Page 1239 - Saunders Comprehensive Review For NCLEX-RN

and is used to treat acne, dandruff,
seborrheic dermatitis, and psoriasis
C. Systemic medications
1. Methotrexate
a. Reduces proliferation of epidermal cells
b. Can be toxic; causes gastrointestinal
effects such as diarrhea and ulcerative
stomatitis and bone marrow
depression leading to blood dyscrasias
c. Can be hepatotoxic; hepatic function
should be monitored during therapy
d. This medication is teratogenic; women
of child-bearing age should wait 3
months after discontinuation of the
medication before becoming pregnant.
2. Acitretin
a. Inhibits keratinization, proliferation,
and differentiation of cells; has
antiinflammatory and
immunomodulator actions; used for
severe psoriasis and reserved for use in
those who have not responded to safer
medications

b. Is embryotoxic and teratogenic:

Medication is contraindicated during
pregnancy; pregnancy must be ruled
out, and 2 reliable forms of
contraception need to be implemented
before the medication is started
(contraception must be implemented at
least 1 month before treatment starts
and be continued for at least 3 years
after treatment is discontinued).
c. If pregnancy occurs during treatment
with the medication, the medication is
discontinued immediately and
possible termination of the pregnancy
is discussed.
d. Dermatological effects include hair loss,
skin peeling, dry skin, rash, pruritus,
and nail disorders; other effects
include rhinitis from mucous
membrane irritation, inflammation of
the lips, dry mouth, dry eyes,
nosebleed, gingivitis, stomatitis, bone
and joint pain, and spinal disorders.
e. Can be hepatotoxic; can elevate

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