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Lindane is an organochloride insecticide that has similar neurotoxic protperties to DDT. It exerts its parasiticidal action by being directly absorbed through the parasite's exoskeleton (primarily lice, or scabies) and their ova. The gamma-aminobutyric acid (GABA(1)) receptor/chloride ionophore complex is the primary site of action for lindane, and other insecticides such as endosulfan, and fipronil. Blockage of the GABA-gated chloride channel reduces neuronal inhibition, which leads to hyperexcitation of the central nervous system. This results in paralysis, convulsions, and death. Lindane has very low ovicidal activity.
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Lindane is absorbed significantly through the skin. A mean peak blood concentration of 28 nanograms per mL occurred in infants and children 6 hours after total body application of lindane lotion for scabies.
Lindane is a moderately toxic compound via oral exposure, with a reported oral LD50 of 88 to 190 mg/kg in rats. Gamma-HCH (which constitutes 99% of lindane) is generally considered to be the most acutely toxic of the isomers following single administration. It is moderately toxic via the dermal route as well, with reported dermal LD50 values of 500 to 1000 mg/kg in rats, 300 mg/kg in mice, 400 mg/kg in guinea pigs, and 300 mg/kg in rabbits. Acute exposure to lindane may lead to central nervous system stimulation (usually developing within 1 hour), mental/motor impairment, excitation, clonic (intermittent) and tonic (continuous) convulsion. Other adverse reactions include central nervous system toxicity, as well as skin and gastrointestinal changes.
Scaboma Lotion is an Anti-parasitic lotion used for the treatment of Scabies (skin infection caused by mites) and Pediculosis (infestation of lice in the scalp). It contains Gamma Benzene Hexachloride as an active ingredient.
Always use Scaboma Lotion exactly as advised by your doctor. It is for external use only. Shake well before use. Wash your hands before and after applying the lotion. Take a sufficient amount of lotion and gently massage it over the affected area. Wash it off the skin completely after 8-10 hours with warm water or as directed by the doctor. Avoid contact with eyes and mouth.
A: Scaboma Lotion is for external use only. Shake well before use. When you apply Scaboma Lotion to yourself or someone else, wear gloves made of nitrile, sheer vinyl, or latex with neoprene. Do not wear natural latex gloves as they will not prevent lotion from reaching your skin. Dispose of your gloves and wash your hands well after applying the lotion. Avoid contact with eyes. If such contact occurs, eyes should be immediately flushed with water. Consult your doctor If irritation or sensitization occurs.
Calamine lotion causes a cooling sensation on your skin that helps relieve itching. Clean your skin with soap and water and let dry. Then apply the lotion to your skin with cotton or a soft cloth. You can use calamine lotion up to four times per day.
Two hundred scabies patients were randomly allocated to receive either oral ivermectin in a single dose of 200 micrograms/kg body weight, or 1% lindane lotion for topical application overnight. Patients were assessed after 48 hours, two weeks and four weeks. After a period of four weeks, 82.6% of the patients in the ivermectin group showed marked improvement; only 44.44% of the patients in the lindane group showed a similar response. Oral ivermectin is easy to administer as a single oral dose, induces an early and effective improvement in signs and symptoms, and compliance is accordingly increased.
This medicine is for external use only. It is poisonous if taken by mouth. Follow the directions on the prescription label. Make sure you know how to properly use the lotion. Do not get this medicine in your eyes. If you do, rinse out with plenty of cool tap water. Seek medical help if the eyes are hurting. Do not use more medicine than prescribed.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not freeze. Keep container tightly closed. After applying the treatment, close the bottle with the leftover lotion and throw it away in a trashcan out of the reach of children. Do not keep this medicine after using it.
To prevent reinfestation, contaminated items such as bedding, clothing, towels, and hats should be washed in hot water and dried in the dryer using the hot cycle for at least 20 minutes. If items cannot be washed and dried this way, dry-clean them or seal them in a plastic bag for 2 weeks and wash normally. For head lice, combs and brushes should be soaked in hot water above 54C or in undiluted lindane for 5 to 10 minutes and rinsed with hot water.
Children: Children are at an increased risk of absorbing too much lindane into their bloodstream. If possible, a safer option should be used in children. Lindane is not recommended for use in children under 6 years old. If lindane is used to treat scabies in young children, they should be dressed in long sleeves, pants, and gloves or mitts to prevent the possibility of lindane entering the mouth.
