What are the types of vitamin A acid drugs?
Retinoic acid drugs can be divided into three generations, including retinoic acid, avitamin A ester, aromatic retinoic acid, etc. 1. The first generation of retinoic acid drugs includes retinoic acid, all-trans retinoic acid, isotretinoin, viamine ester, etc. They are suitable for severe nodular or polymerized acne, and can also be used externally for the treatment of ichthyosis, but there are many adverse reactions, so their use should be controlled. 2. The second generation of retinoic acid drugs includes avitamin A ester, avitamin A, etc. They are mainly used in the treatment of Darrier's disease (keratosis follicularis), pityriasis rubra pilaris, pustular psoriasis, erythrodermic psoriasis, ichthyosis, etc. 3. The third generation of retinoic acid drugs includes aromatic retinoic acid, aromatic retinoic acid ethyl ester, methanesulfonyl aromatic retinoic acid, etc. Drugs launched almost simultaneously also include adapalene and tazarotene (acetretin). They have low concentrations and fewer adverse reactions in treatment, and can be used for the treatment of psoriasis, ichthyosis, Darrier's disease, keratoacanthoma, T-cell lymphoma, lichen planus, and palmoplantar keratoderma. Common adverse reactions to retinoic acid drugs include dry skin and mucosa, urticaria, maculopapule, ecchymosis, palmoplantar peeling, skin pruritus, fixed drug eruption, cheilitis, conjunctivitis, etc. Some statistics show that the incidence rate can reach about 90%. Currently, orally administered retinoic acid drugs used clinically can cause congenital malformations in infants. Therefore, women taking retinoic acid drugs should avoid pregnancy before, during, and for a long time after treatment. Long-term and large-dose use of retinoic acid drugs can easily lead to adverse reactions in the central nervous system, such as headache (with an incidence rate of about 46%) and dizziness. The dose should be controlled or drugs such as oryzanol, vitamin B1, and vitamin B6 can be taken at the same time to reduce or eliminate reactions such as headache. Retinoic acid drugs should not be used for acute dermatitis and eczema diseases; those with digestive tract and liver or kidney dysfunction should use them with caution. Liver function should be checked before avitamin A ester administration, 1 month after administration, and every 3 months afterwards. If liver function abnormalities occur, liver function should be checked once a week. If liver function does not return to normal or continues to worsen in a short period of time, the drug should be discontinued immediately. Blood triglyceride levels should also be monitored during medication, and those with excessively high blood lipids should be prohibited from using it.
