> > Erik Reuter <ereuter@...> wrote:
> > >Deborah Harrell wrote:
> > > Toenail fungus.
> > You lost me at "Toenail fungus". Are we being
> > a test, which one of
> > these does not belong? :-) My best guess is that
> > referring to the
> > FDA's warning in 2001 about Lamisil possibly
> >causing liver damage? If
> > so, how is that the "customers" or "patients"
> >fault? If the FDA has good
> > evidence for danger, why is it still allowing
> > Lamisil to be sold (and heavily advertised)?
> Now you're going to make that song play in my head
> all the way home!
But then I should have had *4* things listed, to give
you the full choice range! :)
> .....mostly 'yep.' In the side effect
> profile for Lamisil (and most if not all antifungals
> that are taken internally), liver damage is listed.
> This has to do with the cell membrane construction
> fungi, which IIRC has more in common with mammalian
> cells...cholesterol-based compounds? (I'll look
> that up.)
Here's a bit of an overview:
"Amphotericin, nystatin, and pimaricin interact with
sterols in the cell membrane (ergosterol in fungi,
cholesterol in humans) to form channels through which
small molecules leak from the inside of the fungal
cell to the outside.
"Fluconazole, itraconazole, and ketoconazole inhibit
cytochrome P450-dependent enzymes (particularly
C14-demethylase) involved in the biosynthesis of
ergosterol, which is required for fungal cell membrane
structure and function.
"Allylamines (naftifine, terbinafine) inhibit
ergosterol biosynthesis at the level of squalene
epoxidase. The morpholine drug, amorolfine, inhibits
the same pathway at a later step...
"...The development of antifungal agents has lagged
behind that of antibacterial agents. This is a
predictable consequence of the cellular structure of
the organisms involved. Bacteria are prokaryotic and
hence offer numerous structural and metabolic targets
that differ from those of the human host. Fungi, in
contrast, are eukaryotes, and consequently most agents
toxic to fungi are also toxic to the host.
Furthermore, because fungi generally grow slowly and
often in multicellular forms, they are more difficult
to quantify than bacteria..."
> My point is more that it's a cosmetic
problem....[advertising suggests that]
> *it needs to be treated with an expensive and
> potentially harmful* drug. It doesn't. But unless
> you do your homework, you'd agree with that worried
> lady in the ad who mutters "Infection...?"
Damon's query and the subsequent responses re: dremels
I personally use an exacto knife to pare down the
offending toenail; I keep threatening to try my
dogshowing friend's 'Happy Jack' treatment for dognail
fungus...I'll let you know if I do, and the outcome!
It's not that I'm against treating nail fungi; I just
want folks to be properly aware of what the
_potential_ consequences are. Lamisil is much less
toxic than frex Amphotericin B, which we nicknamed
'amphoterrible' b/c of its many nasty side effects (of
course, fungal infection of the brain is just a tad
more serious than that of the toenail, and you can't
do without a brain, unlike pretty feet...).
And drugs like Accutane, a definite teratogen, are
justified in being used only for truly dreadful cases
of acne [I do not consider _severe_ acne merely
cosmetic, but actually disfiguring, and so increased
risk, if properly explained, can be acceptable].
Off To Another Lesson Maru UU
Do you Yahoo!?
All your favorites on one personal page � Try My Yahoo!