FDA weight loss drugs

Stimulants:

Amphetamines:

Amphetamines such as Adderall, Adderall XR, Dextroamphetamine and Mydasis are stimulates which can help people with ADHD. Some people use amphetamines for weight loss or to boost energy and alertness. High doeses can cause a rise in body temperature, irregular heartbeat and even cardiac arrest. Nicknames for amphetamines include “speed”, “black beauties” or “bennies”. 

Methyphenidate: is a stimulate in ADHD drugs such as Concerta, Daytrana, Metadate, Methylin and Rtalin. 

FDA Approved Medicines for weight loss

Contrave: (AKA/ naltrexone/Bupropion): Nalpropion Pharmaceuticals, Inc. holds New Drug application No. 200063 for and markets Contrave for weight management in overweight or abese adults. Nalpropion also holds three patents: US Patents No: 7,462,626 drawn to a method for treating overweight or obesity by adminsitering bupropion in an amount effective to induce weight and adminsitering naltrexone in an amount effective to enhance the weight lowss activity of buropion. However, these patents were held to be invalid for obviousness given the prior art literature below. The court holding that the combination of the drugs could not have been unexpected given that the combination of the two drugs was already known and that both drugs were understood to be useful for the purpose of inducing weight loss. 

O’Malley (US Patent No: 6,541,478) entitled “Smoking Cessation Treatment Using Naltrexone and Related Compounds” discloses that weight gain is a significant problem with smoking cessation and that the use of opinoid antagnonist, including naltrexone, alone or with other withdrawal attenuating agents minimizes weight gain during treatment. 

Jain “Bupropion SR vs. Pacebo for weigth loss in obese patients with depressive symptoms” 10 Obesity Res. 1049-56 (2002), J.A. 7171-78) discloses that studies suggest that bupropion SR is also effective for weight loss)

Atkinson (“Bupropian SR Enhances Weight Loss: A 48-week double-blind, placebo-controlled trial, 10 Obesity Res. 633-41 (2002), J.A. 7160-68) discloses a small but significant weight loss in women but no significant effect in mean with long-term naltrexone administration. 

Dante (US Patent no: 5,817,665) discloses that a woman in her thirites who was started on naltrexone without making any other changes rapidly lost her craving for sweets and lost thrity pounds in three weeks. 

Using Bacteria to Control Weight Loss

Arla Foods amda, the largest producer of dairy produces in Scandanavia, has patnet 9,113,641 which relates to a composition of L. paracasei and a milk product used to regulate fat uptake. 

Jiinis Biopharmaceuticals has a patent directed to mutagenized L. acidophilus strains. 

Nestec S.A. has a number of patents relacting to formulations of lactic acid bcteria used to prevent weight gain. Patent Nos. 8,318,150, 8318,151 describe the use of two strains of the same probiotic species, Lactobacillus rhamnosus whereas Patent No. 8,440, 178 describes the use of two additional L. rhamnosus strains and Patent No. 8,454,949 related to the use of similar probiotic species, L. helveticus. Another patent 9,101,651 is for the use of probiotic L. rhamosus strain.  

Foods for Weight Loss: 

The benefits of a diet rich in fruits, vegetables, legumes, nuts and whole grains is hard to dispute. Combined with exercise, an ideal body weight and a bit of alcohol, that kind of diet is your best bet against chronic ill health.

Other ways to deliver Nutraceuticals

Chewing Gum:

Fertin Pharma has weight loss products in the form of chewing gum. 

Micro-Laser

Sono-Bello 

Symptoms of hemorrhoids are swollen veins in the lower portion of the rectum or anus. Hemorrhoids may be internal or external of the anus.

Treatment for Hemorrhoids includes ointment containing corticoids such as steroids. Typically corticoids are administered to reduce swelling and reduce the body’s immuen response. 

Herbal Remedies for the Treatment of Hemorrhoids 

US Patent No. 4,761,285 discloses a composition compresing Leptandra Bulver’s roote, chick-peas and grape seeds for the relief and treatment of hemorrhoids. 

US Patent No. 6,482,442 discloses a mixture comprising honey and olive oil for treatment of patients afflicted with hemorrhoids.

FDA opiod drugs   Drugs of Abuse

Most over-the-counter pain medications fall into two categories; nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. NSAIs releive pain, reduce fever and treat some cold symtpoms. Their ability to reduce inflammation often make them more effeective than acetaminophen, which is used to treat mild to moderate pain and to bring down fevers.

Many plant derived compounds have anti-inflammatory activities. Most of their actions are related to their ability to inhibit cytokine, chemokine or adhesion molecule synthesis and/or action. Many inflammatory disorders including sepsis, rheumatoid arthritis and asthma are intimately associated with an imbalance of the cytokine network.

A substantial body of evidence obtained from both in vivo and in vitro studies supports the concept that various plant-derived compounds with anti-inflammatory properties exert their effects through the modulation of the cytokine system. Plant-derived medicines such as flavonoids, tannins, and anthraquinones have been shown to exhibit anti-inflammatory activities, although their exact anti-inflammatory mechanisms are not well established.

Receptors that transmit impulses perceived as pain in animals are called nociceptors. Some of these receptors are free nerve endings found in the skin and other tissues and are stimulated by actual or potential tissue damage. Vertebrate nociceptors communicate with other pain pathway sensory neurons using two main neurotransmiters, substance P and glutamate. These carry the messages through the spinal cord and to the brain respectively. When tissue is damaged, prostaglandins are released, increasing the sensitivity of nociceptors and subsequently the intensity of pain. The analgesic effects of ibuprofen and aspirin are a function of their ability to inhibit the production of prostaglandins.

Mammals produce natural painkillers called endorphins and enkephalins. These neurotransmitters inhibit the release of substance P by binding to opiate receptors in the spinal cord. This same mechanism is responsible for the powerful analgesic effects of narcotics such as morphine and heroin.

Types of Pain:

Arthritis:

–Capsaicin: Capsaicin cream warms the skin when applied over the joint and temporarily blocks “sutance P” which delivers paid messages to the brain. It has shown some effectiveness in treials for osteorthritis and rheumatoid arthritis and is useful adjunctive therapy for some people. Use gloves and avoid getting the eyers in your eyes, nose or mouth when applying.

–Curcumin: is the active ingredient of the spice turmeric, which is known to have anti-inlflammatory proeprties.

–EGCG: is an antioxidant forund in green teach. EGCG may protect cartilage and bond and lower the rsik of both osteoarthritis and rheumatoic arthritis.

–Vitamin D: is important for helping the body adsorb calcium, which keeps bones strong. It can also help fight inflammation. People with RA consistently had lower levels of vitamin D in their blood than those without arthritis wen studied. If you are low in vitamin D, your smptoms of RA could also get worse.

–Glucosamine: is one of the most popular supplements for arthritis. Glucasamine supplements may hep lubricate joints and help cartilage retain water and prevent its breakdown. Blucasmine supplements are generally safe but can interact with blood thinners like wararin (Coumadin). They may also affect blood surage levels. There are no majr foood sources of glucosame. Most supplements are made from chitosame, a natural substance found in the outer shells of shrimpt, lobsters and croabs. Other types of glucosame are made in the lab if you are allegeric to shellfish.

