Tx of head lice Flashcards
Only tx for lice that is Ovicidal, Pediculicidal and safe
Malathion
Crucial first step in assuring no re-infetion
modify behavoir and change all household exposures
dosage/frequency of pediculicidals (only)
days 0-7-14
*2 or 3 courses of tx spaced one week apart to acheive complete lice eradication
dosage/frequency of pediculicidal/ovicidal
one or 2 courses of therapy one week apart
chemical methods do what to the louse
paralyze and dehydrate fatally
physical methods do what to the louse
suffocate
there is resistance to which tx.’s in the US
permethrin and Lindane
accidental ingestion of Malathion results in
DUMBBELS
it inhibits AchE—> cholinergic excess
reversible tx for malathion overdose
atropine (muscarininc antagonist) and pralidoxime
synthetic pyrethrin
permethrin
cause louse paralysis by binding to voltage gated sodium channels.
permethrin
why is permethrin safe
human voltage gated channels are not susceptible to permethrin or pyrethrins
rare side effect is asthma exacerbation in patients allergic to ragweed
permethrin
resistance has arrisen due to knock down mutations of louse sodium channels
permethrin
disfavored anti-louse agent bc of neurotoxicity and its persistence in the environment
Lindane
major side effect seizures
Lindane
only used in patients who cannot take Malathion or Permethrin
Lindane–> shampoo
how does lindane cause seizures
blockage of GABA action…effects similar to DDT, when absorbed sytemically
BBW for lindane
skin dz/conditions or neonatal prematurity will increase drug systematization; contraindicated in pt.’s with seizure disroders
disfavored in young patients in whom the BBB is immature
ivermectin–> ok in old ppl
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
ivermectin
reported to wrosen bronchial asthma
ivermectin
is there resistance to ivermectin
no
ovicidal and pediculicidal activities of 94% and 62%
petroleum jelly
