Dermabrasion Medication

Updated: Sep 08, 2016
  • Author: Gaurav Bharti, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Medication

Medication Summary

Antiviral prophylaxis is instituted in all patients. Patients with very recent or frequent herpetic infections and those patients with postoperative breakthrough herpes simplex virus (HSV) infections may require a greater prophylactic dosage (ie, valacyclovir at 500-1000 mg/day for 10-14 days or famciclovir at 500-1000 mg/day for 10-14 days).

Most patients do not require antibiotic prophylaxis. However, immunosuppressed patients, those with a history of impetigo, or carriers of Staphylococcus species may benefit from prophylactic antibiotics (ie, cephalexin at 1000-2000 mg/day for 10-14 days or ciprofloxacin at 500-1000 mg/day d for 10-14 days). If prophylactic antibiotics are administered, fluconazole at 200 mg/day for 10 days prevents secondary yeast infections

Sedating medications preprocedure and for anesthesia include flurazepam, diazepam, meperidine, and hydroxyzine.

Skin conditioning medications can include trans -retinoic acid, tretinoin cream, topical hydroquinone (for postoperative hyperpigmentation).

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Antiviral Agent, Other

Class Summary

These agents are inhibitors of DNA polymerase in herpes simplex virus (HSV)–1 and HSV-2 strains, inhibiting viral replication.

Famciclovir (Famvir)

Famciclovir is a prodrug that when biotransformed into its active metabolite penciclovir, may inhibit viral DNA synthesis/replication.

Acyclovir (Zovirax)

Acyclovir has an affinity for viral thymidine kinase and, once phosphorylated, causes DNA chain termination when acted upon by DNA polymerase. The drug, which requires 5 daily doses, can be associated with compliance problems.

Valacyclovir (Valtrex)

Valacyclovir is a prodrug that is rapidly converted to the active drug acyclovir. It is more expensive than acyclovir, but its dosing regimen is more convenient.

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Antibiotics, Other

Class Summary

For patients who do not respond to standard antimicrobial treatments, therapy should be guided by culture sensitivity.

Ciprofloxacin (Cipro)

Ciprofloxacin inhibits DNA gyrase and topoisomerase IV for bactericidal activity. Use it as an alternative for methicillin-resistant Staphylococcus aureus (MRSA) infection.

Cephalexin (Keflex)

Cephalexin is a first-generation cephalosporin that inhibits bacterial replication by inhibiting bacterial cell-wall synthesis. It is bactericidal and effective against rapidly growing organisms, forming cell walls. Resistance occurs through alteration of penicillin-binding proteins.

Cephalexin is effective for the treatment of infections caused by streptococci or staphylococci, including penicillinase-producing staphylococci; it may be used to initiate therapy when such infections are suspected. Its primary activity is against skin flora. It is used for treatment of skin infections or for prophylaxis in minor procedures.

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Antifungal Agents

Class Summary

These agents are used to treat secondary yeast infections.

Fluconazole (Diflucan)

Fluconazole is a synthetic oral antifungal (broad-spectrum bistriazole) that selectively inhibits fungal cytochrome P-450 and sterol C-14 alpha-demethylation.

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Anxiolytics, Benzodiazepines

Class Summary

These agents treat presurgery-associated anxiety. By binding to a specific receptor site, these agents appear to potentiate the effects of gamma-aminobenzoic acid (GABA) and to facilitate inhibitory GABA neurotransmission and other inhibitory neurotransmitters.

Diazepam (Valium, Diastat, Diastat AcuDial)

Diazepam depresses all levels of the CNS (eg, limbic and reticular formation), possibly by increasing the activity of GABA. Diazepam diminishes or terminates seizures. Individualize the dosage and increase cautiously to avoid adverse effects.

Flurazepam

Flurazepam is frequently chosen as a short-term treatment of insomnia. It enhances the inhibitory effects of the GABA neurotransmitter on neuronal excitability that results by increased neuronal permeability to chloride ions. The shift in chloride ions results in hyperpolarization and stabilization of the neuronal membrane.

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Antihistamines, 1st Generation

Class Summary

H1 receptor antagonists act by competitive inhibition of histamine at the H1 receptor. Agents in this class have sedating properties.

Hydroxyzine (Vistaril)

Hydroxyzine antagonizes H1 receptors in the periphery. It may suppress histamine activity in the subcortical region of the CNS.

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Analgesics, Opioid

Class Summary

Analgesics ensure patient comfort, promote pulmonary toilet, and possess sedating properties, which are beneficial for patients having surgery. These agents are used for comfort and sedation and to blunt the discomfort of surgical incisions.

Meperidine (Demerol, Meperitab)

Meperidine is an analgesic with multiple actions, similar to those of morphine; it may produce less constipation, smooth muscle spasm, and depression of cough reflex than similar analgesic doses of morphine. Meperidine may be used in combination with promethazine to provide a synergistic effect.

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Anesthetics

Class Summary

Anesthetics may be used for regional nerve blocks of the mental, infraorbital, supraorbital, and supratrochlear nerves.

Lidocaine anesthetic (Xylocaine, Zingo)

Lidocaine is an amide local anesthetic used in 1-2% concentration. The 1% preparation contains 10 mg of lidocaine for each 1 mL of solution; the 2% preparation contains 20 mg of lidocaine for each 1 mL of solution. Lidocaine inhibits depolarization of type C sensory neurons by blocking sodium channels. Adding epinephrine prolongs the duration of the anesthetic effects from lidocaine by causing vasoconstriction of the blood vessels surrounding the nerve axons.

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Retinoid-like Agents

Class Summary

Retinoids decrease the cohesiveness of abnormal hyperproliferative keratinocytes and may reduce the potential for malignant degeneration. They also modulate keratinocyte differentiation.

Tretinoin topical (Retin-A, Renova, Atralin, Tretin X)

Tretinoin inhibits microcomedo formation and eliminates lesions. It makes keratinocytes in sebaceous follicles less adherent and easier to remove.

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Depigmenting Agents

Class Summary

These agents are used for gradual bleaching of hyperpigmented skin.

Hydroquinone (Alphaquin HP, Eldopaque Forte, Nuquin HP)

Hydroquinone is a 1,4-benzenediol that suppresses melanocyte metabolic processes, especially enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylamine. Exposure to sun reverses the effects and causes repigmentation.

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Antiseptics

Class Summary

These agents inhibit growth of gram-positive and gram-negative bacteria.

Chlorhexidine gluconate (Hibiclens, Avagard, Betasept Surgical Scrub, Hibistat)

Chlorhexidine binds to negatively charged bacterial cell walls and extramicrobial complexes. It has bacteriostatic and bactericidal effects.

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