Lice and Pinworm

Lice - Pharm

RID	NIX	Ivermectin 0.5% Lotion
Synergized pyrethrins 0.17-0.33% combined with piperonyl butoxide 2-4% MOA: block nerve impulse transmission resulting in paralysis, death The piperonyl butoxide prevents breakdown of pyrethrins Indications: head and pubic lice Application Apply and leave on for 10 min Rinse/shampoo hair Use nit comb after Repeat in 7-10 days Localized ADRs	Permethrin 1% (synthetic pyrethroid) MOA: Na channel blockade of nerve cells leading to paralysis Indications: head lice Application Shampoo/rinse/towel dry hair Apply and leave on for 10 min Rinse hair Use nit comb after Repeat treatment not required unless lice observed in 7-10 days Localized ADRs **Remember: RID (DRI) = REPEAT, NIX = NO REPEAT	MOA: Binds to glutamate-gate chloride channels on nerve and muscle cells Nerve blockade, death Indications: head lice Application (Similar to RID) Apply on dry hair Leave on for 10 min Rinse hair (no shampoo for 24h) Product only applied once, if second application is needed → REFER Use of nit comb is not required Localized ADRs

Lice - Exclusion

• Exclusions:

  • Allergy

    • Chrysanthemums or pyrethrins (synergized pyrethrins)

    • Ragweed (potential cross sensitivity with synergized pyrethrins)

    • Pyrethrins (permethrin)

  • Presence of secondary infection in affected area

  • Age

    • <2 months for permethrins

    • <2 years for pyrethrins

  • Eyebrow or eyelid infestation

  • Pregnancy/breastfeeding

  • Presence of active tumors

  • Regional resistance to pediculicides

Pinworm - Pharm (dosing by weight, max dose)

• Pyrantel dosing by weight, max dose

• Pryantel Pamoate

  • Dosing: 11mg/kg 

  • Max Dose: 1g 

• May repeat in 2 weeks if s/x persist

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