Tetracyclines Isotretinoin

The answer is d. (Hardman, p 1575.) Isotretinoin is actually a form of high-dose vitamin A therapy Vitamin A itself or retinol (vitamin A could be used, but they have less advantageous pharmacokinetic properties. Antibiotics such as tetracyclines are used in acne, but they have little effect on the nodulocystic form... 

Antibacterial preparations that may be used topically in acne include erythromycin, tetracycline and clindamycin. Isotretinoin is a tretinoin isomer used in the management of acne. 

Drugs that may be affected by tetracyclines include oral anticoagulants, digoxin, insulin, isotretinoin, methoxyflurane, oral contraceptives, penicillins, and theophyllines. 

PORFIMER I. ACE INHIBITORS -enalapril 2. ANALGESICS -celecoxib, ibuprofen, ketoprofen, naproxen 3. ANTIARRHYTHMICS — amiodarone 4. ANTIBIOTICS -ciprofloxacin, dapsone, sulphonamides, tetracyclines 5. ANTICANCER AND IMMUNOMODULATING DRUGS -fluorouracil (topical and oral) 6. ANTIDIABETIC DRUGS-glipizide 7. ANTIMALARIALS -hydroxychloroquine, quinine 8. ANTIPSYCHOTICS -chlorpromazine, fluphenazine 9. CALCIUM CHANNEL BLOCKERS - diltiazem 10. DIURETICS -bumetanide, furosemide, hydrochlorothiazide II. PARA-AMINOBENZOIC ACID (TOPICAL) 12. RETINOIDS-acitretin, isotretinoin 13. SALICYLATES (TOPICAL) t risk of photosensitivity reactions Attributed to additive effects Avoid exposure of skin and eyes to direct sunlight for 30 days after porfimer therapy... 

Clinically important, potentially hazardous interactions with acetaminophen, acitretin, aspirin, chloroquine, digoxin, doxepin, fat-soluble vitamins A, D, E, K, hydroxychloroquine, isotretinoin, lovastatin, mycophenolate, raloxifene, sulfasalazine, sulfonylureas, tetracycline, tricyclic antidepressants, ursodeoxycholic acid, valproic acid... 

Clinically important, potentially hazardous interactions with acitretin, bexarotene, fish oil supplements, isotretinoin, minocycline, prednisone, tetracycline, warfarin... 

Antibiotics such as tetracyclines and macrolides are the agents of choice for papulopustular acne. In severe papulopustular and nodu-locystic/conglobate acne, oral isotretinoin is the treatment of choice. Hormonal therapy represents an alternative effective regimen in female patients. 

Systemic side effects generally are less significant with short-term therapy. Transitory elevations in serum transaminases occur rarely. Hyperlipidemia is frequent, with 25% of patients developing increased triglyceride levels and, less frequently, increased cholesterol and low-density lipoproteins, and decreased high-density lipoproteins. Myalgias and arthralgias are common complaints. Headaches occur and rarely are a symptom of pseudotumor cerebri. Use of isotretinoin concomitantly with tetracycline antibiotics may increase the risk of pseudotumor cerebri. 

Isotretinoin, etretinate, acitretin Tetracyclines Thalidomide Tobacco smoke Toluene... 

The development of pseudotumour cerebri (benign intracranial hypertension) has been associated with the concurrent use of acitretin or isotretinoin and tetracyclines. 

Oral isotretinoin can be used in patients with severe varieties of rosacea in whom only partial remissions with oral tetracyclines and metronidazole were obtained. 

Oil acne is treated with the usual acne vulgaris modalities, such as topical benzoyl peroxide and retinoic acid. Systemic treatment is often needed with tetracycline, erythromycin or minocycline, or with isotretinoin in severe cases. The key factor is avoiding contact with oils and grease. Work clothes should be changed daily and frequent cleansing of the skin with soap and water is advised. 

---