G-Well, Hexit, PMS Lindane, Scabene
Gamma-benzene hexachloride, GBH
Therapeutic: pediculicides, scabicides
Second-line treatment of parasitic arthropod infestation (scabies and head, body, and crab lice) for use only in patients who are intolerant to or do not respond to less toxic agents.
Causes seizures and death in parasitic arthropods. Therapeutic Effects: Cure of infestation by parasitic arthropods.
Adverse Reactions/Side Effects
All adverse reactions except dermatologic are signs of systemic absorption and toxicity
CNS: SEIZURES, headache. CV: tachycardia. GI: nausea, vomiting. Derm: contact dermatitis (repeated application), local irritation.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Monitor signs of systemic absorption and toxicity. Signs include headache, seizures, fast heart rate (tachycardia), and GI reactions (nausea, vomiting). Report these signs to the physician immediately.
Monitor the administration site(s) for local irritation or inflammation. Report severe or prolonged skin reactions to the physician.
Check that the patient and family or caregivers understand topical application procedures and adhere to the recommended dosing schedule.
Instruct patient about proper hygiene, e.g., thoroughly wash and dry the affected areas, do not share combs or hair brushes, avoid sexual contact with carriers of lice or crabs, and so forth.
Absorption: Significant systemic absorption (9–13%) greater with topical application to damaged skin.
Distribution: Stored in fat.
Metabolism and Excretion: Metabolized by the liver.
Half-life: 17–22 hr (infants and children).
TIME/ACTION PROFILE (antiparasitic action)
|ROUTE ||ONSET ||PEAK ||DURATION |
|topical ||rapid ||6 hr ||190 min |
Contraindicated in: Hypersensitivity; Areas of skin rash, abrasion, or inflammation (absorption is increased); History of seizures; Lactation; Premature neonates(increased risk of CNS toxicity).
Use Cautiously in: Pregnancy (do not exceed recommended dose; do not use >2 courses of therapy); Children ≤2 yr, geriatric patients, patients with skin conditions (increased risk of systemic absorption and CNS side effects).
Drug-Drug: Concurrent use of medications that lower seizure threshold (may ↑ risk of seizures). Simultaneous topical use of skin, scalp, or hair products may increase systemic absorption.
Topical (Adults and Children >1 mo): 1% lotion applied to all skin surfaces from neck to toes; wash off 6 hr after application in infants, after 6–8 hr in children or after 8–12 hr in adults; may require a 2nd treatment 1 wk later.