TOG - Retinoids in Pregnancy Flashcards
How long after cessation of retinoids should women wait to conceive?
1/12
What conditions does Accutane (isotretinoin) treat?
- Nodulo-cystic and conglobate acne,
- Severe acne
- Scarring acne which has not responded to an adequate course of systemic antibacterials
- Acne which is associated with psychological problems
What is the elimination 1/2 life of isotretinoin?
6-36 hours
How long is standard isotretinoin treatment?
4-6 months
What are the side effects of isotretinoin?
- Mood disturbance
- Dryness of skin and mucous membranes
- Facial erythema, eczema, hair loss, photosensitivity, skin fragility, paronychia and pyogenic granuloma
- Myalgia and arthralgia
- Photophobia, impaired night vision and keratitis
- Nausea, colitis and pancreatitis
- Abnormalities of liver function including hepatitis
- Elevation of triglyceride and cholesterol levels
- Bacterial overgrowth, e.g. Staphylococcus aureus
- Cutaneous vasculitis
- Acne flare
What are the fetal malformations associated with isotretinoin?
20-35% risk malformation
Pharyngeal arches most affected - ?hypervitaminosis A
Craniofacial defects:
(ear, eye, cleft palate, micrognathia), depressed nasal bridge, dysmorphism, ocular hypertelorism)
Central nervous system defects:
(microencephaly, facial nerve palsy, hydrocephalus, cortical and cerebellar defects)
Cardiovascular defects:
(Fallot’s tetralogy, septal defects, transposition of the great vessels and aortic arch hypoplasia)
Thymic abnormalities:
(hypoplasia, aplasia and ectopia)
Also neuropsychological development
How often should supervised UPTs be performed when on maintenance therapy with isotretinoin?
- At time of prescription or 3/7 before
- Monthly during treatment
- 5/52 after completion
What is the recommended contraception when taking isoteretinoin?
Hormonal + barrier
What % of women who fall pregnant on isoteretinoin opt for TOP?
84%
