Providers and consumers should realize that isotretinoin is a potent drug with the potential to cause birth defects and reserve its use for severe recalcitrant nodular acne. Isotretinoin is not for use in mild forms of acne and should not be shared among family members.
Most orbital motorways (or beltways) are purpose-built major highways around a town or city, typically without either signals or road or railroad crossings. In the United States, beltways are commonly parts of the Interstate Highway System. Similar roads in the United Kingdom are often called orbital motorways.
All highways are maintained by state governments, although they receive federal aid to build and maintain freeways signed as part of the 46,000 mile (75,000 km) nationwide Interstate highway network. A large number of expressways are actually government or privately operated toll roads in many East Coast and Midwestern states.