Supplements containing both glucosame and chondroitin are also very popular. Healthy cartilage naturally has glucosamine and chondroitin. Glucosamine and chondroitin seem to have anti-inflammatory properties which may help with pain, swelling and some of the symptoms of arthritis.

–Omega-3 Fatty Aids: are found in ish oils and can help control inflammation.

–Salicylates: Certain arhtritis creams which contain salicylates (compounds related to saspirin) work by decreasing pain and inflammation. Some brand names include Aspercrem, Benay, Flexall and Sportscreme. Their effectivenss is unclear.

–Topcial NSIDS:  penetrate the skin and give short temr relief. It is likely that the topical route is safer than taking NSAIDs by mouth. Several available products by precription include Pennsaid and Voltaren gel.

–Lidocain Patches: 

Knee Pain:

–MACI (autologous cultured chondrocytes on porcine collagen membrane) (Vericel): is an autologous cellularized scaffold product which is approved for repair of symptomatic, single, or multiple full-thickness cartilage defects of the knew with or withon bone invovement in adults.

Common Pain Medications:

Common OTC nonsteroidals include aspirin (Bayer, Anacin, Bufferin), naproxen (Aleve) and ibuprofen (Advil, Motrin). Prescription NSAIDs are commonly used to treat pain from arthritis, gout, menstrual cramps and headaches.

Ibuprofen and naproxen are NSAIDs that keep your body from making prostagladins, which are linked to both inflammation and pain. The are prescribed for things like headaches, back pain, arthritis and lupus. NSAIDs such as asprin and ibuprofen exert their effects through inhibition of COX.

Acetaminophen includes brands such as Tylenol and Actamin.

Traditional non-steroidal anti-inflammatory drugs (“NSAIDS”) such as aspirin, ibuprofen, ketoprofen, and naproxen are believed to function by inhibiitng the activity of enzymes called cyclooxygenases. Cyclooxygenases catalyze the production of a molecule called prostaglandin H2, which is a precursor for other prostaglandins that perform various functions in the human body. In the early 1990s, scientists discovered the existence and separate functions of two distinct cyclooxygenaseses, referred to as “COX-1” and “COX-2”. COX-1 is epressed (i.e., produced biologically) in the gastrointestinal tract, where it is involved in the production of prostaglandins that serve a beneficial role by, for example, providing protection for the stomach lining. COX-2 is expressed in response to inflammatory stimuli, and is thought to be responsible for the inflammation associated with diseases such as arthritis. It is now known that the traditional NSAIDs inhibit both COX-1 and COX-2, and as a result they not only reduce inflammation, but also can cause undesirable side effects such as stomach upset, irritation, ulcers, and bleeding. After the separate functions of COX-1 and COX-2 were discovered, it was hypthesized that it would be possible to reduce inflammation without gastrointestinal side effects if a method could be found for selectively inhibiting the activity of COX-2. To that end, University of Rochester scientists developed a screening assay determing whether a particular drug displayed such selectivity, and filed US Patent Application 5,837,479 which was issued in 1998. The patent contained a claim to a method for selectively inhibiting PGHS-2 activity in a human host, comprising administering a non-steroidal compound that selectively inhibits activity of the PGHS-2 gene produced in a human host in need of such treatment. Unfortunately for Rochester, the patent was latter held invalid for lack of written description when it went to sue Pfizer for its sale of its COX-2 inhibitors Celebrex®. The Court held the patent invalid because it did not disclose any compounds that could be used in its claimed methods. This case could be distinguished from a different case named In re Herschler, 591 F.2d 693 (CCPA 1979) where the written description was satisfied by a specificaiton that described a claimed compound by the process by which it was made, rather than by its structure, because the application taken as a whole, reasonable leads persons skilled in the art to the recited reactions and, concomitantly, to the calimed compound. In Hershler, the court found adequate written description support for broad claims to processes for topically adminsitering a physiologically active steroidal agent to a human or animal by concurrently adminsitering the steroidal agent and dimethyl sulfoxied even though the specification disclosed only one example of a physiologically active steoridal agent because unlike non-steoridal compounds that selectively inhibit activity of the PGH@-2 gene product, numerous physiologically active steoridal agents were known to those of ordinary skill in the art. University of Rochester v. Searle Co Inc., USCA, Federal Circuit, 2004).

–Newer NSAIDS: selectivity of COX-2 is the main feature of celecoxib, etoricoxib. Because COX-2 is usually specific to inflamed tissue, there is much less grastric irritation associated with COX-2 inhibitors, with a decreased risk of peptic ulceration. However, the selectivity of COX-2 does not seem to negate other side-effects of NSAIDs, such as the risk of kidney failure, and there is evidence that indicates an increase in the risk of heart attack thrombosis and stroke through an increase of thromboxane unblanced by prostacylin (which is reduced by COX-2 inhibition). Rofecoxib (brand name Vioxx) was withdrawn in the 2004 because of such concerns. Some other COX-2 selective NSAIDS, such as celecoxib and etoricoxib are still on the market.

Side Effects and Contraindications: NSAIds are normally safe for occasional use. If taken too long, however, they can damage the kidney by reducing blood flow to the kindeys. If taken when one is dehydroated or when blood prossure is low, they can cause acute kidney injury. Ibuprofen dose should not exceed 400 mg (two of the 200 mg pills) eveyr 6 hours. The naproxen OTC dose should not exceed 220 mg every 8 hours.

Muscle Relaxants:

—Cyclobenzaprine is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. Cyclobenzaprine is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury. See Drugs.com

Natural COX inhibition: 

Flavonoids: have been found to inhibit COX-2.

Fish oils: such as cod liver oil provide alternative fatty acids to arachidonic acid. These acids can be turned into some anti-inflammatory prostocyclins by COX instead of pro-inflammatory prostaglandins. Fish oils have been proposed as a reasonable altnerative for the treatment of rheumatoid arthritis and provide less cardiovascular sik than other treatments including.  NSAIDs.

Hyperforin: has been shown to inhibit COX-1 around 3-18 times as mucha s asprin.

Calcitriol (vitamin D) significantly inhibits the expression of the COX-2 gene.

Herbal Medicines for Anziety

Ashwagandha (Withania somnifera): Withania somnifera (WS), widely known as ashwagandha, is an Ayurvedic herb that has recently gained recognition as a treatment for anxiety and stress in the United States. Although used as a broad-spectrum remedy in India for centuries, WS has only recently been under investigation in laboratory settings. WS is categorized as an anti-inflammatory and antioxidant herbal supplement. ( Morely, “An Alternative Treatment for Anxiety: A Systematic Review of Human TrialResults Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera)” J Alternative Medicine 2014)

Herbal Medicines for Pain

Artemisia: has been traditionally used in Korean herbal medicine to treat uteritis and jaundice. Flavonoids, such as 5,6,3′,5′-tetramethoxy 7,4′-hydroxyflavone (p7F), isolated from Artemisia are also known to possess anti-inflammatory activityies. For example, p7F reportedly inhibited the epxression or production of proinflammatory mediators such as COX-2/PGE2 and iNOS/NO in LPS stimulated RAW 264.7 cells. p7F also suppressed the sesrium level of TNF-alpha in mice treated with collagen and inhibited NF-0kB as well as NF-kB promoter activity in RAW 264.7 cells stimulated with LPS.

