bioavailability of some vitamins such as thiamin, vitamin B6, niacin, folate, and carotenoids are increased with cooking by being freed from the food microstructure. Blanching or steaming vegetables is a way of minimizing vitamin and mineral loss in cooking.
Secondary vitamin A deficiency is associated with chronic malabsorption of lipids, impaired bile production and release, and chronic exposure to oxidants, such as cigarette smoke, and chronic alcoholism. Vitamin A is a fat-soluble vitamin and depends on micellar solubilization for dispersion into the small intestine, which results in poor use of vitamin A from low-fat diets. Zinc deficiency can also impair absorption, transport, and metabolism of vitamin A because it is essential for the synthesis of the vitamin A transport proteins and as the cofactor in conversion of retinol to retinal. In malnourished populations, common low intakes of vitamin A and zinc increase the severity of vitamin A deficiency and lead physiological signs and symptoms of deficiency. A study in Burkina Faso showed major reduction of malaria morbidity with combined vitamin A and zinc supplementation in young children.
Oral Isotretinoin is best absorbed when taken with a high-fat meal, because it has a high level of lipophilicity.[70] The efficacy of isotretinoin doubles when taken after a high-fat meal compared to when taken without food.[71] Due to Isotretinoin's molecular relationship to Vitamin A, it should not be taken with Vitamin A supplements due to the danger of toxicity through cumulative overdosing.[72] Accutane also negatively interacts with tetracycline, another class of acne drug, and with micro-dosed ('mini-pill') progesterone preparations, norethisterone/ethinylestradiol ('OrthoNovum 7/7/7'), St. John's Wort, phenytoin, and systemic corticosteroids.
Vitamins are classified as either water-soluble or fat-soluble. In humans there are 13 vitamins: 4 fat-soluble (A, D, E, and K) and 9 water-soluble (8 B vitamins and vitamin C). Water-soluble vitamins dissolve easily in water and, in general, are readily excreted from the body, to the degree that urinary output is a strong predictor of vitamin consumption. Because they are not as readily stored, more consistent intake is important. Fat-soluble vitamins are absorbed through the intestinal tract with the help of lipids (fats). Vitamins A and D can accumulate in the body, which can result in dangerous hypervitaminosis. Fat-soluble vitamin deficiency due to malabsorption is of particular significance in cystic fibrosis.
Rice Krispies contain rice, sugar, salt, malt flavoring, iron, ascorbic acid (vitamin C), alpha tocopherol acetate (vitamin E), niacinamide, vitamin A palmitate, pyridoxine hydrochloride (vitamin B6), riboflavin (vitamin B2), thiamin hydrochloride (vitamin B1), folic acid, vitamin B12 (as cyanocobalamin), and vitamin D.
Vitamins can be divided into two groups: water-soluble vitamins and fat-soluble vitamins. Water-soluble vitamins include vitamin C and the B vitamins (folate, thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B6, vitamin B12). Most dialysis patients will need to supplement vitamin C and B vitamins to replace what is lost in the dialysis solution. Fat-soluble vitamins include vitamins A, D, E, and K. Excessive amounts of these vitamins can be harmful for people with kidney failure because they can build up in the body and become toxic so they are not generally supplemented in dialysis patients. However, vitamin D is sometimes an exception to this generalization. A doctor will prescribe vitamin D if it is necessary.
Giving vitamin D to TB patients who are vitamin D deficient may be beneficial in a proportion of patients. When taken as a group, vitamin D supppliementation appears to have no benefit when using sputum culture conversion as an endpoint, and giving vitamin D supplements to TB patients who have normal vitamin D levels does not provide any benefit from the point of view of TB. In a subset of patients with the "tt" genotype of the TaqI vitamin D receptor and who are vitamin D deficient, vitamin D supplementation appears to hasten sputum culture conversion. There are no studies of vitamin D using the gold standard outcome of relapse, so the true benefit of vitamin D is not at present known.
