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Permethrin

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VOL: 101, ISSUE: 22, PAGE NO: 29

Generic and proprietary names

Generic and proprietary names
- Permethrin.

- Lyclear.

Action
- Interferes with the nervous system of parasites, paralysing and eventually killing them.

- Permethrin is active against head lice but formulation of current products makes them unsuitable for treating head lice.

Classification
- Parasitical preparation.

Indications
- Scabies.

- Crab lice (Phthirus pubis).

Contraindications
- Not to be used on broken or secondarily infected skin.

- Avoid use in children under six months.

Cautions
- Medical supervision is required if using dermal cream to combat scabies in children aged between two months and two years.

- Avoid contact with eyes.

Common side-effects
- Pruritus.

- Erythema.

- Stinging.

Rare side-effects
- Rashes.

- Oedema.

Administration
- Topical cream.

Nursing considerations
Scabies

- Avoid application after bathing as raised temperature may increase absorption into the blood and remove the preparation from the site of action.

- Two applications of permethrin with a week between doses.

- In patients with hyperkeratotic scabies, two to three applications on consecutive days may be needed to ensure preparation penetrates the crusts of skin to kill all the mites.

Crab lice

- Preparation should be applied, allowed to dry naturally and washed off after 12 hours.

- A repeat treatment must be applied a week later to kill lice from any surviving eggs.

Patient teaching
- Permethrin should be kept in a closed container in a cool, dry place and out of the reach of children.

- Permethrin should be protected from light.

Scabies

- All members of the affected family should be treated at the same time.

- The preparation should be applied to the whole body including the neck, face, scalp and ears.

- The preparation must be applied to the webs of the toes and fingers.

- It is important to reapply the preparation to the hands after washing them.

- The itch can persist for some time after the infestation has been eliminated.

Crab lice

- All surfaces of the body must be treated including the scalp, ears, neck and face.

- It is important not to miss the eyebrows and any other facial hair such as beards.

- Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines.

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