Isotretinoin

Isotretinoin
Nama sistematis (IUPAC)
	Asam (2Z,4E,6E,8E)-3,7-Dimetil-9-(2,6,6-trimetilsikloheks-1-en-1-il)nona-2,4,6,8-tetraenoat
Data klinis
Nama dagang	Ivory, dll
AHFS/Drugs.com	monograph
MedlinePlus	a681043
Data lisensi	US Daily Med:pranala
Kat. kehamilan	X(AU)
Status hukum	Harus dengan resep dokter (S4) (AU) ℞-only (CA) POM (UK) ℞-only (US) ℞ Preskripsi saja
Rute	Oral, topikal
Data farmakokinetik
Bioavailabilitas	Variabel
Ikatan protein	99,9%
Metabolisme	Hati
Waktu paruh	10–20 jam
Ekskresi	Ginjal dan feses
Pengenal
Nomor CAS	4759-48-2
Kode ATC	D10AD04
PubChem	CID 5282379
Ligan IUPHAR	7600
DrugBank	DB00982
ChemSpider	4445539
UNII	EH28UP18IF
KEGG	D00348
ChEBI	CHEBI:6067
ChEMBL	CHEMBL547
Data kimia
Rumus	C20H28O2
SMILES	eMolecules & PubChem
	InChI InChI=1S/C20H28O2/c1-15(8-6-9-16(2)14-19(21)22)11-12-18-17(3)10-7-13-20(18,4)5/h6,8-9,11-12,14H,7,10,13H2,1-5H3,(H,21,22)/b9-6+,12-11+,15-8+,16-14- ; Key:SHGAZHPCJJPHSC-XFYACQKRSA-N ;

Isotretinoin, juga dikenal sebagai asam 13-cis-retinoat, adalah obat yang digunakan untuk mengobati penyakit kulit seperti iktiosis tipe harlequin, dan iktiosis lamelar, serta jerawat kistik parah atau jerawat sedang yang tidak responsif terhadap antibiotik.^[2] Isotretinoin digunakan di luar label untuk mengobati karsinoma sel basal dan karsinoma sel skuamosa, meskipun bukti klinis menunjukkan itu tidak efektif dalam pengaturan ini.^[3] Obat ini merupakan retinoid, yang berarti terkait dengan vitamin A, dan ditemukan dalam jumlah kecil secara alami di dalam tubuh. Isomernya yakni tretinoin juga merupakan obat jerawat.

Efek samping yang paling umum adalah bibir kering (keilitis), kulit kering dan rapuh (xeroderma), mata kering dan peningkatan kerentanan terhadap sengatan matahari. Efek samping yang tidak umum dan jarang terjadi termasuk nyeri otot (mialgia), dan sakit kepala. Beberapa efek samping tersebut dapat bertahan lama setelah penghentian penggunaan obat.^[4] Isotretinoin dapat menyebabkan gagal hati, oleh karena itu kadar darah pasien harus diuji secara teratur.^[5] Obat ini diketahui menyebabkan cacat lahir karena paparan di dalam rahim karena kemiripan molekulnya dengan asam retinoat, turunan vitamin A alami yang mengendalikan perkembangan embrio normal. Hal ini terkait dengan efek samping kejiwaan, paling umum depresi tetapi juga (lebih jarang) psikosis dan perilaku yang tidak biasa. Efek samping langka lainnya termasuk hiperostosis dan penutupan epifisis prematur, yang telah dilaporkan persisten.

Istotretinoin dipatenkan pada tahun 1969 dan disetujui untuk penggunaan medis pada tahun 1982.^[6]

Referensi

^ Kesalahan pengutipan: Tag <ref> tidak sah; tidak ditemukan teks untuk ref bernama brands
^ Mohiuddin AK (2019). "A Comprehensive Review of Acne Vulgaris". Journal of Clinical Pharmacy. 1 (1): 17–45.
^ Clouser MC, Roe DJ, Foote JA, Harris RB, Alberts DS (2010-11-05). "Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence". Nutrition and Cancer. 62 (8): 1058–1066. doi:10.1080/01635581.2010.492089. PMC 4104190. PMID 21058193.
^ Moy A, McNamara NA, Lin MC (September 2015). "Effects of Isotretinoin on Meibomian Glands". Optometry and Vision Science (dalam bahasa American English). 92 (9): 925–930. doi:10.1097/OPX.0000000000000656. PMID 26154692.
^ Erşan M (2017-09-05). "Sivilce ilacı karaciğerini mahvetti" [Acne drug destroyed her life]. www.hurriyet.com.tr (dalam bahasa Turki). Diakses tanggal 2024-06-20. [Prof. Dr. K. Yalçın Polat, President of the Department of General Surgery at the Memorial Ataşehir Hospital: Our patient's blood values were very high when she was hospitalized. It was not easy for us to decide to have a liver transplant. During our three-week treatment, her liver values continued to rise and she entered liver failure, which made us take this decision. In the liver biopsy, we saw necrosis (non-living tissue) in the liver. If we had waited a little longer, she would have fallen into a coma and we would have then lost the patient. The cause of her liver failure is the medication she takes for acne. Unfortunately, this drug is very widely used. Liver enzymes should be closely monitored while taking isotretinoin. Every kind of drug reaches the liver, and each of them has side effects as well as positive effects. Even if the liver tolerates these and cleans the toxins, it can still be affected as in the case of Mrs. Çilingir.]
^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. hlm. 476. ISBN 978-3-527-60749-5.

[brands-1] Kesalahan pengutipan: Tag <ref> tidak sah; tidak ditemukan teks untuk ref bernama brands

[2] Mohiuddin AK (2019). "A Comprehensive Review of Acne Vulgaris". Journal of Clinical Pharmacy. 1 (1): 17–45.

[3] Clouser MC, Roe DJ, Foote JA, Harris RB, Alberts DS (2010-11-05). "Dose response of retinol and isotretinoin in the prevention of nonmelanoma skin cancer recurrence". Nutrition and Cancer. 62 (8): 1058–1066. doi:10.1080/01635581.2010.492089. PMC 4104190. PMID 21058193.

[:5-4] Moy A, McNamara NA, Lin MC (September 2015). "Effects of Isotretinoin on Meibomian Glands". Optometry and Vision Science (dalam bahasa American English). 92 (9): 925–930. doi:10.1097/OPX.0000000000000656. PMID 26154692.

[5] Erşan M (2017-09-05). "Sivilce ilacı karaciğerini mahvetti" [Acne drug destroyed her life]. www.hurriyet.com.tr (dalam bahasa Turki). Diakses tanggal 2024-06-20. [Prof. Dr. K. Yalçın Polat, President of the Department of General Surgery at the Memorial Ataşehir Hospital: Our patient's blood values were very high when she was hospitalized. It was not easy for us to decide to have a liver transplant. During our three-week treatment, her liver values continued to rise and she entered liver failure, which made us take this decision. In the liver biopsy, we saw necrosis (non-living tissue) in the liver. If we had waited a little longer, she would have fallen into a coma and we would have then lost the patient. The cause of her liver failure is the medication she takes for acne. Unfortunately, this drug is very widely used. Liver enzymes should be closely monitored while taking isotretinoin. Every kind of drug reaches the liver, and each of them has side effects as well as positive effects. Even if the liver tolerates these and cleans the toxins, it can still be affected as in the case of Mrs. Çilingir.]

[Fis2006-6] Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. hlm. 476. ISBN 978-3-527-60749-5.

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