Lice and Scabies Flashcards
What are the differences between nits and lice?
Nits are eggs and need to pick them out –> attached to hair follicle –> do not wash out and laid close to scalp for warmth
Lice will get away from light and will stay near the scalp where there is warmth
Describe the life cycle/transmission of lice?
- Lice will lay eggs (nits) that can survive some shampoos
- Therefore you need to hit the eggs with a second time with shampoo once they hatch
- Cannot wait to long and have lice become adults that start the egg laying cycle again
Can lice jump from one person to another?
Unlikely; would need really close and lengthy contact
- They have to know they can set up nicely somwhere else
- Need to sense the warmth of the next scalp
Lice Transmission
- Mainly young children
- Most probable route is:
Hats
Head to head (Rare 2-3 mins of contact)
Unlikley –> towel, bed, combs, brushes, furniture, pets
No difference between clean and dirty hair –> Lice can survive shower
Symptoms of Lice
None <–> Itching
GBH/Lindane (Kwellada)
- Historical –> off the market
Insecticide (pediculocide) for lice
Was safe fro head lice
Issues came from scabies where consistent use lead to neurological symptoms in kids
Pyrethins (+ piperonyl butoxide) MOA and Directions For USe
- Insecticide
- Chrysantheum plant extract
- safe in children
- Directions for use:
Apply to dry hair
Shampoo for 10 mins
- S/e –> Local rxns
- Needs repeats, nit removal and resistance is possible
Permethrin 1% MOA and Directions of Use
- Synthetic pyrethroid
Very safe in children
Directions for use:
Wash hair with regular shampoo
Add cream rinse for 10 mins
- Has residula activity; however, still a good product to repeat
Nit removal needed and resistance is possible
Rinse out
What are the pediculoside txs?
Permethrin
Pyrethins/pb
Permethrin
Lindane
Are some lice resitant to certain tx’s?
Yes
Should pharmacists use the word pediculoside or insecticide?
NO
SH-206
Physical Agent
- Essential oil; repeat every 2 days
Other Physical Agents for Lice?
1) Isopropyl Myristate
- 10 min, nit pick, repeat in 7 days
2) Coconut/anise oil
- 15 min, nit pick, repeat in 9 days
3) Dimethicone
10 mins and nit comb time, nit pick, and reapply as needed
Can shampoo’s, insectides and/or physical agents kill nits?
NO
Olive Oil
- aromatic compounds are somewhat deadly to lice
What is the drug of choice for Lice? How is it used?
NYDA
- Dimethicone –> safe just make sure to cover the hair
Penetrates deeply in lice/eggs breathing system - Death of lice and eggs within 58 seconds
30 min of contact, then start nit combing with product in hair (product will dry)
Then 8 hours of contact and recheck in 8-10 days
8 HOURS IMPORTANT AND NIT PICKING
Can the scalp be itchy after a few days?
Yes
Lice will put anticoagulants in the scalp
What if tx fails? What caused the tx to fail?
Tx may have failed due to:
missing some lice
reinfestation
resistance
- Use a different agent
- if used NYDA, use again as no resistant lice to it and may have missed some lice
Other tx’s for head lice
Bug Busting –> Not medicated shampoo, just combing with lice comb every 3 days
Heat –> No medicated shampooeither, just a heat source –> Not to effective
Electrocution –> Not high hopes it works
Te tree oil –> hard to know right amount to use
Dry-on Suffocation method using lotion
When will the itch stop?
After a few days
How fast do they work?
10 mins
When can the kids go back to school?
The next day if has a NO NIT Policy
How can one clean the house of lice?
- Hot water and dry cleaning
Should nit combs be dipped in vinegar?
NOT if using Permethrin
What kind of comb is needed?
- Not fancy
- Cheap plastic one
How do Nits grow?
- hair growing speed
Nit distance from scalp dtermines viability - 1/2 inch to far for egg to hatch
Are body lice common?
NO
Is there a tx for body lice?
No tx the clothes
- Crawl from clothes, feed on skin and leave back into clothes
Pubic Lice Shape
- Crab Like
Pubic Lice Tx
- Pyrethins/pb
Officially indicated - Same procedure, shave the area
- No repeast; shave the area
Scabies
- Tons world wide
Crowded areas and people stuck in dire situations - Bugs right in skin
- Tons of antigenic material –> itching after initial tx
Scabies Transmission
- Person to person close contact
Scabies Tx
- Neck line all the way down body
Tough to diagnose
Scabies Tx issues
- Treat head to toe for 12 hours
Permethrin = 5% dermal cream/lotion
Itch will persist for a few weeks
repeat after 7 days
Blind tx of close contacts
treating Lice and Scabies Blindly
Lice –> Go ahead –> every 2 days not even looking, low-level risk but may be overkill
Scabies –. TREAT BLINDLY
Bed Bugs Tx
- Woodwork, come out to feed in bed then go back
- Treating the itch –> Calamine
