Exam 1 Study Guide Anthelmintics – Pinwoms ● Pyrantel Pamoate ○ OTC drug and is active against intestinal nematodes. This drugs is an alternative to mebendazole or albendazole for infestations with hookworms or pinworms ○ Mechanism of action: depolarizing neuromuscular blocking agent that causes spastic paralysis of intestinal parasites. Paralyzed worms are cleared in the feces ○ Adverse effects: ■ Neonates given formulations containing benzyl alcohol or its derivatives have developed a potentially fatal “gasping syndrome” w/ complications that include respiratory distress, cardiovascular collapse, seizures and metabolic acidosis ■ GI effects: N/V, diarrhea, stomach pain, cramps ■ CNS effects: dizziness, drowsiness, headache, and insomnia Ectoparasites – scabies and lice ● ● Scabies treatment ○ Pesticide-containing lotion or cream such as permethrin (5% formulation) ○ Entire body surface must be treated (excluding face and scalp in adults) ○ Single oral dose of ivermectin ○ Other options: crotamiton, malathion and lindane (lindane should not be used in children) ○ To prevent reinfestation, bedding and intimate clothing should be machine washed and dried ○ Intense itching continues for a week or two after successful treatment due to hypersensitivity reaction to the burrowed dead mites, feces, and eggs. Educate the patient on this issue before treatment Lice treatment ○ Head lice: ■ topical pediculicides are preferred such as: permethrin, pyrethrins, malathion,lindane, spinosad, and topical ivermectin ■ Drugs that suffocate the lice: benzyl alcohol ■ first -line therapy for children: 1% permethrin or pyrethrins ■ Choice of agent depends on the amount of resistance lice has developed ■ After drug treatment, dead lice and nits should be removed with a fine-toothed comb ○ Body lice: ■ Most body lice can be removed from host by removing the infested clothing; any remaining lice can be killed with pesticide (permethrin and malathion) ■ clothing and bedding should be disinfected by washing and drying at high temperature ● ■ Oral ivermectin is used if topical treatments fail ○ Pubic lice: ■ Permethrin (1% lotion) and malathion (0.5% lotion) are drugs of choice for eliminating crabs ■ Alternatives are pyrethrins with piperonyl butoxide and oral ivermectin ■ Eyelash infestation is treated with petrolatum ophthalmic ointment ■ Clothing and linen should be disinfected by washing and drying at high temperature Permethrin – oral and topical ○ See above^ Neurosensory function – pain ● ● Opioids (morphine) ○ Addiction ■ Physical dependence and tolerance is seen due to both because of the analgesic and euphoric properties of opioids ■ Physical dependence comes from the fact opioids can cause withdrawal ○ Acute pain ■ Acute < 6 months ■ Chronic > 6 months ○ Side effects – which ones reduce over time and which ones do not ■ Respiratory depression ■ Constipation ■ nephrotoxicity ■ Urinary retention -- foley catheter ■ euphoria/dysphoria ■ Sedation ■ Pain relieving (analgesic) Naloxone ○ Used to reverse effects of opioids, opioid overdose RNmath ● ● ● ● Conversions (ounces to mL, teaspoons to mL, etc) single doses Total amount of a drug in a vial Input and output calculations