Aspirin: Sodium salicylate (S) is the active component of aspirin and is one of the most widely used over the counter drugs for the treatment of pian, fever, inflammation in addition to heart attacks, chest pain and other health conditions. It is not recommended for children, however, because it may cause Reye’s syndrome. High doses of salicylate also induce temporary hearing loss and tinnitus.

Coumarins (known as 1,2-benzopyrone or o-hydroxy-cinnamic acid-8-lactone) compirse a very large class of phenolic derivative found in plants and consist of fused benzene and alpha-pyrone rings. Over 1300 have been identified, chiefly as seocndary metablolites in green plants in fugi and bacteria.

Curcumin: is a non-nutritive, non-toxic compound in turmeric, a spice that has been used for centuries in India and elsewhere as an herbal medicinal treatment of wounds, jaundice and rhematoid arthritis. In addition, it inhibits the proliferation of a variety of tumor cells and exhibits potent anti-oxidant activity, which depends upon dthe presence of phenolic groups in the aryl rings. a compound obtained from the rhizome of Curcuma longa L (Zingiberaceae) is a polyphenol with antiflammatory activity and was reported to significantly block IL-12 mediated T cell proliferation and Th1 differentiation, an action that possibly implies its ability to reduce the production of pro-inflammatory cytokines.

Baicaline, Baicalein and wogonin are flalvonoids present in Scutellaria baicalensis (Georgi (Lamiaceae), a plant used in the treatment of a variety of inflammatory dieases such as bronchitis, nephritis, hepatitis, astham, and atopic dermatitis. The anti-inflammatory activites of these falvonoids have been attributed to their antioxidant properties and to their ability to inhibit LPS pinduced NO production and iNOS gene expression, as well as the increase in TNFalpha levels by RAW264.7 cells.

Dietary Polyunsaturated fatty acids (PUFAs): especially the n-3 series that are found in marine fish oils have significant benefits such as decreased morning stiffness and numbers of tender joints.

Ginkgo biloba: Clinical trails with AD pateints have demonstrated potential benefits in cognitive function and memory impairments from treatment with the extract of Ginkgo biloba, known to be enriched with flavonoids. Ginkgo biloba extract has been shown to proten hippocampal neurons from nitric oxide or beta-amyloid derived peptides-induced neutrotoxicity.

Flavavonoids:

–Quercetin: belongs to the flavonoids group and like vitamin C has antioxidant properties. It is a polyphenol dervied from plants such as onions, apples, green tea, berries and St John’s wort. In fact it has been used to remove “zombie” cells which are agining or deteriotating cells thought to cause many problems associated with aging such as arthritis.

–Green tea: appears to act like true antioxidants such as vitamin C, being protective at low concentrations, while at high concentrations becoming pro-oxidant.

Fish Oil: OmegaXL is sold commercially and reported to be very effective against inflammation and pain.

–-Krill Oil:

Krill oil is a good source of omega-3s. SeperBalKrill

Terpenes

Extract of T. wilfordii could be useful as a source and template for novel antiarthritic and cartilage-protective drugs. It has been reported to markedly inhibt mRNA synthesis and protein expression of MMP-3 and MMP-13, incuded by the pro-inflammatory cytokines IL-1?, IL-17 and TNF? as assessed in primary osteoarthritic human or normal bovine chondrocytes.

Celastrol has been reproted to inhibt rat adjuvant-induced arthritis. Celastrol has been rpoposed as possibly useful for improving performance in memory, learning and psychomotor activites, and common features of the nuerodegenerative diseases accompanied by inflammation, such as Alzheimer’s disease.

Ginsenosides Rb1 and Rb2, the major constituents of Panax ginseng C.A. Meyer are reported to inhbit RNF-alpha production in RAW 264.7 and U937 cells stimulated with LPS. The inhibtory activity of Rb1 and Rb2 was significantly increased by inhibitors of protein kinase C and A, protein tyrosine kinase or by drugs used for the treatment of arthritis (chloroquine and steroid drugs), but not by AMP phosphodiesterase inhibitors. It has been susggested that ginenosides could be of clinical interest for the management of TNF-alpha mediated diseases, such as arthritis.

1,25(OH)2D3: is the activated form of Vitamin D. It is a secosteroid hormone that has, in addition to its central function in calcium and bone metabolism, important effects on the grwoth and differentiation of many cell types and pronounced immunoregulatory properties. Its biological effects are mediated by the Vitamin D receptor (VDR), a member of the superfamily of nuclear hormone receptors functioning as a ligand activated transcription factor that fbinds to specific DNA sequence elements, Vitamin D responsive elements, in Vitamin D responsive genes and ultimately influences theri rate of RNA polymerase II-mediated transcription. APCs, and notably DCs, express teh VDR and are key targets of VDR ligands.

inhibits pro-inflammatory and Th-1 cytokine production, reducing the expression of co-stimulatory and MHC class II molecules on antigen presenting cells. Out of many drugs targeting DCs, only 1,25(OH)2D3 and its analogues were able to enhance the secretion by DCs of IL-10, a potent anti-inflammatory cytokine.

Macrolid antibiotics: have been shown to affect a number of processes involved in inflammation, including migration of neutrophils, the oxidative burst in pahgocytes, and the production of various cytokines by bronchial epithelial cells, lympocytes, and monocytes. Although it is presumed that NF-kB and AP-1 which are crucial regulators of proinflammatory gene expression, are potentially the most important targets for at least some anti-inflammatory effects of macrolides, the precise mechaisms remain to be clarified.

Parthenolide is a sesuiterpene lactone in Tanacetum parthenium which is one of Mexican-Indian medicinal plants used as anti-infalmmatory agents. It has reported antinocicptive action and anti-inflammatory effect in vitro. Parthenolide exerts anti-inflammatory activity by inhibiting the expression of inducible cycolooxygenase, proinflammatory cytokines and inducible nitirc oxide synthase. In addition, sesquiterpene lactones specifically inhibit activaiton of NF-kB by preventing the degradation of IkB-alpha and IkB-beta.

Triptolide: has been used extensively as an anti-inflammatory and immunosuppressive agent for the treatment of various autoimmune diseases and prolongation of allograft survival in organ transplantation. 

Barbituates:

Barbituates are sedatives like phenobarbital, pentobarbital (Nembutal) and secobarbital (Seconal). They help with anziety, sleep problems and some seizures. They can be addictive, however, particularly in higher doses.

Benzodiazepines:

Benzodiazepines include alprazolam (Xanax), clonazempan (Klonopin), and diazepam (Valium). They can help with anziety, panic attachs and sleep problems. They work well and are safer than barbituates. But overuse can also lead to addiction.

