>I wrote: > > Erik Reuter <[EMAIL PROTECTED]> wrote: > > >Deborah Harrell wrote: <snippage throughout> > > > Toenail fungus.
> > You lost me at "Toenail fungus". Are we being > given > > 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 > of > 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: http://gsbs.utmb.edu/microbook/ch076.htm "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 noted... <grin> 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]. Debbi Off To Another Lesson Maru UU __________________________________ Do you Yahoo!? All your favorites on one personal page � Try My Yahoo! http://my.yahoo.com _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
