View source for Acne and scabies agents

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''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
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'''Acne and scabies agents''' &mdash; Acne and antiparasitic agents; Topical retinoids, antibacterial peroxide, systemic retinoid, topical scabicide.

== Identification ==
* '''Therapeutic class:''' Acne and antiparasitic agents.
* '''Pharmacologic class:''' Topical retinoids, antibacterial peroxide, systemic retinoid, topical scabicide.

== Pharmacology ==
* '''Mechanism of action:''' Retinoids normalize skin cell turnover; benzoyl peroxide is antibacterial and keratolytic; isotretinoin reduces sebum; permethrin kills scabies mites and lice.
* '''Onset / peak / duration:''' Acne improvement over weeks; isotretinoin courses last months.
* '''Half-life / therapeutic level:''' Varies; no routine level.

== Clinical use ==
* '''Indications:''' Acne (topicals and isotretinoin), scabies and lice (permethrin).
* '''Usual dose, route, frequency:''' Topicals at night (retinoids); isotretinoin PO daily; permethrin applied and washed off after a set time.
* '''Maximum dose / adjustments:''' Isotretinoin dosed by weight over a defined course.

== Safety ==
* '''Contraindications:''' Isotretinoin in pregnancy (severe teratogen); retinoid topical caution in pregnancy.
* '''Black box warning:''' Isotretinoin carries a boxed warning for severe birth defects; it requires the iPLEDGE risk program with two forms of contraception and regular pregnancy testing.
* '''Interactions:''' Isotretinoin with vitamin A (additive toxicity) and tetracyclines (intracranial hypertension); topical retinoids increase sun sensitivity.
* '''Pregnancy / lactation:''' Isotretinoin absolutely contraindicated.
* '''High-alert:''' No.

== Adverse effects ==
* '''Common side effects:''' Skin dryness, peeling, redness, photosensitivity; isotretinoin causes dry lips and skin and elevated lipids.
* '''Serious effects to report:''' Isotretinoin mood changes, severe headache or vision changes, abdominal pain, pregnancy; severe skin reaction.
* '''Antidote / reversal:''' Discontinue.

== Nursing process ==
* '''Assessment before administration:''' Pregnancy status and iPLEDGE enrollment (isotretinoin), baseline lipids and LFTs (isotretinoin), skin condition.
* '''Interventions during therapy:''' Strict contraception and monthly testing for isotretinoin; apply topicals at night; sun protection.
* '''Monitor:''' Skin response, lipids and LFTs (isotretinoin), mood (isotretinoin), pregnancy testing.
* '''Evaluation / expected outcome:''' Clearer skin or eradicated mites.

== Patient teaching ==
* '''Patient teaching:''' Use sun protection; isotretinoin requires two forms of birth control and monthly tests; report mood changes; permethrin applied head to toe and washed off after the directed time, treat close contacts and wash bedding.
* '''Notify provider if:''' Pregnancy or missed contraception, mood changes, severe headache or vision changes (isotretinoin).
* '''Administration tips:''' Topical retinoids at night; isotretinoin only through iPLEDGE.

[[Category:Topical Anti-infectives and Acne and Scabies Agents]]