Opiods: 

Fentanyl is a powerful synthetic opioid up to 100 times more potent than morphine. As little as two milligrams, about the size of 5 grains of salt, can be fatal. Recent overdoses and deaths have occurred following use of illicit drugs, including marijuana, cocaine, and counterfeit prescriptions, as a result of these illicit substances containing fentanyl or similar extremely potent compounds. Individuals may not be aware that these illicit substances contain fentanyl and can be fatal. Recent overdoses and deaths have occurred following use of illicit drugs, including marijuana, cocaine, and counterfeit prescriptions, as a result of these illicit substances containing fentanyl or similar extremely potent compounds. Individuals may not be aware that these illicit substances contain fentanyl and can be fatal.

In 2013, illegally manufactured fentanyl and fentanyl analogs (IMFs) entered the U.S. illegal drug supply as adulterants of or replacements for white powder heroin in the Northeast and have now replaced heroin as the dominant opioid in the United States.

–Carfentanil: a fentanyl analog 100 times more potent than fentanyl, has reemerged in the U.S. drug supply. Introduction of illegally manufactured fentanyls has led to a sharp rise in overdose deaths, likely because of their high potency and rapid onset of effects.

Oxycodone: is another type of painkiller. Its in drugs like OxyCotin, Percocet, Percodan, and Roxicodon.

Availability of counterfeit prescription pills (counterfeit pills) containing illegally made fentanyl, including counterfeit M-30 oxycodone (counterfeit M-30) pills, has risen sharply in the United States and has been increasingly linked to overdose deaths.

–Oxycodone hydrochloride: is the active pharmaceutical ingredient in OxyContin®, an opioid analgesic used to treat moderate to severe pain. Constipation is a common side effect of taking opiods so you may need a stool laxative. Other possible side effects include naseua, drowsiness and having a hard time getting an erection.

Hydrocodone: is an opioid that is widely used to treat pain and has been FDA approved since 1943. It is marketed in both extended release (Zo-hydro ER) and immediate release formulations and is often combined with other active ingredients. Like many opiods, hydrocodone is primarily metabolized in the human liver. If liver function is impaired, metabolism of opiods is slowed. Thus, the same does of hydrocodone may pose a higher isk of overdose in a patient with hepatic impairment than in a healthy patient due to potential build-up of the drug int eh pateint’s bloodstream.

Drugs like Vicodin, Lortab, and Lorcet cotain hydrocodone + acetaminophen.

Morphine: Brands of morphine include Avinza, Kaian, and MS contin. Doctors usually prescribe morphine for extreme pain and codeine for milder pain. These drugs dull pain but in higher doses also cause a euphoric high.

Vicodin and Percocet: are short acting opiods. Withdrawl symptoms are more likely with these opiods. Various devices have also been used to deliver the naloxone. For example, a device called the Mucosal Atomoization Device allows a liquid form

Opiod Overdose Treatment:

–-Naloxone: Numerous naloxone products have been used to treat opiod overdose. Naloxone is an opioid receptor antagonist that blocks opids form reaching the opioid receptors, thus helphing reverse the effects of opiod overdose. It is known to administer naloxone intranasally.

Sleep Medicines:

Drugs like Zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata) can help one sleep better.

Local Anesthetics

Benzyl alchohol: can be used as a local anesthetic, especially with epinephrine.

Diarrhaoe can be classified as acute or chronic. Acute diarrhoea has an abrupt onset, resolves wihtin about 14 days and is usually caused by an infectious agent, although drugs, poisons (including bacterial toxins) or acute inflammatory reactions can contribute. Worldwide, rotavius is the major cause of infectious diarrhoea, particularly amoung young children. Other viral (adenovirus, enterovirus and nororvius) bacterial (E. coli, Salmonella, Shigella, Campylobacter and Vibrio cholerae) and parasitic (Cryptosporidium and Giardia) agents are also important pathogens.

Treatment

Oral rehydration remains the major treatment for diarrhoea, although it does not reduce the volume or duration of diarrhoea.

Other options include antibiotics and gut motility suppressing agents.

Plant-based medicines include the following:

Boraginaceae (Trichodesma indicum)

Euphorbiaceae (roots of Jatropha cureus) are used traditionally to control dysentery and diarrhaea in the ewestern coastal areas of India.

Onagraceae (Jussiaea suffruticosa) is well known in India as a treatment for dysentery and diarrhaea.

Zangrado: is sold commercially by Rainforest Phytoceuticals, Delmar, NY.

Tea has a component known as “EGCG”. EGCG has reportedly been found to inhibit cell growth and to induce apoptosis with human lung cancer cell lines and the Ha-ras gene transformed human bronchia epithelial 21BES cell line.

The targets for the chemopreventive and anti-cancer effects of EGCG have not been clearly elucidated. EGCG has multiple biological effects by acting on different targets directly or indirectly. EGCG has been reported to inhibit a number of enzymes and signal transduction pathways such as the following.

• Blocks EGF receptor and platelet derived growth factor : This can inhibit the growth factor induced activation of activator protein 1, a transcription factor critically involved in the action of various growth factors and cytokines. Additionally, EGCG it has been reported that EGCG inhibits adhesion kinase activity, indicating a negative interference of green tea with cell adhesion and cell movement process. 
• CDK inhibitor p21: EGCG has been reported to crease the expression of the CDK inhibitor p21 in human breast carcinoma cells. 
• AP-1: Exposure to UVB radiation is associated with human non-melanoma skin cancer and exposure induces AP-1 activation. EGCG inhibits UVB-induced in cultured human keratinocytes. 

In H-as-transformed JB6, the H-ras-activated AP-1 pathway is a major growth stimulant. In these cells, the AP-1 activation was inhibited by EGCG, EGC, theaflavin-3,3′-digallate and other polyphenols and the inhibition of the phosphorylation of  was inhibited. Because the ras genes are activated in many animal carcinogenesis models and in human cancers, inhibition of the phosphorylation of c-jun and Erk could be an important mechanism for the inhibition of cancer formation and growth.

•  EGCG has been reported to inhibit activation of the MAPKs,  in human epidermal keratinocytes after exposure to UV-B radiation and oxidative stress. For example, the phosphorylation of ERK1 and ERK2 in normal NIH-pATMras cells was reportedly not affected by EGCG wherase phosphoyrlation was significantly decreased in transformed cells. 

EGCG also reportedly inhibited UVB induced upregulation of these MAPK proteins in mouse skin. Increased AP-1 activity has been shown to be involved in the promotion and progression of various types of cancers. Thus inhibition of AP-1 activation may be a relevant molecular target for for EGCG. It is suggested that treatment of EGCG prevents UVB induced phosphorylation of MAPK by preventing UVB induced oxidative stess such as depletion of antioxidant enzymes and prevention of LPO and protein oxidation. Prevention of 

phosphorylation of MAPK proteins may thsu prevent the down stream events such as activation of AP-1 and NF-kB which would lead to the prevention of photocarcinogenic events in the skin.

macrophages: In murine peritoneal macrophages and the macrophage cell line (J774.1) EGCG inhibited LPS-induced phosphorylation of p38 mitogen-activated protein kinase (MAPK), but not Jun N-terminal kinase (JNK), while it augmented LPS induced phosphorylation of p44/p42 extracellular signal-related kinase (ERK).

EGCG has been reported to inhibit Jun, a nuclear proto-oncogene which constitutes a part of the transcription factor AP-1 while at the same time having a minimal effect on cellular Jun content of normal cells.

