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INTRODUCTION

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spinosad (spy-no-sad)

Natroba

Classification

Therapeutic: pediculocides

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Indications
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Treatment of head lice in adults and children >4 yr.

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Action
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Causes neuronal hyperexcitation in insects, resulting paralysis and death of lice. Therapeutic Effects: Eradication of head lice.

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Adverse Reactions/Side Effects
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EENT: ocular erythema. Local: erythema.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor symptoms such as itching scalp to help document drug effectiveness.

  • Watch for and report excessive redness, warmth, and irritation in the scalp and eyes.

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Interventions
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  • Avoid contact with infected areas or wear protective gloves when treating patient.

  • Always wash hands thoroughly and disinfect bedding and equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection.

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Patient/Client-Related Instruction
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  • Advise patient to report any increased local sensitivity to this drug.

  • Instruct patient about proper hygiene; e.g., clean or discard infected clothing, not share combs and hats with others, thoroughly wash and dry the scalp, and so forth.

  • Advise patient to apply the drug as directed; that is, apply the drug topically for the recommended period of time before washing off.

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Pharmacokinetics
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Absorption: Undetectable systemic absorption follows topical use.

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Distribution: Unknown.

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Metabolism and Excretion: Unknown.

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Half-life: Unknown

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TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION

topical

within min

unknown

unknown

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Contraindications/Precautions
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Contraindicated in: Pedi: Children <6 mo (↑ risk of benzyl alcohol absorption).

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Use Cautiously in: OB: Use in pregnancy only if clearly needed; Lactation: use with caution; Pedi: Safe and effective use in children <4 yr not established.

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Interactions
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Drug-Drug: None noted.

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Route/Dosage
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Topical (Adults and Children >4 yr): Apply amount necessary to wet scalp, leave in place for 10 min, then rinse; may be repeated after 7 days if live lice are still seen.

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Availability
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Topical suspension: 0.9% in 120-mL bottles

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