insect bites/stings and pediculosis Flashcards
diseases mosquitos carry
- west Nile virus
- zika virus
diseases ticks carry
- rocky mountain spotted fever
- Lyme disease
serious spider bites
black widow, brown recluse, hobo spiders
venomous insects
bees, wasps, hornets, yellow jackets, fire ants
allergic response occurs after ____ sting
second sting
anaphylactic rxn from sting occurs within
5-30 minutes
signs and symptoms of anaphylactic rxn
light headedness, loss of consciousness, fall in BP, choking, wheezing, incontinence, nv, disorientation, difficulty breathing
gold standard insect repellant
DEET
what product has a strong odor and can be irritating to skin
DEET
application of DEET
apply every 4-8 hours
do not use DEET on
children less than 2 months old, and use lowest concentrations on children
concentrations of 50-100%
for adults only and only for periods of high exposure to insects for long periods of time
picaridin
alternative to DEET, less odor and not as irritating to skin
permethrin sprays
may be used on clothing and camping gear (not on skin)
treatment of insect bite/sting goals
relieve symptoms and prevent secondary bacterial infection
exclusion for self care of insect bites
- systematic symptoms
- less than two years old
- suspected spider bite needing medical attention
- signs of secondary infection
exclusion for self care of insect stings
- allergic reaction
- allergic response away from site of sting
- previous stings
- previous severe reaction to sting
- personal or family hx or allergic reactions
- less than two years old
non pharm treatment of bites/stings
apply ice pack to area in 10 min intervals and remove stinger ASAP
pharm treatment of bites/stings
- local anesthetics
- topical antihistamines
- counterirritants
- hydrocortisone 1%
- skin protectants
local anesthetics for bite/sting
decreases pain and itch, apply 3-4 times daily up to 7 days
phenol anesthetic should be avoided in
children and pregnancy
topical antihistamine in bite/sting
diphenhydramine .5-2%
apply 3-4 times daily for up to 7 days
counterirritants in bite/sting
menthol/camphor
3-4 times daily up to 7 days
skin protectants
- zinc oxide
- calamine
- titanium dioxide
3 types of lice
head, body, pubic
presentation of head lice
- presence of nits
- nits are greyish and attached firmly
- hatched nits are lighter in color and easier to locate
- the presence of black specks (lice feces) can also indicate infestation
body lice
usually in individuals who do not shower or change clothing frequently
pubic lice
usually spread through sexual contact, toilet seats, shared undergarments, or bedding; can also be found in armpits, eyelashes, and facial hair
lice treatment goals
rid patient of lice by killing adult and nymph lice by removing nits from patients hair
non pharm treatment of lice
- inspect hair and use nit comb
- vacuum carpets and furniture
- wash everything in hot water and dry in hottest setting
- seal things that can not be washed in bags for 2 weeks
- avoid infected individuals
exclusions for self care of lice
- hypersensitivity to chrysanthemums, ragweed
- less than 2 years old for pyrethrins
- less than 2 m/o for permethrins
- lice infestation of eyelids or eyebrows
- pregnancy or breast feeding
- active tumors
- lice persists after 2 applications of meds
pharm treatment for lice
- synergized pyrethrins
- permethrin
indication of pyrethrins
treatment of head and pubic lice
do not use children less than 2 y/o
synergized pyrethrins
piperonyl butoxide to increase pyrethrin concentrations with louse
moa of pyrethrins
block louses’ nerve impulse transmission causing paralysis and death
application of pyrethrins
1) apply to dry hair
2) let set for 10 min and then rinse
3) use nit comb
4) two applications required
indication of permethrin
treatment of head lice only
do not use on patients less than 2 months
moa of permethrin
delays repolarization of sodium channels in louse nerve cells, causing paralysis
application or permethrin
- apply to wet clean hair
- let sit for 10 min and rinse
- use nit comb
- one application required
alternative therapies for lice
- lice enzyme shampoos
- oil-based products
- sodium chloride products
pediculosis emerging therapies
DSP and dimethicone