Human Leukemia cell lines: EGCG has been reported to induce activation of both JNK and p38 in U937 and OCI-AML1a cell lines.

Mouse Skin: UVB irradiation of mouse skin induced phosphorylation of ERK1/2, JNK, and p38. Topic application of EGCG reportedly inhibited this inducement

• TNF?: Inibition of TNF? has also been proposed as a possible mechanisms for the cancer preventive activity of EGCG. 
• NF-?pathway: EGCG also has profound effects on the NF-?pathway which may also contribute to the anticarcinogenic effect of tea polyphenols . 

human leukemic cell line: (U937 cells) EGCG did not induce degradation of IkB-alpha, the essential upstream signalling even of NF-kB activation. 

• ornithine decarboxylase (ODC) has been closely linked with cellular proliferation and has been regarded as an oncogene. EGCG has been reported to cause a progressive decrease of ODC protein in transformed cells. 
• Phosphorylation by tyrosine kinase: Tyrosine kinase plays an important role in signal transduction and in malignant transformation processes. Increased tyrosien phosphorylation fo a 130 kD protein has been implicated in cell transformation by Src-family tyrosine kinases. EGCG has been reported to inhibit tyrosine phosphorylation while not affecting it in normal cells.

  PDGF and epidermal growth factor (EGF) result in activation of receptor tyrosine kinases, which then activate Ras, Raf, and MAPK phosphorylation that in turn activate transcription factors such as c-fos, c-jun, c-myc and other intermediate genes. EGCG has been shown to reduce the autophosphorylation level of EGF-R induced by EGF. In addition, EGCG blocked EGF binding to its receptor. 

  • Apoptosis: More apoptosis has been reportedly induced in transformed cells than in normal controls by EGCG. Interestingly a number of pathogens (e.g., C. pneumoniae) inhibit apoptosis (mitochondrial cytochrome c release and caspase 3 activation). Could EGCG counteract these effects too?
  • Free radicals: Reactive oxygen species (ROS) are low molecular mass compounds, including superoxide anion radical, hydrogen peroxide, singlet oxygen and hydroxyl radicals that are associated with normal cellular metabolism. Accumulating evidence suggests that ROS, produced by either endogenous or exogenous sources are critically involved in multiple stages of carcinogenesis. A number of polyphenolic compounds extracted form green tea leaves have been found to be good antioxidants against lipid peroxidation in phospholipid bilayers. 

  In brief, H2O2 production was added to LHC-9 medium either in the prsence or in the absence of cells and with or without catalase (30 units/mL). At different time points the amount of H2O2 in medium were analyzed using H2O2 the H2O2 assay kit (Molecular Probes, Eugene, OR). The presence of catalase delayed the EGCG induced onset of cell death, usggesting that H2O2 is in part involved in the EGCG induced apoptosis. 

  Treatment with EGCG activated components of the TGF? signaling pathway, including TGF?and TGF-?2 and TGF-?-stimulated protein TSC22, SMAD2, SMAD3, and SMAD6, and SMAD anchor for receptor activation (SARA) and some downstream targets including fibronectin, firbroniectin receptor, laminin, laminin receptor. Treating cells with ctalase abolished the activation of these genes. In contrast, decreased expression of a gene cluster of the BMP signaling pathway including its BMPR2, SMAD7 and some components of the MAPK pathway, FK506 binding protein 5, cullin5, were not blocked by catalase. BMPs belong to the t

  • Enzymes involved in DNA replication: Catechins has been shown to inhibit DNA replication in various leukemia cancer cell lines. (It has even been found to inhibit the activities of cloned HIV-1 RT), duck hepatitis B virus replications complexes reverse transcriptase, herpes simplex virus 1 DNA polymerase and cow thymus DNA polymerase alpha.

(for general information about cancer, how it develops and its biology)

Miscellaneous Websites for Nutritional herbs, products recipes and healthy eating for cancer patients 

Cancer Recipes (from Cancer Treatment Centers of America)

See also the American Cancer Institute

Nutritional or dietary factors are attracting a great deal of interest because of their perceived ability to act as highly effective chemopreventive agents. They are perceived as being generally safe and may have efficacy as chemopreventive agents by preventing or reversing premalignant lesions and or reducing second primary tumor incidence. Many of these compounds appear to act on multiple tumor promoter-stimulated cellular pathways. Some of the most interesting products are resveratrol and , theafavins and even caffeine. Other potentially effective dietary compounds include perillyl alcohol, PEITC, giner and CAPE. Many of these compounds act by effecting multiple target signaling pathways including inducing apoptosis and/or suppressing ,  and/or XOX-2 expression.

The search for natural products with anti-inflammatory, immunomodulatory or antineoplatic potential is an important issue in drug discovery. There is great interest in drugs involving new targets to treat inflammatory, autoimmune, or cancer-related diseases. It has been surmised that the search for compounds that inhibit transcription factors, such as  or , should be a good approach for finding new lead compounds with anti-inflammatory potential. Among the products shown to inhibit NF-?B are the following:

Garlic: Garlic has been shown to be effective in treating human prostate and bladder cancers (US Patent 6,465,020).

Hypericine from St. John’s Wort (Hypericum perforatum L.) has been studied extensively for its use in the treatment of depression. Hypericin is also known to induce apoptosis in different neoplastic cell lines. 

Capsaicin which is a major  from chili pepper (Capsicum annum L.). This compound has been shown to induce apoptosis in vitro and inhibit phorbol ester-induced NF-?B and AP-1 activation in human HL-60 leukemia cells. Capsaicin is a widespread phenolic natural product with recognized antioxidant, anti-bacterial and anti-cancer activity. 

US Patent No. 6,235,788 discloses a method for treating pre-malignant basal and squamous cell lesions of the epithelium by applying an effective amount of Capsaicin in a base of aloe veral topically on an area of the lesion.

Dimethylglycine: is an intermediary metabolite amino acid found in low levels in many foods and is produced in the body from choline. DMG is an endogenous compound and an enzyme system in the body effectively converts the substance into metabolites that are either used by the body or are safely excreted. U.S. Pat. No. 4,385,068 discloses treating irradiated animals with a derivative of this compound to alleviate the effects of excess radiation on the immune system. The literature is replete with articles using the termin vitamin “B-15” to refer to DMG although this may not be completely accurate. U.S. Patent Publication 20060183801 discloses using NN-dimethyglycine or a salt thereof to inhibit certical, breast or prostate cancer.

ellagic-acid. Blue-black berries called “Blackcaps” have been reported to have anti-cancer effects due to their reported antioxidant effects (ellagic-acid). 

Some natural compounds have reported to exhibit anti-cancer effect, due to their modulation of cytokines important in anti-cancer activity. Such compounds include:

AHCC (Activated hemiCellulose Compound): which is a biologically active substance obtained by enzyme treatment of plant fiber existing in the cell wall of fungal mycelia. See US Patent No. 6,403,083 AHCC reportedly augments IL-12 production in tumor bearing patients. IL-12 is well known for its anti-tumor activities but is toxic when administered on its own.

