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INTRODUCTION

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alitretinoin (a-li-tret-i-noyn)

Panretin

Classification

Therapeutic: antineoplastics

Pharmacologic: retinoids

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Indications
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Topical treatment of cutaneous lesions from AIDS-related Kaposi's sarcoma (KS).

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Action
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Binds to and activates retinoid receptors, resulting in inhibition of KS cells. Therapeutic Effects: Decreased cutaneous lesions of KS.

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Adverse Reactions/Side Effects Local: pain, pruritus, rash, edema, exfoliative, dermatitis, paresthesia.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Assess the area being treated to help document whether drug therapy is successful in reducing skin lesions.

  • Monitor any new or increased reactions at the site of application, including inflammation, irritation, burning, swelling, numbness, tingling, exfoliation, and rash. Report severe or prolonged skin reactions to the physician.

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Interventions
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  • Protect skin from breakdown, especially over bony prominences.

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Patient/client-Related Instruction
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  • Check that the patient and family or caregivers understand topical application procedures, and adhere to the recommended dosing schedule.

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Pharmacokinetics
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Absorption: Small amounts are absorbed.

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Distribution: Unknown.

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Metabolism and Excretion: Some metabolism occurs.

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Half-life: Unknown.

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TIME/ACTION PROFILE (response of KS lesions)

ROUTE ONSET PEAK DURATION
topical 2 wk 4–14 wk unknown

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity to retinoids; OB: Potential for birth defects; Lactation: Use breast milk alternative.

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Use Cautiously in: Patients with childbearing potential; Pedi: Safety not established.

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Interactions
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Drug-Drug: Do not use concurrently with insect-repellent products containing N,N-diethyl-m-toluamide (DEET). Alitretinoin increases DEET absorption.

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Route/Dosage
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Topical (Adults): Apply generous coating twice daily to KS lesions initially; application may be increased to 3–4 times daily.

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Availability
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Topical gel: 0.1% in 60-g tubes.

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