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Chapter 99Chapter 99

EctoparasiticidesEctoparasiticides

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EctoparasiticidesEctoparasiticides

Parasites live on surface of hostParasites live on surface of host Scabies (Scabies (Sarcoptes scabieiSarcoptes scabiei)) Pediculosis—lice (Pediculosis—lice (Pediculus humanusPediculus humanus))

Pubic (pubis)Pubic (pubis) Head (capitis) Head (capitis) Body (corporis)Body (corporis)

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Pharmacology of EctoparasiticidesPharmacology of Ectoparasiticides

Topical drugsTopical drugs Forms: creams, gels, lotions, shampoosForms: creams, gels, lotions, shampoos Principal agentsPrincipal agents

• Permethrin (Nix, Elimite, Acticin) Permethrin (Nix, Elimite, Acticin) – – resistance can resistance can developdevelop

• Malathion (Ovide)Malathion (Ovide)• Crotamiton (Eurax)Crotamiton (Eurax)

Oral treatmentOral treatment Ivermectin (Stromectol)Ivermectin (Stromectol)

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PermethrinPermethrin

Trade names: Nix, Elimite, ActicinTrade names: Nix, Elimite, Acticin Toxic to mites, lice, and their ova (also fleas Toxic to mites, lice, and their ova (also fleas

and ticks)and ticks) Residual activity up to 2 weeks after Residual activity up to 2 weeks after

treatmenttreatment Only one application is generally requiredOnly one application is generally required Devoid of serious side effectsDevoid of serious side effects

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MalathionMalathion

Trade name: OvideTrade name: Ovide Organophosphate cholinesterase inhibitorOrganophosphate cholinesterase inhibitor Kills lice and their ovaKills lice and their ova Approved for treatment of head liceApproved for treatment of head lice Devoid of significant side effectsDevoid of significant side effects

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CrotamitonCrotamiton

Trade name: EuraxTrade name: Eurax Used to treat scabiesUsed to treat scabies Not indicated for pediculosisNot indicated for pediculosis Massaged into the skin of the entire bodyMassaged into the skin of the entire body A second application at 24 hours is neededA second application at 24 hours is needed Treatment may be repeated in 7 daysTreatment may be repeated in 7 days

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Pharmacology of EctoparasiticidesPharmacology of Ectoparasiticides

Adverse effectsAdverse effects Skin irritationSkin irritation Temporary burning, stinging, and numbnessTemporary burning, stinging, and numbness