A vitamin is an organic compound required by an organism as a vital nutrient in limited amounts. An organic chemical compound (or related set of compounds) is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. The term is conditional both on the circumstances and on the particular organism. For example, ascorbic acid (vitamin C) is a vitamin for anthropoid primates, humans, guinea pigs and bats, but not for other mammals. Vitamin D is not an essential nutrient for people who get sufficient exposure to ultraviolet light, either from the sun or an artificial source, as then they synthesize vitamin D in skin. Humans require thirteen vitamins in their diet, most of which are actually groups of related molecules, "vitamers", (e.g. vitamin E includes tocopherols and tocotrienols, vitamin K includes vitamin K and K). The list: vitamins A, C, D, E, K, Thiamine (B1), Riboflavin (B2), Niacin (B3), Pantothenic Acid (B5), Vitamin B6, Biotin (B7), Folate (B9) and Vitamin B12. Vitamin intake below recommended amounts can result in signs and symptoms associated with vitamin deficiency. There is little evidence of benefit when consumed as a dietary supplement by those who are healthy and consuming a nutritionally adequate diet.
Vitamin A, and more specifically, retinoic acid, appears to maintain normal skin health by switching on genes and differentiating keratinocytes (immature skin cells) into mature epidermal cells. Exact mechanisms behind pharmacological retinoid therapy agents in the treatment of dermatological diseases are being researched.
For the treatment of acne, the most prescribed retinoid drug is 13-cis retinoic acid (isotretinoin). It reduces the size and secretion of the sebaceous glands. Although it is known that 40 mg of isotretinoin will break down to an equivalent of 10 mg of ATRA — the mechanism of action of the drug (original brand name Accutane) remains unknown and is a matter of some controversy. Isotretinoin reduces bacterial numbers in both the ducts and skin surface. This is thought to be a result of the reduction in sebum, a nutrient source for the bacteria. Isotretinoin reduces inflammation via inhibition of chemotactic responses of monocytes and neutrophils. Isotretinoin also has been shown to initiate remodeling of the sebaceous glands; triggering changes in gene expression that selectively induce apoptosis. Isotretinoin is a teratogen with a number of potential side-effects. Consequently, its use requires medical supervision.
Alfalfa is rich in chlorophyll, carotene, protein, calcium and other minerals, vitamins in the B group, vitamin C, vitamin D, vitamin E, and vitamin K. The sun-dried hay of alfalfa has been found to be a source of vitamin D, containing 48 ng/g (1920 IU/kg) vitamin D and 0.63 ng/g (25 IU/kg) vitamin D. There is reference to vitamin D and vitamin D being found in the alfalfa shoot; this is awaiting verification.
Vitamin D (ergocalciferol) and Vitamin D (cholecaliferol) share a similar mechanism of action as outlined above. Metabolites produced by vitamin D is sometimes named with a "er-" or "ergo" prefix to differentiate them from the D-based counterparts. Nevertheless, these differences are present in the metabolism of Vitamin D and Vitamin D:American researchers Elmer McCollum and Marguerite Davis in 1914 discovered a substance in cod liver oil which later was called "vitamin A". British doctor Edward Mellanby noticed dogs that were fed cod liver oil did not develop rickets and concluded vitamin A, or a closely associated factor, could prevent the disease. In 1922, Elmer McCollum tested modified cod liver oil in which the vitamin A had been destroyed. The modified oil cured the sick dogs, so McCollum concluded the factor in cod liver oil which cured rickets was distinct from vitamin A. He called it vitamin D because it was the fourth vitamin to be named. It was not initially realized that, unlike other vitamins, vitamin D can be synthesised by humans through exposure to UV light.
Isotretinoin was first marketed as Accutane by Hoffmann-La Roche. It sold well for many years, but in 2009, Roche decided to remove Accutane from the US market after juries had awarded millions of dollars in damages to former Accutane users over inflammatory bowel disease claims. The American College of Gastroenterologists has released a position paper stating that people with inflammatory bowel disease should not be precluded from having their acne treated with isotretinoin. It then became generic and as of 2017 was marketed under many brand names worldwide.[1]
Although the vitamin A was not identified until the 20th century, written observations of conditions created by deficiency of this nutrient appeared much earlier in history. Sommer (2008) classified historical accounts related to vitamin A and/or manifestations of deficiency as follows: "Ancient" accounts; 18th- to 19th-century clinical descriptions (and their purported etiologic associations); early 20th-century laboratory animal experiments, and clinical and epidiomologic observations that identified the existence of this unique nutrient and manifestations of its deficiency.All retinoid forms of vitamin A are used in cosmetic and medical applications applied to the skin. Retinoic acid, termed Tretinoin in clinical usage, is used in the treatment of acne and keratosis pilaris in a topical cream. An isomer of tretinoin, isotretinoin is also used orally (under the trade names "Accutane" and "Roaccutane"), generally for severe or recalcitrant acne.
