Which medication should a pregnant adolescent avoid continuing for acne?

• A. Isotretinoin (Accutane)
• B. Acetaminophen
• C. Penicillin
• D. Tetracycline

Answer: (A)

Isotretinoin is a powerful acne medication that is highly teratogenic. Exposure during pregnancy can cause severe birth defects affecting the brain, heart, face, and other organs, and can also lead to miscarriage. Because the fetus is extremely vulnerable in the first trimester, continuing this drug during pregnancy is contraindicated. If pregnancy occurs or is suspected, the medication should be stopped immediately, and a clinician should be consulted for safer acne management during pregnancy. In practice, isotretinoin is managed under strict pregnancy prevention programs with mandatory contraception and pregnancy testing, underscoring why it is the one to avoid in a pregnant adolescent. For reference, acetaminophen is generally safe for short-term use in pregnancy, penicillin is typically safe for infections, and tetracycline is avoided in pregnancy due to effects on fetal teeth and bone, but the specific reason this scenario calls for avoiding a continuing acne medication is the high teratogenic risk of isotretinoin.