Medications for acne vulgaris: Nursing pharmacology

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Notes
ACNE MEDICATIONS, PART 1/2 | |||
DRUG NAME | salicylic acid, azelaic acid (Azelex, Finacea), benzoyl-peroxide | tretinoin (Retin-A, Avita), adapalene (Differin) | erythromycin (Ery, Erygel), clindamycin (Cleocin, Clindesse), tetracycline, doxycycline(Oracea) |
CLASS | Keratolytics | Vitamin A derivatives | Antibiotics |
MECHANISM OF ACTION | Soften and shed stratum corneum → decrease skin thickness and improve skin moisture | Blunt inflammatory process, modulate keratinization → help eliminate comedones | Inhibit bacterial overgrowth → reduce inflammation |
INDICATIONS |
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ROUTE(S) OF ADMINISTRATION |
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SIDE EFFECTS |
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CONTRA-INDICATIONS AND CAUTIONS |
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ACNE MEDICATIONS PART 2/2 | ||||
DRUG NAME | isotretinoin (Absorica, Accutane, Zenatane) | spironolactone (Aldactone, CaroSpir), estrogen with progestin Ortho-Cyclen, Yaz) | ||
CLASS | Retinoids | Hormonal agents | ||
MECHANISM OF ACTION | Decrease sebum formation and secretion, blunt inflammation, keratolytic effects | Decrease androgen levels → reduce sebum production | ||
ROUTE OF ADMIN. |
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SIDE EFFECTS |
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CONTRA-INDICATIONS AND CAUTIONS |
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NURSING CONSIDERATIONS: ACNE MEDICATIONS | ||
ASSESSMENT AND MONITORING | Assessment and monitoring: isotretinoin Assess
Monitor
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CLIENT EDUCATION |
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Transcript
Acne vulgaris is a common skin disorder characterized by raised, red bumps that occur when hair follicles get clogged by particles like dead skin cells or oil, and it primarily occurs on the face, neck, chest, and back.
Although the exact cause of acne is not completely understood, there are a few main factors that are known to contribute to acne formation.
These include keratin plugs that block the opening of the hair follicle; increased sebum released by sebaceous glands, which sometimes occurs in response to increased androgen production during puberty; and overgrowth of bacteria like Cutibacterium acnes that trigger local inflammation.
Acne vulgaris can be categorized into different types based on specific characteristics. Mild acne usually consists of comedones, while moderate acne usually consists of pustules, and severe acne usually consists of cysts and nodules.
Depending on the severity and location of acne, there are various medications that can be used to treat acne.
These include topical medications, such as keratolytics like salicylic acid, azelaic acid, and benzoyl peroxide, vitamin A derivatives like tretinoin and adapalene, and topical antibiotics like erythromycin or clindamycin; as well as systemic medications, such as oral antibiotics like the tetracyclines tetracycline and doxycycline, oral retinoids like isotretinoin, and hormonal agents like spironolactone or oral contraceptives containing a combination of estrogen and progestin.
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Davis's Drug Guide for Nurses" F.A. Davis (2020)
- "Vitamin A" MedlinePlus
- "Isotretinoin" Medline Plus (2018)
- "The effect of isotretinoin on insulin resistance and adipocytokine levels in acne vulgaris patients" Turkish Journal of Medical Sciences (2018)
- "Acne Vulgaris" Merck and the Merck Manuals (2020)