On January 5, 2002, just four months after the September 11, 2001, terrorist attacks, 15-year-old amateur pilot Charles Bishop crashed a Cessna plane into the Bank of America Plaza. Bishop died, but there were no other injuries (because the crash occurred on a Saturday, when few people were in the building). A suicide note found in the wreckage expressed support for Osama bin Laden. Bishop had been taking a prescription medicine for acne called Accutane that may have had the side effect of depression or severe psychosis. His family later sued Hoffman-La Roche, the company that makes Accutane, for $70 million; however, an autopsy found no traces of the drug in the teenager's system.
Vitamins and minerals include vitamin C (ascorbic acid), vitamin E (alpha tocopherol acetate), niacinamide, reduced iron, vitamin B (pyridoxine hydrochloride), vitamin B (thiamin hydrochloride), vitamin A (palmitate), vitamin B (riboflavin), folic acid, and vitamin B
Some dermatologists have praised isotretinoin for its ability to treat severe acne, with current research calling it "a drug of choice" with "immense promise … in reducing dermal irritation and increasing the therapeutic performance, thus resulting in an efficacious and patient-compliant formulation". However, there have also been many reports and studies criticizing the negative side effects of isotretinoin have been published over the years. The author of a 2002 paper from Harvard Law School wrote: "Accutane also has the potential to destroy lives. Accutane is an extremely dangerous teratogen: It can cause severe birth defects when taken during pregnancy. About one quarter of babies born who have been exposed to Accutane during gestation have major congenital deformities. Those babies born without major malformations frequently develop severe learning disabilities. A whole segment of Accutane babies do not even survive pregnancy: 40% are spontaneously miscarried." The author goes on to compare Accutane to Thalidomide.
Typical of milk, several dietary minerals are found in kefir, such as calcium, iron, phosphorus, magnesium, potassium, sodium, copper, molybdenum, manganese, and zinc in amounts that have not been standardized to a reputable nutrient database. Also similar to milk, kefir contains vitamins in variable amounts, including vitamin A, vitamin B (thiamine), vitamin B (riboflavin), vitamin B (niacin), vitamin B (pyridoxine), vitamin B (folic acid), vitamin B (cyanocobalamin), vitamin C, vitamin D, and vitamin E. Essential amino acids found in kefir include methionine, cysteine, tryptophan, phenylalanine, tyrosine, leucine, isoleucine, threonine, lysine, and valine, as for any milk product.
Before 1935, the only source of vitamins was from food. If intake of vitamins was lacking, the result was vitamin deficiency and consequent deficiency diseases. Then, commercially produced tablets of yeast-extract vitamin B complex and semi-synthetic vitamin C became available. This was followed in the 1950s by the mass production and marketing of vitamin supplements, including multivitamins, to prevent vitamin deficiencies in the general population. Governments mandated addition of vitamins to staple foods such as flour or milk, referred to as food fortification, to prevent deficiencies. Recommendations for folic acid supplementation during pregnancy reduced risk of infant neural tube defects. Although reducing incidence of vitamin deficiencies clearly has benefits, supplementation is thought to be of little value for healthy people who are consuming a vitamin-adequate diet.
The term "vitamin" is derived from the word "vitamine", coined in 1912 by biochemist Casimir Funk, who isolated a complex of micronutrients essential to life, all of which he presumed to be amines. When this presumption was later determined not to be true, the "e" was dropped from the name. All vitamins were discovered (identified) between 1913 and 1948.
In February 2002, Roche's patents for isotretinoin expired, and there are now many other companies selling cheaper generic versions of the drug. On June 29, 2009, Roche Pharmaceuticals, the original creator and distributor of isotretinoin, officially discontinued both the manufacture and distribution of their Accutane brand in the United States due to what the company described as business reasons related to low market share (below 5%), coupled with the high cost of defending personal-injury lawsuits brought by some people who took the drug.[75] Generic isotretinoin will remain available in the United States through various manufacturers. Roche USA continues to defend Accutane and claims to have treated over 13 million people since its introduction in 1982. F. Hoffmann-La Roche Ltd. apparently will continue to manufacture and distribute Roaccutane outside of the United States.[76]