Lindane, a persistent pesticide once extensively used worldwide, was withdrawn for agricultural uses in the U.S. in 2006, and targeted for global phaseout under an international treaty by more than 160 nations in 2009. However, due to aggressive lobbying by Morton Grove, the main distributor of lindane pharmaceutical products in the U.S., the chemical has remained in lice and scabies products in this country.
"We can't remove every potentially harmful chemical exposure from a child's life, making it imperative to remove those that we can," said Deborah Altschuler, president and co-founder of the National Pediculosis Association. The NPA first testified against lindane at FDA hearings in 1983 and 1984, and developed an online resource center at headlice.org.
Many health care professionals already use a wide range of alternatives to lindane including combing tools specially designed to remove lice and nits, as well as essential oils and extracts to treat scabies.
Lindane 1% cream or lotion (also known as gamma benzene hexachloride) has been found to be an effective alternative option in treating this ectoparasitosis. Nevertheless, its potential neurotoxicity (especially with repeated applications) has limited its use; thus, the product is no longer available in certain countries.
Crotamiton is used as 10% cream or lotion with a success rate between 50% and 70%, significantly less effective than permethrin. Although this topical agent is labeled for application over 1 to 2 days, daily application for 5 days has yielded improved cure rates.
The effectiveness of malathion 0.5% lotion has been demonstrated by several small studies, with cure rates ranging from 83% to 100%. It is appropriate for treating hairy areas of the body (such as the scalp) and requires two applications 7 days apart.
Organochlorines tend to be well-absorbed orally, and all undergo extensive hepatic metabolism once absorbed. Skin absorption is variable: lindane and cyclodienes demonstrate excellent dermal penetrability, whereas DDT and toxaphene are poorly absorbed through skin.
Lindane is the most well studied organochlorine with regard to pharmacokinetics, and demonstrates how different anatomic sites show variability in absorption characteristics. For example, 9% of a topically applied dose of lindane is absorbed from the skin of the forearm, while almost 100% can be absorbed through the thinner skin of the scrotum and perineum. Studies also show that younger, malnourished and repeatedly exposed patients are at increased risk for transdermal absorption of lindane and toxicity. One gram of lindane topically can result in seizures in children, and 10 g are considered potentially lethal in adults. Lindane shows a peak serum concentration approximately 6 hours after a topical exposure and the serum half-life is 18 hours to several days due to its lipophilic nature.
The major acute effect of the organochlorine agents is central nervous system stimulation. Several mechanisms seem to contribute to this effect. DDT causes axonal sodium channels to remain open longer than normal, contributing to a general hyperexcitability of nervous tissues. Other organchlorines, such as lindane and the cyclodienes, affect the functions of GABA by antagonizing (inhibiting) the CNS GABA receptors. Each of these mechanisms results in CNS hyperexcitability, resulting in seizures, tremors, paresthesias, ataxic gait and other neurological effects.
Some of these agents can cause sudden seizures, without any prodromal symptoms. These include lindane, cyclodienes and toxaphene. These sudden seizures can happen from 1 to 6 hours post-exposure, and the effects can last for days in severe cases.
In the past there were many reports of lindane toxicity in children, where it was often used as a pediculocide. Young children seem to be especially vulnerable to transdermal lindane toxicity for a combination of reasons: immature liver enzymes, increased skin surface area-to-weight ratio, low cost and wide-spread availability of lindane, and inappropriate skin application. Lindane formulations in concentrations of 1% or higher are especially dangerous, and can cause seizures in young children even after a single inappropriate or excessive application. Repeated exposures and malnutrition also increase the risk of toxicity. In addition, nausea, vomiting, cyanosis or pallor, and hypotension can also be seen with toxic exposures. There are also reports of hematologic toxicity (pancytopenia and aplastic anemia) with repeated exposures to lindane.
Definitive laboratory confirmation of the presence of organochlorines in the serum, urine or tissues can be done using gas chromatography, but this process typically takes days and is not useful in the acute management of these agents. Where lindane is suspected as a toxin, serum concentrations can help to guide management and prognosis. A level of 0.02 to 0.20 mg/L is indicative of a toxic exposure with higher levels at greater risk for seizures. Poison center and toxicologist consultation is recommended for any suspected ingestions when specific laboratory testing for organochlorine levels is ordered. It is important to note that specialized testing is not readily available so test results may be delayed for days to weeks after specimens are collected and sent; clinical signs and symptoms are therefore paramount for diagnosis and management of these ingestions. 041b061a72