Bugs, Lice

Head
Body
Pubic

Fine nit combs are important

Pyrethrin lotion
Permethrin lotion

Permethrin cream
Malathion
Lindane
Benzyl alcohol

block nerve impulse transmission  paralysis and death

Disrupts sodium channel  delaying repolarization  paralysis

SE: pruritis, burning of scalp, irritation
Do not use if pt allergic to ragweed/chrysanthemums

5x stronger than the lotion

Not FDA approved for lice

Also contains terpineol which acts as a pediculicide
Malodorous

Inhibits respiration of lice by obstructing respiratory spiracles causing lice asphyxiation

An organochlorine insecticide that inhibits neurotransmission in parasitic arthropods

Not considered a first-line product

Only prescribe the necessary amount to treat lice/scabies

* Last resort*

Fermentation product of the soil bacterium Saccharopolyspora spinosa

MOA: compromises the CNS of lice by interfering with the nicotinic acetylcholine receptorneuronal excitation and paralysis

Nuvo lotion (Nuvo method)

Spread by close contact and via transmission of infected items (clothing, sheets, etc.)

Permethrin cream 5% (Elimite®)

Crotamiton 10% (Eurax®)

Lindane (Kwell®)


Ivermectin (Stromectol®)

Typically transmitted by sexual contact
Pruritis, rash, pustular lesions (possible)
Patient may have nits in eyelashes, eyebrows, hair

Permethrin 1% cream rinse
Apply to affected area and leave on for 4-6 hours, followed by a warm bath
Pyrethrins with piperonyl butoxide
AAA leave on 4-6 hours, then bathe
Do NOT use permethrin or pyrethrins in those allergic to chrysanthemums or ragweed
Antihistamines & low-dose topical steroids for relief
Sex partners should be treated
Non-sex partners do not need to be treated
Decontaminate bedding and clothing (bag for 2 weeks)

Malathion lotion 0.5%
Use for treatment failure or allergy
AAA leave on 12-24 hours
Ivermectin
200mcg/kg x 1, repeat in two weeks

No treatment is required unless infection occurs

Best recommendation- get out