The catechin, EGCG is well known for its antitumorigenic/pro-apoptotic properties, at least at high concentrations (50 uM) in vitro. Increased consumption of relatively high concentrations of tea polyphenols has also been found to correlate with reduced incidence of certain cancers and to induce apoptosis and cell cycle arrest. EGCG has been reported to induce apoptosis of neck squamous cell carcinoma cells and to cause a decrease in phosphorylated ERK1/2, Bcl-2, and Bcl-XL proteins, an increase in Bax and activation of caspase 9. 

However, at low concentrations, EGCG may have the reverse effect on aptosis. EGCG was reported to prevent an increase in espression of proapoptotic genes  in a neuroblastoma cell line caused by treatement with 6-OHDA at low concentrations (1 uM). 

EGCG has also been reported to be a powerful antioxidant protecting skin cells against photodamage. Thus use of eGCG in commercial skin products may be beneficial. Green tea polyphenols supplemented supplemented with moisturizing creams, skin care lotions, facial and depilatory creams and sunscreen may prevent a variety of solar UV light-induced human skin disorders. However, extensive clinical trails are still required to test the long-term treatment effects of polyphenols from green tea, their half-life period and optimum dose for beneficial effects.

Selenium: Participants treated with a supranutritional dose of selenium in the form of selenized sbewer’s yeast for 4.5 years (200 ug of selenium daily, with the average daily intake of Se in the US at about 100 ug) had substantial reductions in the incidence and mortality of prostate cancer. The mechanism may be related to inhibition of Nf-kB pathway (sodium selenite pentahydrate from J.T. Baker, Inc., Phillipsburg, NJ).

Vasoactive intestinal peptide analogs US 2003/0158110A1

Rosy Periwinkle: Rosy Periwinkle originally was used in its natural form in Madagascar to treat diabetes. Its derivitive drugs, vincristine and vinblastine, are used to treat Hodgkin’s disease and childhoold leukemai.

Great Foods:

Energy boosting Foods (AARP website)

Indigenous people have used natural products for medicines for thousands of years. Some well-known examples includes the wound healing properties of tumeric and neem tree extracts, which has long been known in India, and extracts of the African “hoodia” cactus, used by San people to stave off hunger. 

Flow Hive (honey on tap)  Antidoto natural (in spanish)

Kemin Industries  

Artemisia annua: is widely used to combat malaria, a disease that leads to millions of deaths per year, largely in sub-Saharan Africa. It appears to recognize heme, the oxysgen-binding structure embedded in hemooglobin or red blood cells, a principle target of malaria parasites. The peroxide enables artemisin to alkylate heme and thus interfere with its role in supporting parasites within such cells.

Several simpler, syntehtic artemisin-based knockoffs are being evaluated as alternative to the natural product, including drugs being developed by Ranbaxy Laboratories Limited (http://www.ranbaxy.com/index.html).

Bacteria: Bacteria can be good or bad depending on your perspective! Yogurt is very good bacteria. Somne strains, like Lactobacillus casei and Lactobacillus reuteri have been shown to prevent colds and improve the immuen response as well as shorten sick time. Enjoy plain,k organic low or non-fat yogurt with omega-3-rich ground flax see with fresh or forzen fruit for even more nutrition.

Berberine: a five-membered ring alkaloid is extracted from the roots of a variety of plants, including golden seal, Oregon grape and tree turmeric. It has deomonstrable activity against Giardia lamblia, a paraside that causes diarrhea.

Betafectin (PGG-Glucan): has reported animicrobial against S. aureus.

Cathelicidin: is a natural antimicrobial which targets microbes such as bacteria, firuses and funci. It kills pathogens by punching holes in the external membrane of a microbe. It is produed by white blood cells and  has been shown to increase it.

Cranberries and blueberries are flavonoids that have demonstrated antibacterial proerties, especially in the urinary tract. Cranberry juice has been particularly effective at preventing E. coli bacteria form adhering to the urinary tract’s endothelial wall and inhibit adhesion of H pylori in the gastric wall, a precursor of gastric ulcer.

Dear Antler Velvet: is believed to be very beneficial for recovery for sports injuries and the like. 

Echinacea: also known as the American coneflower or purple coneflower, has long been used by native North Americans for its resistance booting properties and wound-healing benefits. Consumption of Echinacea at the first sign of symptoms has been clinically shown to reduce both the severity and duration of cold and flu. Species are used as herbal immunomodulators world-wide. They are a popular herbal remedy reported beneficial for fighting the common cold. However, a recent report in the New England Journal of Medicine casts doubt on whether it really has an beneficial effect against the common cold.

Elderberry: has reported benefits against several cold and flu symptoms. Elderberry tea is effective in releiving coughs, treating sinus condgetion, and reducing the pain and swelling of a sore throat. It is rich in vitamins A and C.

F. religiosa (pipal): is a large glabrous evergreen tree that belongs to the family Moraceae and is widely distributed in the tropical area of the world. The bark of F. religiosa shows antitumor and antimicrobial activites and helps in the treatment of asthma, diarrhea, gonorrhea, ulcers, scabies, hiccups and vomiting. (Kumari, J. Agric. Food Chem. 2010, 58, 8027-8034).

Fish: such as salmon and tuna are rich in omega-3 fatty acids and can lower inflammation levels which can contribute to colds and flu.

Honey: Antibacterial properties of honey have been well documented; several compounds are found in honey that considerably contribue to its antibacterial activity, such as hydrogen peroxide, methylglyoxal, leptosin, melanoidins, oxidative stress and hydroxyl radicals. The sheer number of these compounds suggests that honey works thorugh a multimodal mechanisms of action. (Brudzynski, WO 2015/164981). 

Garlic: is reported benefits for colds, flue, ear infections and mucous reduction. It may be taken with conventional antibiotics. It is good for coughs and bronchitis. Garlic contains .Garlic as been useful against numerous strains of Staphylococcus epidermis and oral gacteria, including Streptococcus mutans and P. gingivalis, which it can kill on contact.

 Ginsan: Ginsan is a soluble acidic polysaccharide extracted from the roots of Panax Ginseng C. A. Meyer. It has reported benefits for resistence to infection. It has also reportedly been beneficial for mental efficiency.Three primary species of ginseng exist for therapeutic consumption: Panax ginseng (Asian ginseng), Panax notogeinsegn and Panax quinquefolius (American ginseng).

Numbers of S. aureus found in the spleens and kindyes of mice treated with ginsan prior to infection were lower than those detemined in control mice infected only with the bacteria. As to possible mechanisms for the increased bacterial activity after ginsan treatment, ginsan increased the phagocytic activity of BALB/c a mouse-originated macrophage like cell line against infection with S. aureus. Expression of TLRs, including TLR2, TLR4, and TLR9 was, to the contrary, reduced in peritoneal macrophages that were treated with ginsan before subsequent contact sith S. aureus Inflammatory cytokines like IL-12 were also downregulated at an early pahse of sepsis in mice that were treated with ginsan before the bacterial challenge. Also reduced by ginsan treatment was expression of phospho-JNK1/2, phospho-p38 MAPK, and NF-kB.

