8 - Scabies + Lice Flashcards
What Scabies medication is this?
Leave on body for 8-14 hours
Safe in children > 2 months of age!
SAFE IN PREGNANCY!
PERMETHRIN = Elimite 5% cream
RX only
Bathe before medication, apply to ENTIRE BODY except FACE
TREAT OTHER HOUSEHOLD MEMBERS
Infestation of Scabies
Adult FEMALE burrows UNDER skin
EGGS Deposited and hatch
Larvae -> adults
Can survive 2-3 days off skin
Infect the:
web spaces / wrists / elbols / umbilicus / knees / buttocks / scrotum
S/Sx of Lice
Bite causes a Wheal to develop
24 hours -> PAPULE
Itching / Scratching –> Secondary INFECTION
EX-ST
for Pediculocides
HYPERsensitivity to Chrysanthemums / Ragweed
pyrethrins / permethrin
Presence of secondary skin infection
<2y/o for Pyrethrins
<2m/o for Permethrins
avoid eyelids / eyebrows
PREGNANCY OR BREAST FEEDING
What type of Pediculocide?
Head Lice only
Strong Odor / FLAMMABLE
RX ONLY
leave on scalp for 8 - 12 hours
MALATHION
Ovide
Treatment for SCABIES
PERMETHRIN 5% Cream
RX only, leave on for 8-14 hours, treat other household members
safe in children >2moths & pregnancy
CROTAMITON
RX only, bathe b4 applying TREAT OTHER HOUSEHOLD MEMBERS
DNU in pregnancy / BF
Ivermectin
tablets for head lice & scabies, RX ONLY, not for pregnant/BF/children <15kg
Lindane
head / pubic lice, but also for scabies, but SEIZURES IN CHILDREN
What type of Lice?
Encountered in all people regardless of hygiene practice
transmitted through:
sexual contact / toilet seats / sheets
Phthirus PUBIS
PUBIC LICE
CRAB LICE
What type of Pediculocide?
DNU if patient is < 2 MONTHS OLD
HEAD LICE ONLY
- DNU if allergies to* chrysanthemums
- Do NOT apply to eyelashes / eyebrows*
PERMETHRIN
HEAD LICE ONLY AND < 2 MONTHS
AA for 10 min then RINSE
Pruritis / Burning / Irritation
Which Pediculosides ALSO treat Scabies?
LINDANE
but reports of seizure
IVERMECTIN
tablets avoid in pregnancy / BF / children <15kg
RX ONLY
Directions for use of
Pediculocides
Applly enough to Wet the dry hair/scalp
leave it in for 10 minutes
After rinsing –> use a NIT REMOVAL COMB
wash hands immediately
- AVOID EYES / MUCOUS MEMBRANES*
- do not use on eyelashes or brows*
may REPEAT process in 7-10 days if needed
What type of Pediculocide?
Head Lice + SCABIES
RX ONLY
DNU in Pregnancy / Breast Feeding / Children <15kg
IVERMECTIN
Stromectol
3mg tablets –> 200mcg/kg
REPEAT in 1-2 weeks
What type of Pediculocide?
HEAD LICE ONLY
Do NOT use in children < 4 years old
- *NO CONTRAINDICATIONS**
- aside from age*
RX ONLY
SPINOSAD
RX ONLY
AA for 10 min then RINSE
Pruritus / Burning / Itching
What type of Lice?
Commonly called “cooties”
Live / Hide in CLOTHING
Crawl onto th ebody to feed
larger / longer type of lice
seen in crowded / unsanitary conditions
Pediculus Humanus CORPORIS
Body Lice
Adjunctive Measures for treating
Pediculocides
Machine wash ALL CLOTHING in HOT WATER
Dry clean non-washable fabrics
Wash brushes / combs
Vacuum furniture / rugs
PUBIC LICE = ALL PARTNERS SHOULD RECIEVE TREATMENT
Types of Pediculocides:
RX TREATMENTS
Spinosad
HEAD only, <4 y/o
Lindane
Head + Pubic, REPORTS OF SEIZURE, resistance
but EFFICACIOUS IN SCABIES
Malathion
HEAD only, strong odor, flammable -> 8-12 hours
Benzoyl Alcohol 5%
HEAD only, asphyxiates lice, 6months>, dose varies by hair length
Ivermectin
3mg ORAL tablet, both lice & SCABIES, repeat in 1-2 weeks
DNU in PREGNANCY / BF / children <15kg
Unproven Remedies of
LICE / Pediculosis
Mayonnaise
Petrolatum Jelly
Olive Oil
Tea Trea Oil
Emerging Therapies of
LICE / Pediculosis
DSP Lotions
Nuvo method = shrink wraps lice
Dimethicone 4% Lotion
Immobilizes lice in 5 minutes
Louse Buster
HEAT applying machine, needs technician
Non-Pharmacologic Therapy of
Pediculosis
Prevent future lice infestations
Avoid PHYSICAL CONTACT w/ infected individuals
Avoid SHARING personal articles
Causes of SCABIES
Sarcoptes Scabiei
POOR HYGIENE
Crowded conditions
POVERTY / MALNUTRITION
Sexual promiscuity
What type of Pediculocide?
Head + Pubic Lice
REPORTS OF SEIZURE IN CHILDREN
Some lice are becoming RESISTANT
EFFICACIOUS IN SCABIES
LINDANE
Types of Pediculocides:
OTC TREATMENTS
Pyrethrins
Head/Pubic, allergies to chrysanthemus / ragweeds, avoid EYES
Permethrin
HEAD only, chrysanthemus allergy, <2months
Pathophysiology / Life-Cycle
of LICE
Head lice -> hair shaft
Feed on blood of host
Female lays eggs which are CEMENTED into place to the hair
Adult on head = 20 day life –> 10 eggs/day
hatch in 5-10 days
ADULT AGAIN in 6-10 days
What type of Pediculocide?
HEAD only
RX ONLY
ASPHYXIATES the lice
6 months +
local side effects
BENZOYL ALCOHOL 5%
Ulefia
AA x 10 min REPEAT IN 7 DAYS
Dose adjusted on HAIR LENGTH
6months +
What type of Pediculocide?
DNU if patient is <** **2 years old
Head + Pubic Lice
- DNU if allergies to* chrysanthemums / ragweed
- Do NOT apply to* eyelashes / eyebrows
PYRETHRINS
AA x 10 min –> repeat in 7-10 days
AE = irritation / erythema / itching
