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RxPrep
Acne
| Question | Answer |
|---|---|
| First line tx for mild acne? | Topical BPO or retinoid |
| Preferred approach when using topicals? | Combination therapy |
| First-line for moderate acne? | Topical combo OR PO antibiotic + BPO + retinoid |
| First-line for severe acne? | PO antibiotic + topicals OR isotretinoin |
| Last line drug for severe acen? | Isotretinoin |
| When are antibiotics used for acne? | Only for moderate-severe |
| When is isotretinoin used? | Severe, refractory nodular acene |
| Examples of topical retinoids? | Tretinoin, adapalene, tazarotene |
| Which retinoid is OTC? | Adapalene |
| What is the major class warning for retinoids? | Teratogenic, avoid in pregnancy |
| Can topical retinoids be used in pregnancy? | No, still teratogenic as topical |
| Counseling for retinoids? | Can cause irritation/redness, apply at night May worsen acne initially |
| Why are retiniods effective for acne? | Decreased follicular plugging |
| How long does it take retinoids to work? | 4-12 weeks |
| Which retinoid is less irritating? | Altreno (tretinoin lotion) |
| Which acne medication can cause photosensitivity? | Retinoids (topical and systemic) |
| Which retinoid is the most irritating? | Tazarotene |
| Unique side effect of BPO? | Can bleach clothing |
| Starting strength for BPO? | 2.5-5% |
| BPO can prevent what issue during acne treatment? | Antibiotic resistance, must always be used with topical abx |
| What topical ABX can be used for acne? | Topical clinda and erythromycin |
| What is dapsone used for? | Topical acne treatment |
| CI of dapsone? | G6PD deficiency, poses risk of hemolysis in deficiency |
| What is clascoterone (Winlevi)? | Topical androgen receptor inhibitor |
| Use of clascoterone? | Alternative for mild acne |
| Unique warning for clascoterone? | HPA axis suppression (rare) (decreases cortisol and ACTH secretion) |
| What is azelaic acid used for? | Acne and rosacea |
| Common oral antibiotics for acne? | Doxycycline, minocycline |
| When do we use oral antibiotics for acne? | Moderate-severe acne |
| Doxycycline, minocycline warnings and contraindications? | Cant use in pregnancy or kids <8 (tooth coloration) Causes photosensitivity |
| Requirements before starting isotreninoin? | 2 negative pregnancy tests + 2 forms of birth control |
| Brand names of isotrentinoin? | Absorica, Amnesteem, Claravis, Myorisan, Zenatane |
| Common ADRs with Accutane? | Dry skin, lips, eyes ā lipids, ā LFTs Depression, psychosis, suicide risk Arthralgia Night vision changes |
| Patients should avoid vitamin A while on which acne treatment? | Isotretinoin |
| What two acne treatments cannot be used together? Why? | tetracyclines and Zentane (increased intracranial pressure) |
| How long after stopping Zentane is pregnancy safe? | Avoid pregnancy for at least 1 month after stopping. |
| Labs required for Absorica tx? | Pregnancy tests, lipids, LFTs |
| When use oral contraceptives? | Females with hormonal acne |
| When is spironolactone used? | Females with androgen-related acne |
| Retinoid application amount? | Pea-sized |
| Counseling for topical retinoid users? | Use sunscreen daily, apply to the entire face, not just where the acne is. |
| What would combination therapy look like for acne? | BPO + topical retinoid or BPO + topical antibiotic |
Created by:
cdaughtry