Dermatologic Pharmacology (Part 4) Flashcards
how would you treat mild comedonal acne?
topical retinoid
how would you treat mild mixed papular/pustular acne?
topical retinoid + topical antimicrobial
how would you treat moderate mixed and papular/pustular acne?
oral antibiotic + topical retinoid +/- BPO
how would you treat moderate nodular acne?
oral antibiotic + topical retinoid + BPO
how do you treat severe nodular/conglobate acne?
oral isotretinoin
what is the topical retinoid we discussed?
tretinoin
when do you use tretinoin?
once daily, at bedtime
what are the three topical antimicrobials we discussed?
bezoyl peroxide, clindamycin, and erythromycin
what is azaleic acid?
a dicarboxylic acid–> the plant defense response to an infection; it kills acne bacteria and decreases the production of keratin
what is azaleic acid used for?
to treat mild to moderate acne and also treats post-inflammatory hyperpigmentation
what are the 6 oral antibiotics used for acne treatment that we discussed?
tetracycline, doxycycline, minocycline, erythromycin, azithromycin, and trimethoprim-sulfamethoxazole
what are the atypical adverse effects associated with trimethoprim-sulfamthoxazole?
stevens-johnson syndrome and toxic epidermal necrolysis
what are the two hormonal agents used for treating acne?
oral contraceptives and spironolactone
what is spironolactone useful for?
adult women with menstrual cycle-related breakouts of acne
what is the oral retinoid we discussed?
oral isotretinoin
what are the atypical adverse effects associated with oral isotretinoin?
teratogenicity
what is the mechanism of action of retinoids?
They are vitamin A like compounds and as such they undergo some metabolism, enter into the cell, they bind to receptors that dimerize; they bind to recognition sites on the DNA retinoic acid recognition sites and then bring about gene transcription
what are the effects of retinoids?
normalization of follicular keratinization, decreased cohesiveness of keratinocytes, and reduced follicular occlusion and microcomedone formation
what are home skin care recommendations?
apply a gentle synthetic detergent cleanser