Glucans: 1, 3/1, 6 glucans can enhance white blood cell activity. All types of mushrooms are good sources.

Goldenseal: has reported antibacterial properties and benefit against the cold and flu. It has also been reported beneficial in fighting sinus and lung congestion, sore throats, swollen lymph nodes and fever.

Hyssop: has reported benefits for respiartory infections, bronchitis and lung condtions.

K3: The compound K3 purified from Japanese pagoda tree flower has been found to have various in vitro anti-HIV effects against various strains (laboratory strain, drug-resistant strain and clinical isolate strain). The mechanism of action inhibition of cell entry as well as RT activity. The anti-viral activity was measured by syncytium reduction and p24 antigen reduction.

Lactoferrin (LF): is a cationic metal binding glycoprotein that is presetn in high concentration in milk and other exocrine secretion such as tears and cervical mucus. Plasma LF, considered to be netrophil derived and normally ver low, can increase several times during bacterial infections and in the presence of tumors.

LF is believed to play a role in host defense and in iron metabolism.

St John’s Wort (Hypericum perforatum): has reported antiseptic properties. Extracts from this plant have also been used to treat mild to severe depression. A novel protein p27SJ, present in a laboratory callus culture of Hypericum perforatum reportedly suppressed transcription of HIV-1 in several human cell types including primary culture of microglia and astrocytes.

Licorice: reportedly reduces throat irritations, lung congestion and inhibits various viruses such as SARS and Epstein-Barr viruses.

Oregano which is a common culinary herb has been reported to be effective in the treatment of, and prophylactic use for parasitic infections. See US Patent No. 5,955,086 The effective chemical in oregano for its anti-bacterial effects appears to be the chemical compound carvacrol.

Selenium: Fish and seafood, expecially tuna, osyters and swodfish are a great source of this important nutrient. Chicekn, Brazil nuts and whole grains are other sources. Selecnium is a potent antioxidant and has been implicated with an improved immuen response.

Vitamen C: It is well known that Vitamin C is important for the immune response. Fresh fruits such as oranges kiwi, and organic berriesare good sources. Supplements are only recommended if you get early symptoms of the flu.

Proanthocyanidin and proanthocyanidin polymers: are found as colorless phenolic substances in a wide variety of many platns, particularly those with a sood habit of groth (e.g., the Croton species). They have been reported to be neneficial for treating respiratory virus infections (US 5,211,944).

Vitamin D3 is known to have a potentiating effect for macropahge mycobactericidal activity.

Vitamin E: A daily Vitamin E supplement of 200 IU may halp prevent colds among the elderly living in nursing homes. Nuts are a rich source of Vitamin E.

Zinc: Zinc is reportedly necessary for a properly functioning immune system. Under a Zinc deficiency, immune functions change from a Th1 cell-based predominantly cellular response to a Th2 based, predominantly humoral repsonse as a result of which various diseases follow a less favourable course. Under Th2, levels of IL-4, IL-6, Il-10 and prostaglandin Ew (GE2) are raised while levels of Il-2, Zn++, NO and other molecules are lowered. This makes it easier for viruses like HIV to multiply. The Th2 cytokine IL-4 in fact increases the number of CSCR4 and BLTR co-receptors, as a result of which, under Th2, the HIV strains that infect immune cells are best able to accelarate the AIDS disease process.

Zinc deficieny has also been reported to promote cancer. Under the influence of Th1 cells, zinc inhibits the growth of tumours by activating the endogenous tumour suppressor endostatin, which inhibits angiogenesis.

Good soruces of zinc is meat.

Tea:  have been shown to have in vitro antimicrobilal effects on the influenza virus, Vibrio cholerae, Staphylococcus aureus, Campylobacter jejuni, C. coli and others. In addition tea polyphenols have an in vitro inhibitory effect on C. trachomatis and C. pneumoniae.

Foods with Antioxidant/Antibacterial Properties

Nonfat Brown Cows Milk

Strawberrys (good source vitamin C) (stabilize blood sugar)

Apple sauce muffins

Apples (great antioxidants)

cinemon: (can lower LDL; only need 1/4 teespoon)

Garlic: People taking garlic supplements have been shown to get fewer colds.

Honey has a potent broad spectrum antibacterial activity that rapidly clears infection from wounds when applied topically. It has been used as a medicine for the treatment of burns, infected wounds and skin ulcers. A large volume of literature also reports its effectivenss for the treatment of periodontal disease, mouth ulcers and other problems of oral health. Honey used in wound dressing is disclosed in US Patent Application Publication No. 2004/00054313. There are many different types of honey available which may also vary significantly in their antibacterial potency.

srambled egg whites (lower calories, can add with whole egg)

salmon (wild best. farm ones have high mercury)

penapple

cottage cheese

halopinas

olives

scallons

Cough and Decongestants:

Dextromethorphan: is a common ingredient in over the counter cough medicines to stop cough. Large doses can cause highs and hallucinations. 

Pseudoephedrine: is a docongestant in many non-prescription cold medicines. While it helps to clear a stiffy nose it also contains the illegal ingredient methaphetamine (“meth”).

Foods for Coughing:

–Anise seeds have antibacterial properties and also shown to eas ecoughing.

–Fennel: can help clear chest congestion and sooth a persistent cough. One can drink tea made from fennel seeds (Yogi Tea’s throat confort).

–Honey: is believed to be effective for many ailments/diseases. Many mix it with cinnamen powder and apply it on bread for breakfast rather then jelly/jam. One tablespoon honey mixed with half a tablespoon cinamen powder is believed effective against arthritis. One tabelspoon lukewarm honey with 1/4 spoon cinamen powder for 3 days may help relieve cough associated with colds.

Preservatives

Sodium benzoate (salt of benzoic acid): is the sodium salt of benzoic acid, widely used as a food preservative and pickling agent. The mchanism starts with the adsorption of benzoic acid into the cell. If the intracellular pH falls to 5 or lower, the anaerobic fermentation of glucose through phosphofructokinase decreases sharply, which inhibits the growth and survival of microorganisms that cause food spoilage. many foods are natural sources of benzoic acids, its salts (such as sodium benzoate) and its esters. Fruits and vegetables can be rich sources, particuarly berrys such as cranberry and bilberry. Other sources include seafood such as prawns and dairy products. 

National Outbreak Reporting System (NORS) (CDC launched NORS in 2009 where public health departments voluntarilly enter outbreak information).

Phytoremediation:

Phytoremdiation is the use of plants in bioremediation, the process in which living organisms are used to remove or detoxify pollutants in the enviornment.

Some root cell membrane channels and transporters lack absolute specificity and can take up heavy metals like aluminum and other toxins. Although iin most cases uptake of toxins is letal or growth limiting, some plants have evolved the ability to sequester or relase these compounds into the atmosphere.

Phytoremediation can work in a number of ways with both aquatic and soil pollutants. Plants may secrete a substance form their roots that breaks down the contaminant. More often, the harmful chemical enters the roots and is transported to the shoot system, mkaing it easier to remove the chemical from a contaminated site. After the nuclear reactor disaster at Chernobyl in northern Ukraine, sunflowers effectively removed radioactive cesium from nearby lakes. The plants were floated in foram supports ont he surface of the lakes and latter collected.

