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Nurs 5229 Clinical Pharmacotherapeutics > Acne > Flashcards

Flashcards in Acne Deck (50)
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1
Q

The pathogenesis of acne vulgaris is

A

multifactorial

2
Q

Key factor in acne is

A

Genetics

3
Q

Acne develops as a reult of

A

interplay of the following four factors
–Release of inflammatory mediators into the ski
–Follicular hyperkeratinization with subsequent plugging of the follicle
–Cutibacterium acnes (c. acne) (formerly Propionibacterium acnes) follicular colonization (anaerobic organism present in acne lesions)
–Excess sebum production – regulated by a # of different hormones and mediators

4
Q

Treatment is directted

A

Directed towards known pathogeneic factors
Follicular hyperproliferation
–Excess sebum
–Cutibacterium acnes (formerly Propionibacterium acnes) infection
–Inflammation.

5
Q

the grad and severity of

A

The grade and severity of the acne help in determining which of the following treatments, alone or in combination, is most appropriate.

6
Q

Give realistic

A

Give realistic expectations regarding timelines for improvement

7
Q

two to three

A

Two to three months of consistent adherence to a regimen

8
Q

acney typically

A

Acne typically reoccurs over years; maintenance therapy is important

9
Q

treatment regimen should be

A

Treatment regimen realistic for patient

10
Q

delivery system depnds on

A

Delivery system; depends on patient’s skin type

11
Q

some gels have

A

Some gels – drying effect

12
Q

creams and lotions are

A

Creams and lotions – moisturizing

13
Q

solution sare

A

Solutions are drying, but cover large areas easier than other preparations

14
Q

foams are

A

easy application to hair-bearing areas

15
Q

pledgets are

A

single-use absorbents pads impregnated with medication

16
Q

Treatment for Acne - Nondrug

A

–Cleansing

17
Q

Treatment for Acne - Drug therapy

A

–Benzoyl peroxide–Antibiotics•Topical: Clindamycin•Oral: Tetracycline antibiotics, isotretinoin, hormonal agents–Retinoids•Tretinoin •Adapalene

18
Q

Benzoyl peroxide - Decreases

A

Decrease # of C. acnes colonizing the skin

19
Q

Benzoyl peroxide has what component

A

inflammatory component

20
Q

Benzoyl peroxide used with

A

Used with a topical or oral anti-biotic decreases emergence of antibiotic resistant bacteria

21
Q

Benzoyl peroxide is

A

Comedolytic

22
Q

Benzoyl peroxide limit

A

Limit application of these products to one or two small affected areas during the initial three days of use to test for hypersensitivity

23
Q

Topical Antibiotics - example

A

Clindamycin and erythromycin (most common*)

24
Q

Topical Antibiotics - reduces

A

Reduce # of proinflammatory C. acnes colonizing the skin

25
Q

Topical Antibiotics do not use as

A

Do no use as monotherapy – combine with retinoids or benzoyl peroxide (better efficacy); decrease occurrence of bacterial resistance

26
Q

Combination Therapy - examples

A

Clindamycin 1.2% and tretinoin 0.025% gel•Benzoylperoxide 2.5% and adapalene 0.1% gel•Benzoyl peroxide 2.5% and adapalene 0.3% gel•Antibiotics and benzoyl peroxide

27
Q

Topical Retinoids - Treatment

A

Treatment: non-inflammatory and inflammatory acne

28
Q

Topical Retinoids - derivaties

A

Vitamin A derivatives

29
Q

Topical Retinoids apply

A

Apply once a daily, usually at night

30
Q

Topical Retinoids do not apply

A

Do not apply with benzoyl peroxide

31
Q

Topical Retinoids apply thin

A

Apply think layer to affected area (pea-size)

32
Q

Topical Retinoids skin irritation

A

Skin irritation is common; start with lowest concentration, increase potency as tolerated

33
Q

Topical Retinoids irritation

A

Irritation, dryness, flaking of the skin (1st month); can decrease frequency

34
Q

Topical Retinoids micronized

A

retinoin 0.05% gel contains soluble fish proteins.

35
Q

Azelaic Acid - naturally

A

Naturally occurring dicarboxylic acid with antimicrobial, comedolytic, and mild anti-inflammatory properties.

36
Q

Azelaic Acid inhibits

A

Inhibits effect on tyrosinase and can improve acne-induced post-inflammatory hyperpigmentation.

37
Q

Azelaic Acid inflamm

A

Inflammatory and no-inflammatory acne

38
Q

Azelaic Acid 15%

A

approved - rosacea

39
Q

Salicylic Acid

A

Alternative comedolytic agent that is useful for patients who cannot tolerate or cannot obtain a topical retinoid.

40
Q

Oral Drugs for Acne

A

Antibiotics

41
Q

Antibiotics - moderate

A

Moderate to severe inflammatory acne

42
Q

Antibiotics - Inhibit

A

Inhibit growth of C. acnes within the pilosebaceous unit

43
Q

Antibiotics agents of choice

A

Agents of choice (tetracycline class – anti-bacterial and anti-inflammatory properties)•Doxycycline [Vibramycin], minocycline [Minocin]

44
Q

Antibiotics alterantives

A

Alternatives (resistance is common)•Tetracycline [Sumycin], erythromycin [Ery-Tab]•Use shortest time possible – 3 to 4 months

45
Q

Oral Isotretinoin - used to

A

Used to treat severe nodulocystic acne vulgaris

46
Q

Oral Isotretinoin - is

A

Teratogenic

47
Q

Oral Isotretinoin levels must be monitored

A

Triglyceride levels must be monitored

48
Q

Oral Drugs for Acne - hormonal

A

agents moderate to severe acney

49
Q

Oral Drugs for Acne - hormonal example

A

Spironolactone [Aldactone]

50
Q

Skin Care Recommendations

A

Apply gentle synthetic detergent cleanser with fingers, rinse with warm water twice daily

Do not aggressively scrub skin

Water-based lotions, cosmetics, and hair products are less comedogenic than oil-based products.

Do not pick acne lesions; may exacerbate scarring