1. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc. Chapter 99 Ectoparasiticides

2. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.2 Ectoparasiticides  Parasites live on surface of host  Scabies (Sarcoptes scabiei)  Pediculosis—lice (Pediculus humanus)  Pubic (pubis)  Head (capitis)  Body (corporis)

3. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.3

4. 4 Pharmacology of Ectoparasiticides  Topical drugs  Forms: creams, gels, lotions, shampoos  Principal agents Permethrin (Nix, Elimite, Acticin) – resistance can develop Permethrin (Nix, Elimite, Acticin) – resistance can develop Malathion (Ovide) Malathion (Ovide) Crotamiton (Eurax) Crotamiton (Eurax)  Oral treatment  Ivermectin (Stromectol)

5. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.5 Permethrin  Trade names: Nix, Elimite, Acticin  Toxic to mites, lice, and their ova (also fleas and ticks)  Residual activity up to 2 weeks after treatment  Only one application is generally required  Devoid of serious side effects

6. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.6 Malathion  Trade name: Ovide  Organophosphate cholinesterase inhibitor  Kills lice and their ova  Approved for treatment of head lice  Devoid of significant side effects

7. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.7 Crotamiton  Trade name: Eurax  Used to treat scabies  Not indicated for pediculosis  Massaged into the skin of the entire body  A second application at 24 hours is needed  Treatment may be repeated in 7 days

8. Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.8 Pharmacology of Ectoparasiticides  Adverse effects  Skin irritation  Temporary burning, stinging, and numbness