8. Erika has been prescribed isotretinoin (Accutane) by her dermatologist & is presenting to her primary care provider with symptoms of sadness & depression. A Beck’s Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point? 1 . Prescribe a select serotonin reuptake inhibitor (SSRI) antidepressant 2 . Refer her to a mental health therapist 3 . Contact her dermatologist about discontinuing the isotretinoin 4 . Reassure her that mood swings are normal & schedule follow up in a week 9. Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you be concerned for? 1 . He may have pulled a muscle & needs to rest to recover. 2 . He is at risk for bone injuries & needs to be evaluated for fracture. 3 . Isotretinoin interacts with ibuprofen which is the pain medication of choice. ADV Pharm | TextBook | StudyGuide 58
4 . Teen athletes are at risk for repetitive stress injuries. 10. Catherine calls the clinic with concerns that her acne is worse 1 week after starting topical tretinoin. What would be the appropriate care for her? 1 . Change her to a different topical acne medication as she is having an adverse reaction to the tretinoin. 2 . Switch her to an oral antibiotic to treat her acne. 3 . Advise her to apply an oil-based lotion to her face to soothe the redness. 4 . Reassure her that the worsening of acne is normal & it should improve with continued use. 11. Li is a 6-month-old infant with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include: 1 . Apply liberally to all areas with eczema. 2 . Double the frequency of application when the eczema is severe. 3 . Apply sparingly to eczema areas. 4 . Cover the eczema area with an occlusive dressing after applying a corticosteroid. 12. Jose has had eczema for many years & reports that he thinks his corticosteroid cream is not working as well as it was previously. He may be experiencing tolerance to the corticosteroid. Treatment options include: 1 . Increase the potency of the corticosteroid cream. 2 . Recommend an interrupted or cyclic schedule of application. 3 . Increase the frequency of dosing of the corticosteroid. 4 . Discontinue the corticosteroid because it isn’t working any longer . 13. When prescribing tacrolimus ( Protopic) to treat atopic dermatitis patients should be informed that: 1 . Tacrolimus is the most effective if it is used continuously for 4 to 6 months. 2 . Tacrolimus should be spread generously over the affected area. 3 . The FDA has issued a Black Box warning about the use of tacrolimus & the development of cancer in animals & humans.
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