Names and pronunciation
(lin′dane)
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Drug reference
(lin′dane)
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Func. class.: Scabicide, pediculicide
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Chem. class.: Chlorinated hydrocar- bon (synthetic)
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ACTION: Stimulates nervous system of arthropods, resulting in seizures, death
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USES: Scabies, lice (head/pubic/ body), nits in those intolerant to or who do not respond to other agents
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CONTRAINDICATIONS: Hyper- sensitivity, patients with known seizure disorders, Norwegian (crusted) sca- bies
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Black Box Warning: Seizure disorder Precautions: Pregnancy, breastfeeding, infants, children <10 yr, avoid contact with eyes Black Box Warning: Neurotoxicity Black Box Warning: Abrasions, skin inflammation, breaks in skin: do not use on these areas, increased risk of neurotoxicity • Infestation: head, hair for lice, nits before and after treatment; if scabies present, check all skin surfaces; identify source of infection: school, family, sexual contacts • Isolation until areas on skin, scalp have cleared, treatment completed • Removal of nits with fine-toothed comb rinsed in vinegar after treatment; use gloves Black Box Warning: Seizures: avoid use in children with uncontrolled seizure disorders Black Box Warning: Neurotoxic- ity: when large amounts are used, ab- sorbed systemically, may cause death; use only second line • Pregnancy/breastfeeding: avoid in L pregnancy, breastfeeding Black Box Warning: To remove product after specified time to prevent toxicity • To treat sexual contacts simultaneously Black Box Warning: To check for CNS toxicity: dizziness, cramps, anxiety, nau- sea, vomiting, seizures
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SIDE EFFECTS CNS: Seizures, CNS toxicity, stimulation, dizziness INTEG: Pruritus, rash, irritation, con- tact dermatitis
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INTERACTIONS • Oils may increase absorption; if oil- based hair dressing used, shampoo, rinse, dry hair before applying lindane shampoo
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DOSAGE AND ROUTES Lice • Adult/child: shampoo using 30 mL: work into lather, rub for 5 min, rinse, dry with towel; comb with fine-toothed comb to remove nits; most require 1 oz, max 2 oz
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Available forms: shampoo, (1%)
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Administer: • Caregivers should wear gloves less permeable to lindane, thoroughly clean hands after application; avoid natural la- tex gloves • Shampoo: for lice only; do not use other hair products before use; shake well; hair should be completely dry; use only enough shampoo to lightly coat hair and scalp, work into hair, do not use water; allow to remain only 4 min, rinse, lather away, towel briskly • To scalp only; do not apply to face, lips, mouth, eyes, any mucous mem- brane, anus, or meatus • Topical corticosteroids as ordered to decrease contact dermatitis; antihista- mines • Lotions of menthol or phenol to con- trol itching • Topical antibiotics for infection
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Assess:
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Evaluate: • Therapeutic response: decreased crusts, nits, brownish trails on skin, itch- ing papules in skin folds, decreased itch- ing after several weeks
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To wash all inhabitants’ clothing using insecticide; that preventive treatment may be required of all persons living in same house, using lotion or shampoo to de- crease spread of infection; to use rubber gloves when applying product • That itching may continue for 4-6 wk • That product must be reapplied if ac- cidentally washed off or treatment will be ineffective • Not to apply to face; if accidental con tact with eyes occurs, flush with water
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PHARMACOKINETICS Onset 3 hr, half-life 18-22 hr
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• Adult/child: shampoo using 30 mL: work into lather, rub for 5 min, rinse, dry with towel; comb with fine-toothed comb to remove nits; most require 1 oz, max 2 oz
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