Acne and scabies agents

Acne and scabies agents

Drug monograph · NCLEX study reference
Therapeutic class	Acne and antiparasitic agents
Pharmacologic class	Topical retinoids, antibacterial peroxide, systemic retinoid, topical scabicide
Onset / peak / duration	Acne improvement over weeks; isotretinoin courses last months.
Half-life / level	Varies; no routine level.
Routes	PO (oral), Topical
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Discontinue.
Pregnancy / lactation	Isotretinoin absolutely contraindicated.

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.

Acne and scabies agents — 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.