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INTRODUCTION

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lindane (lin-dane)

G-Well, Image not available.Hexit, Image not available.PMS Lindane, Scabene

Other Names:

Gamma-benzene hexachloride, Image not available.GBH

Classification

Therapeutic: pediculicides, scabicides

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Indications
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Second-line treatment of parasitic arthropod infestation (scabies and head, body, and crab lice) for use only in patients who are intolerant to or do not respond to less toxic agents.

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Action
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Causes seizures and death in parasitic arthropods. Therapeutic Effects: Cure of infestation by parasitic arthropods.

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Adverse Reactions/Side Effects
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All adverse reactions except dermatologic are signs of systemic absorption and toxicity

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CNS: SEIZURES, headache. CV: tachycardia. GI: nausea, vomiting. Derm: contact dermatitis (repeated application), local irritation.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor signs of systemic absorption and toxicity. Signs include headache, seizures, fast heart rate (tachycardia), and GI reactions (nausea, vomiting). Report these signs to the physician immediately.

  • Monitor the administration site(s) for local irritation or inflammation. Report severe or prolonged skin reactions to the physician.

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Patient/Client-Related Instruction
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  • Check that the patient and family or caregivers understand topical application procedures and adhere to the recommended dosing schedule.

  • Instruct patient about proper hygiene, e.g., thoroughly wash and dry the affected areas, do not share combs or hair brushes, avoid sexual contact with carriers of lice or crabs, and so forth.

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Pharmacokinetics
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Absorption: Significant systemic absorption (9–13%) greater with topical application to damaged skin.

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Distribution: Stored in fat.

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Metabolism and Excretion: Metabolized by the liver.

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Half-life: 17–22 hr (infants and children).

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TIME/ACTION PROFILE (antiparasitic action)

ROUTE ONSET PEAK DURATION
topical rapid 6 hr 190 min

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity; Areas of skin rash, abrasion, or inflammation (absorption is increased); History of seizures; Lactation; Premature neonates(increased risk of CNS toxicity).

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Use Cautiously in: Pregnancy (do not exceed recommended dose; do not use >2 courses of therapy); Children ≤2 yr, geriatric patients, patients with skin conditions (increased risk of systemic absorption and CNS side effects).

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Interactions
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Drug-Drug: Concurrent use of medications that lower seizure threshold (may ↑ risk of seizures). Simultaneous topical use of skin, scalp, or hair products may increase systemic absorption.

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Route/Dosage
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Scabies
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Topical (Adults and Children >1 mo): 1% lotion applied to all skin surfaces from neck to toes; wash off 6 hr after application in infants, after 6–8 hr in children or after 8–12 hr in adults; may require a 2nd treatment 1 wk later.

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Head Lice or Crab Lice
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Topical (Adults ...

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