Tx of head lice

Question 1

Only tx for lice that is Ovicidal, Pediculicidal and safe

Answer 1

Malathion

Question 2

Crucial first step in assuring no re-infetion

Answer 2

modify behavoir and change all household exposures

Question 3

dosage/frequency of pediculicidals (only)

Answer 3

days 0-7-14

*2 or 3 courses of tx spaced one week apart to acheive complete lice eradication

Question 4

dosage/frequency of pediculicidal/ovicidal

Answer 4

one or 2 courses of therapy one week apart

Question 5

chemical methods do what to the louse

Answer 5

paralyze and dehydrate fatally

Question 6

physical methods do what to the louse

Answer 6

suffocate

Question 7

there is resistance to which tx.’s in the US

Answer 7

permethrin and Lindane

Question 8

accidental ingestion of Malathion results in

Answer 8

DUMBBELS

it inhibits AchE—> cholinergic excess

Question 9

reversible tx for malathion overdose

Answer 9

atropine (muscarininc antagonist) and pralidoxime

Question 10

synthetic pyrethrin

Answer 10

permethrin

Question 11

cause louse paralysis by binding to voltage gated sodium channels.

Answer 11

permethrin

Question 12

why is permethrin safe

Answer 12

human voltage gated channels are not susceptible to permethrin or pyrethrins

Question 13

rare side effect is asthma exacerbation in patients allergic to ragweed

Answer 13

permethrin

Question 14

resistance has arrisen due to knock down mutations of louse sodium channels

Answer 14

permethrin

Question 15

disfavored anti-louse agent bc of neurotoxicity and its persistence in the environment

Answer 15

Lindane

Question 16

major side effect seizures

Answer 16

Lindane

Question 17

only used in patients who cannot take Malathion or Permethrin

Answer 17

Lindane–> shampoo

Question 18

how does lindane cause seizures

Answer 18

blockage of GABA action…effects similar to DDT, when absorbed sytemically

Question 19

BBW for lindane

Answer 19

skin dz/conditions or neonatal prematurity will increase drug systematization; contraindicated in pt.’s with seizure disroders

Question 20

disfavored in young patients in whom the BBB is immature

Answer 20

ivermectin–> ok in old ppl

Question 21

causes hyper excitability and paralysis by binding selectively and with high affinity to glutamate-gated chloride ion channels present in louse nerve and muscle celss

Answer 21

ivermectin

Question 22

reported to wrosen bronchial asthma

Answer 22

ivermectin

Question 23

is there resistance to ivermectin

Answer 23

no

Question 24

ovicidal and pediculicidal activities of 94% and 62%

Answer 24

petroleum jelly