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Straticamedical.com

What everyone should know about Accutane  
Accutane is a very strong pill that is used to treat acne. It has been used worldwide since the early 1980s. It is really just a huge dose of Vitamin A. If you think Accutane may be right for you, you should know the following information: Who should take Accutane? Accutane is a pill that is normally taken by people who have severe acne or acne that is causing scars. It may also be right for people who have less severe acne that has not responded well to other treatments. Because Accutane causes severe birth defects, it must never be taken by a female who may become pregnant. How does it work? Accutane works by shrinking the oil glands of the face, chest, and back, causing the acne to improve greatly. How is Accutane taken? Accutane is a pill that is taken for approximately 6 months and then discontinued. Even after the medication is discontinued, the benefits continue. That is, the medication continues to fight acne even after you stop taking it. The dose of accutane depends on your body weight, but is typically one or two pills per day. The pills are best taken with a meal or a snack. Will Accutane cure my acne? Accutane is the strongest acne-fighting medication currently in existence. Many patients (about 40%) experience a permanent cure of their acne. Other patients (about 60%) experience a dramatic improvement that usually lasts one or several years. Occasionally it becomes necessary to have acne treatment (accutane or other treatment) again one to several years after taking accutane. Is it Safe? Accutane has been used worldwide since the early 1980s. Most patients experience either no problems at all or else very minor problems (see list of side effects on the reverse side of this sheet). One issue that sometimes concerns patients is depression. It is not known for sure if accutane causes depression. If you have had problems with depression in the past, if you have needed to see a psychiatrist, if you have ever thought about killing yourself, or if these things run in your family, then extra caution should be taken and you should talk to your doctor about whether Accutane is right for you. Another issue that sometimes concerns patients is liver damage. In reality, this is extremely rare and very unlikely to happen, but we do blood tests to catch any changes before they become serious. Is it Expensive? Accutane costs approximately $75 per month. It is covered by all extended health plans, such as Blue Cross or private insurance.
What are the side effects of accutane and how are they managed?
1. Severe birth defects. Accutane causes very very severe birth defects if a woman becomes pregnant
while taking accutane. It has no effect on pregnancies that may happen 28 or more days after Accutane is discontinued. It is absolutely essential that females taking Accutane use two methods of effective birth control while taking accutane, for 2 months prior, and for 1 month after. 2. Dryness, peeling, and cracking of the lips. (90% of patients) Use vaseline or prevex cream to help with
3. Dryness or mild rash of the skin. (30% - 80% of patients) This occurs mostly on the hands and forearms.
Use a moisturizer to help with this. A home humidifier will also help. 4. Dryness of the mouth and nose. (30% - 80%) of patients) Nosebleeds may uncommonly occur. Put
vaseline or nasal lubricant inside the nostrils at bedtime to help with this. A home humidifier will also help. 5. Dryness of the eyes. (30% of patients). This is most common if you wear contact lenses. Dropping artificial
6. Increase in blood fats. Accutane will slightly increase the blood fats while the medicine is being taken. This
is temporary and is almost always not dangerous, but blood tests are done in order to catch any increase that is larger than expected. In rare cases, if the increase is very large, a condition called “pancreatitis” (inflammation of the pancreas) can result. Pancreatitis may require an operation. In order to prevent your blood fats from increasing too much, you should: a. tell your doctor if you have diabetes.
b. eat a low-fat, no-junk-food, no-fried-food, healthy diet.
c. completely avoid alcohol while on accutane.
d. have blood tests when your doctor tells you to.
7. Mild muscle aches, backaches, or joint aches. (15% of patients) Use aspirin, Tylenol, or a heating pad to
help with this. If you have this problem, it usually resolves after about 6 weeks even if you keep taking Accutane. 8. Mild decrease in night vision ability. (rare).
9. Slightly increased sensitivity of the skin to sun. Use sunscreen to prevent sunburn.
10. Depression. (rare) It is not known for sure if accutane causes depression or not. If you have had problems
with depression in the past, if you have needed to see a psychiatrist, if you have ever thought about killing yourself, or if these things run in your family, then extra caution should be taken and you should talk to your doctor about whether accutane is right for you. If you are taking Accutane and you think you are becoming depressed, please phone this office immediately at 428-5554. 11. Inflammatory bowel disease (Crohn’s disease and/or ulcerative colitis) (rare) There have been rare
reports of people who previously had inflammatory bowel disease experiencing a worsening while on Accutane therapy. There have also been rare reports of people who never previously had inflammatory bowel disease who developed it for the first time while on Accutane therapy. 12. If you develop a severe headache, nausea, vomiting or vision changes – stop Accutane and see you
doctor. Do not take supplemental vitamin A or antibiotics from the tetracycline family while on Accutane. 13. Other rare side effects that you are unlikely to experience are: headache, upset stomach, mild temporary hair loss, fatigue, hives, dizziness, etc. Please note that this is not a complete list and that there may be other very rare side effects. If you have any of these unusual side effects, please phone this office immediately at 428-5554. 14. Because accutane makes your skin temporarily more sensitive to injury, please do not have waxing, piercing, electrolysis, dermabrasion, tattooing, or other procedures performed. The healing may be abnormal.
What should I do while I take accutane?
1. All females taking accutane must use two methods of effective birth control while taking accutane, for 2
months prior, and for 1 month after. This is extremely important. 2. Attend your appointments with your dermatologist. 3. Have your blood tests performed when your doctor asks you to. 4. Make sure that your dermatologist knows all the medicines that you take, including over-the-counter, herbal, natural, or Chinese medicines. Do not use other acne treatments, such as creams or antibiotic pills, while you are on accutane, unless told to do so by the doctor. 5. Report any unusual side effects to your dermatologist immediately. 6. To fight skin dryness, use soap only on the armpits and underwear area. Do not use soap anywhere else on your body. Apply a moisturizer when you get out of the shower or bath. 7. Apply vaseline, chap stick, prevex, or other moisturizer to your lips several times per day. 8. Please note that for your safety, we do not refill prescriptions over the phone.

Source: http://www.straticamedical.com/wp-content/uploads/2012/05/Accutane.pdf

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Ambulatory Care Clerkship Goals and Objectives COURSE GOALS: Teach the student the rationale of prescribing medication in an ambulatory care setting;Familiarize the student with laboratory tests and diagnostic procedures used in themonitoring of drug therapy;Teach the student both the physical and laboratory parameters for evaluating effectivemedication use in ambulatory patients,Reinforc

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