The nurse is caring for a young woman who comes to the dermatologist's office. The patient states that she has been taking Estrostep for 6 months and has not seen any improvement in her acne, and she wants to try something more effective
What medication would the nurse expect to be added to the regimen? a. Benzoyl peroxide
b. Spironolactone (Aldactone)
c. Ortho Tri-Cyclen as a substitute for Estrostep
d. Isotretinoin (Accutane)
B
As a rule, spironolactone is added to the regimen after an oral contraceptive, such as Estrostep, has proved inadequate. Spironolactone blocks androgen receptors, which benefits females with acne. Because spironolactone is teratogenic, it must be added after, not before, the contracep-tives.
Benzoyl peroxide and isotretinoin are not indicated as additions to this regimen.
Ortho Tri-Cyclen is not indicated, because it would have the same effect as Estrostep.
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