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Name /bks_53161_deglins_md_disk/malathion
02/17/2014 07:16AM
1
Ovide
Classification
Therapeutic: pediculocides
Pregnancy Category B
Route/Dosage
Topical (Adults and Children ⱖ2 yr): Apply lotion to dry hair and rub until scalp
is moistened; follow 8– 12 hr later with nonmedicated shampoo; additional application may be required after 7– 9 days.
Indications
Treatment of head lice and their eggs (Pediculus humanus capitus).
Action
Acts as a cholinesterase inhibitor, causing death of lice and their eggs. Therapeutic
Effects: Eradication of head lice and their eggs.
● Assess scalp for presence of lice and their ova (nits) prior to and 1 wk after appli-
Potential Nursing Diagnoses
Impaired home maintenance (Indications)
Bathing/hygiene self-care deficit (Indications)
Implementation
● Topical: For topical application only.
TIME/ACTION PROFILE (pediculicidal effect)
PEAK
12 hr
NURSING IMPLICATIONS
Assessment
cation.
Pharmacokinetics
Absorption: Minimal absorption (⬍10%) with topical application.
Distribution: Binds to hair shaft, which may protect against reinfestation.
Metabolism and Excretion: Metabolized to malaoxon, and excreted.
Half-life: 8 hours.
ONSET†
6 hr
DURATION
persists after application†
Patient/Family Teaching
● Instruct patient to apply lotion to dry hair and rub until scalp is moistened; follow
†Due to binding to hair shaft
Contraindications/Precautions
Contraindicated in: Hypersensitivity; Known alcohol intolerance.
Use Cautiously in: OB: Use only if needed; Lactation: Safety not established;
●
Pedi: Children ⬍2 yr (safety not established).
Adverse Reactions/Side Effects
EENT: ocular irritation (with accidental eye exposure). Derm: burns, scalp irrita-
●
tion.
●
Interactions
Drug-Drug: These interactions would only occur if large amounts of malathion
were absorbed. Additive toxicity may occur with carbamate or organophosphate⫽ Canadian drug name.
pg 1 # 1
type insecticides/pesticides. May cause additive respiratory depression with parenteral aminoglycosides.qrisk of systemic toxicity with ester-type local anesthetics, antimyasthenics or cholinesterase inhibitors (including
ophthalmics). May alter the response to edrophonium in patients with myasthenic
weakness.
malathion (ma-la-thi-on)
ROUTE
Topical
Plate # 0-Composite
⫽ Genetic Implication.
●
8– 12 hr later with nonmedicated shampoo. Comb hair with a fine-toothed comb
to remove dead lice and eggs (not necessary but may be desired for cosmetic effects). If required, repeat application in 7– 10 days. Schools usually require children to be nit-free prior to returning to school.
Instruct patient and parent that product is alcohol-based and flammable. Hair
should be allowed to air-dry naturally. Do not use hairdryers, smoke around wet
hair, or expose wet hair to open flames.
Instruct patient to notify health care professional if scalp itching, redness, or rash
occurs.
Instruct patient to avoid getting malathion in eyes. If this occurs, eyes should be
flushed thoroughly with water. Health care professional should be contacted if eye
irritation persists.
Advise patient that others residing in the home should also be checked for lice.
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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Plate # 0-Composite
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● Instruct patient on methods of preventing reinfestation. All clothes, including out-
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door apparel and household linens, should be machine-washed using very hot
water and dried for at least 20 min in a hot dryer. Dry-clean nonwashable clothes.
Brushes and combs should be soaked in hot (130⬚F), soapy water for 5– 10 min.
Remind patient that brushes and combs should not be shared. Wigs and hairpieces should be shampooed. Rugs and upholstered furniture should be vacuumed. Toys should be washed in hot, soapy water. Items that cannot be washed
should be sealed in a plastic bag for 2 wk.
● If patient is a child, instruct parents to notify school nurse or daycare center so that
classmates and playmates can be checked for lice.
Evaluation/Desired Outcomes
● The absence of lice and eggs 1 wk after therapy. A 2nd application is indicated if
lice are detected at this time.
Why was this drug prescribed for your patient?
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