Poplars naturally take up trichloroethylene (TCE) from the soil and metabolize it into CO2 and chlorine.

Websites of Interest: 

Global Campaign for Microbicides Alliance for Microbicide Development International Partnership for Microbicides

Prince Leopold Institute of Tropical Medicine Reprotect; products to protect reproductive health

CDC guidelines for cleaning your home (and COVID disinfection procedures)

Companies involved with Microbicidal Development Indevus Pharmaceuticals (HIV microbicidal products) 

Introduction/Definitions: 

Sterilization is the killing or removal of all microorganisms, including spores. One can sterilize by the following methods: 1) incineration,  2) filtration, 3) heat such as boiling does not kill spores, dry heat for 180 c for 2 hours. moist-heat autoclaving which is exposure to steam at 121C under pressure of 15 lb/square inch for 15 minutes. flash autoclaving is steam at 134c for 3 minutes (Pasteurization is the heating of liquids to a temperature that inactivates important pathogens, but below that needed for sterilization), 4) gas, ethylene oxide autoclaving is used for plastics and other heat sensitive materials. It uses gas alkylate proteins and nucleic acids 5) radiation, which can include UV and X-ray andchemical.  What makes a good sterilization agent or disinfectant? Well the best agent is one which leaves the least number of organisms. The number of survivors (N) is inversely proportional to the concentration of the agent and to the time (T) of application of the agent. 

Disinfection is the killing of many, but not all microorganisms. Disinfectants are generally chemicals used on inanimate objects. 

Antiseptics are disinfectants used on body surfaces. 

Antimicrobials exhibit selective or greater toxicity to parasites and have many modes of activity. The Minimum inhibitory concentration (MIC) refers to the tube showing the least amount of agent with no growth after dilutions of the agent in tubes with a constant amount of bacterial isolate. How does one test for antimicrobicity? One way is Disc diffusion where you seed a bacterial isolate over an agar plate and place discs containing antimicrobial agents on the agar. A zone of inhibition develops if the organisms is susceptible to the agent.

Antimicrobial resistance is due to resistant strains found in a small proportion of a population which are selected out. Resistance is mediated primarily by large scale use of antibiotics.

Dessication: Vegetative cells exposed to normal room air graually become dehydrated or desiccated. Delicate pathogens such as Streptococcus pneumoniae, the spiochete of syphilis or Neiseria gonorrhae can die after a few hours of air drying, but mahy others are not killed and some are even preserved. Endospores of Bacillus and Clostridium are viable for thousands of years under extremely drug conditions. Staphylococci and streptococci in dred secretions and the tubercle bacillus srrounded by sputum can remain viable in air and dust for lenghty periods. Many viruses (expecially nonenveloped) and fungal spores can also withstand long periods of desiccation. Desiccation can actually be a way to preserve foods because it reatly reduces the amount of water avilable to support microbial growth. 

Lyophilization: is the combination of freezing and drying. It is a common method of presrving microorganisms and other cells in a viable state for many eyars. Pure cultures are frozen instantenously and exposed to a vacuum that rapidly removes the water. This method avoids the formation of ice-cyrsatls that would damage the cells. 

Products for Disinfection

Detergents: target the cytoplasmic membrane of bacteria. These agents physically bind to lip layer of the cytoplasmic membrane which opens up the cytoplasmi membrane and allows damaging chemicals to enter the cell and important ions to exit the cell. 

Alcohols are protein denaturants.  A concentraiton of 50% and higher dissolve membrane lipids, isrupt cell sulrface tensiona nd compromise membrane integrity. Teh rte of evaporation decreases effectivneness and inhalaiton of vapors can affect the nervous system. 

–Ethanol is 70% alchohol and isopropyl is 95%. Activity of alchohol is more active in the presence of water (70% alcohol is more effective than 95% alcohol). A concentraiton of 60-80% alchol is deemed most efective due to the fact that proteins require water in order for denaturation to cocur. A concentration of 70% ethyl alchol requires a10 minutes to kills Staphylococcus aureus, 2 min to kills E coli and 10 minutes to kill poliovius. 

Detergents: are polar molecules that act as surfactants. Anionic detergents have limited microbial power but cationic detergents such as quaternary ammonium compounds (“quats”) are effective. The positively cahrged end of the molecule binds the negatively charged bacterial surface proteins and the long, uncharged hydrocarbon chains allows the detergent to disrupt the cytoplasmic mebrane. Detergents are effective against virsues, algae, fungi and gram positive bacterial. They are used to clearn restaurant equipement, surfaces and restrooms. Some quats were banned in consumer products in 2017. 

Hydorgen Peroxide. A 3% hydrogen peroxide can kills SA in 12.5 seconds, gonorrheae in 0.3 sec and herpes in 12.6 seconds. 

Halogens oxidize. 2 types are 1)  iodine and 2) chlorine (5% solution of sodium hypochlorite) 4) surfactants are hydrophobic and hydrophilic groups that solubilize.

–Chlorine (Bleach): Chlorine can kill TB in 50 seconds, entamoeba cysts in 150 minutes and Hepatitis A virus in 10 minutes. In solution, these compounds combine with water and release hypcholorous acid (HOCl) which denatures enzymes and suspend metabolic reactions. Chlorine is used to disinfect drinking water, sweage and waste water. Hypochlorites are used in health care to treat wounds, disinfect bedding and instruments, sanitize food equipement and in restaurants, pool and spas. Chloramines  are alternatives to pure chlorines in treating drinking water. 

—-Chlorhexidine: is a complex organic base containing chlorine and two phenolic rings. It targets bacterial membranes where slective permeability is lost, bacterail cell walls, and proteins resulting in denaturation. Its effects on virsues and fungi are variable. It is often used in hand scrubs, prepping skin for surgery, as an obstetric antiseptic and as a mucous membrane irrigant. 

–Iodine: can kill endospores slowly and all other microbes. A 2% iodine and 2.4% sodium iodine (aquoues iodine) is used as a topical antiseptice. A 5% iodine and 10% potassium iodine is used as a dissinfectant for plastica nd rubber instruments as well as cutting blades. Iodine can be extremely irritating to the skin and is toxic when absorbed. Many iodophos were banned in consumer productsin 2017. 

Phenol was the original agent used to disinfect. So the effectivness of all other agents are based on phenol. (i.e., ratio of the [phenol] to the [agent] required to cause the same amount of killing under the same standard conditions. Phenol is a protein denaturant. Two types of phenols are hexachloropheneand chlorhexidine which alters membrane permeability.

ultraviolet (UV) radiation: ranges in wavelenght of about 100 to 400 nm. It is most lethal from 240-280 nm with a peak at 250 nm. Because UV radiation passes reapidly through air, slightly through liquids and only poorly through solids, the object to be disinfected must be directly exposed to it for full effect. 

UV is a pwerful method for destroying fungal cells and spores, bacterial vegetative cells, protozoa and viruses. Bacterial spores are about 10 times more resistant to radiation than are vegetative cells but they can be killed by increasing the time of exposure. 

Germicidal lamps cn cut down on the concentraiton of airborne microbes by up to 99%.