Spinosad

INTRODUCTION

Indications

Treatment of head lice in adults and children >4 yr.

Action

Causes neuronal hyperexcitation in insects, resulting paralysis and death of lice. Therapeutic Effects: Eradication of head lice.

Adverse Reactions/Side Effects

EENT: ocular erythema. Local: erythema.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor symptoms such as itching scalp to help document drug effectiveness.

• Watch for and report excessive redness, warmth, and irritation in the scalp and eyes.

Interventions

• Avoid contact with infected areas or wear protective gloves when treating patient.

• Always wash hands thoroughly and disinfect bedding and equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection.

Patient/Client-Related Instruction

• Advise patient to report any increased local sensitivity to this drug.

• Instruct patient about proper hygiene; e.g., clean or discard infected clothing, not share combs and hats with others, thoroughly wash and dry the scalp, and so forth.

• Advise patient to apply the drug as directed; that is, apply the drug topically for the recommended period of time before washing off.

Pharmacokinetics

Absorption: Undetectable systemic absorption follows topical use.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown

Contraindications/Precautions

Contraindicated in: Pedi: Children <6 mo (↑ risk of benzyl alcohol absorption).

Use Cautiously in: OB: Use in pregnancy only if clearly needed; Lactation: use with caution; Pedi: Safe and effective use in children <4 yr not established.

Interactions

Drug-Drug: None noted.

Route/Dosage

Topical (Adults and Children >4 yr): Apply amount necessary to wet scalp, leave in place for 10 min, then rinse; may be repeated after 7 days if live lice are still seen.

Availability

Topical suspension: 0.9% in 120-mL bottles