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A acne vulgaris é das doenças dermatológicas mais frequentes a nível mundial, afetando praticamente toda a população em pelo menos alguma fase da sua vida. É uma doença crónica e inflamatória com diferentes lesões e graus de gravidade que afeta maioritariamente a face, tórax e dorso. Possui também uma elevada complexidade a nível psicossocial que pode dar origem a estados depressivos e de isolamento social, sendo necessário terapêuticas efetivas que vão desde tópicas a sistémicas como é o caso da isotretinoína. A isotretinoína é considerado o fármaco mais efetivo e com menos taxa de reincidência para o tratamento da acne em casos moderados que não respondem à antibioterapia oral e como primeira opção para casos de acne graves ou muito grave. Além disso, a sua indicação terapêutica não se verifica apenas no acne, sendo prescrita noutras patologias dermatológicas. No entanto, é um fármaco que exige várias medidas a serem tomadas pelo doente antes, durante e após o fim da terapêutica. Consequentemente, é necessário os seus utilizadores efetuarem análises laboratoriais, nomeadamente, um hemograma completo, a enzima creatinina fosfocinase e ao perfil lipídico e hepático. Além disso, a isotretinoína é um fármaco com efeitos teratogénicos. Os efeitos adversos relacionados com a terapêutica é o que gera mais preocupações e numerosos ensaios clínicos em torno deste fármaco. Os mais comuns são a nível mucocutâneo e oftalmológico, depois existem revisões de efeitos gastrointestinais, neuromusculares, osteoarticulares, hematológicos, cardiovasculares e psiquiátricos. Considerando, os doentes que são mais vulneráveis aos efeitos secundários da isotretinoína através do seu histórico pessoal e familiar, estes podem beneficiar da sua ação terapêutica ao serem feitas algumas alterações, como a introdução de regimes de baixas dosagens. No entanto, pode sempre existir casos de doentes que não possam fazer uso da sua ação terapêutica devido a certas patologias pré-existentes. Contundo, apesar da controvérsia que existe, a isotretinoína é um fármaco com um perfil de eficácia e segurança bastante elevado mas que necessita de certas precauções.
Acne vulgaris is one of the most frequent dermatological diseases worldwide, affecting practically the entire population at some stage in their lives. It is a chronic and inflammatory disease with different lesions and degrees of severity, affecting mainly the face, chest and back. It also has a high psychosocial complexity that can lead to depressive states and social isolation, requiring effective therapies ranging from topical to systemic, such as isotretinoin. Isotretinoin is the most effective medicine with the lowest relapse rate for the treatment of acne in moderate cases that do not respond to oral antibiotherapy, and as the first option for cases of severe or very severe acne. Furthermore, its therapeutic indication is not only for acne, but is also prescribed for other dermatological pathologies. However, it is a medicine that requires several measures to be taken by the patient before, during and after the end of therapy. Consequently, its users are required to take laboratory tests, including a complete blood count, creatinine phosphokinase enzyme, and lipid and liver profile. In addition, isotretinoin is a teratogenic medicine. Therapeutic-related adverse effects are what generate the most concern and numerous clinical trials surrounding this pharmaceutical. The most common are mucocutaneous and ophthalmologic, then there are reviews of gastrointestinal, neuromuscular, osteoarticular, hematologic, cardiovascular, and psychiatric effects. Considering, patients who are more vulnerable to the side effects of isotretinoin through their personal and family history, they can benefit from its therapeutic action by making some changes, such as introducing low-dose isotretinoin. However, there may always be cases of patients who cannot make use of its therapeutic action due to certain pre existing pathologies. Therefore, despite the controversy, isotretinoin is a medicine with a highly effective and safe profile, but it requires certain precautions.
Acne vulgaris is one of the most frequent dermatological diseases worldwide, affecting practically the entire population at some stage in their lives. It is a chronic and inflammatory disease with different lesions and degrees of severity, affecting mainly the face, chest and back. It also has a high psychosocial complexity that can lead to depressive states and social isolation, requiring effective therapies ranging from topical to systemic, such as isotretinoin. Isotretinoin is the most effective medicine with the lowest relapse rate for the treatment of acne in moderate cases that do not respond to oral antibiotherapy, and as the first option for cases of severe or very severe acne. Furthermore, its therapeutic indication is not only for acne, but is also prescribed for other dermatological pathologies. However, it is a medicine that requires several measures to be taken by the patient before, during and after the end of therapy. Consequently, its users are required to take laboratory tests, including a complete blood count, creatinine phosphokinase enzyme, and lipid and liver profile. In addition, isotretinoin is a teratogenic medicine. Therapeutic-related adverse effects are what generate the most concern and numerous clinical trials surrounding this pharmaceutical. The most common are mucocutaneous and ophthalmologic, then there are reviews of gastrointestinal, neuromuscular, osteoarticular, hematologic, cardiovascular, and psychiatric effects. Considering, patients who are more vulnerable to the side effects of isotretinoin through their personal and family history, they can benefit from its therapeutic action by making some changes, such as introducing low-dose isotretinoin. However, there may always be cases of patients who cannot make use of its therapeutic action due to certain pre existing pathologies. Therefore, despite the controversy, isotretinoin is a medicine with a highly effective and safe profile, but it requires certain precautions.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2021, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Acne Isotretinoína Efeitos adversos Patologia Mestrado integrado - 2021
