II. Precautions

  1. Do not use in infants
  2. Much greater risk of toxicity than with other agents
  3. Percutaneous absorption 10-20 fold over Permethrin
  4. Serum levels are 40 fold higher than Permethrin
  5. CNS toxicity 2-4 fold over Permethrin
    1. Seizure risk in epileptics and children

III. Mechanism

  1. Organochlorine similar to DDT
  2. Organochlorine Agents
    1. Chlorobenzilate
    2. Dicofol
    3. Dienochlor
    4. Endosulfan
    5. Lindane

IV. Indications

V. Preparation

  1. Lindane 1% Shampoo (60 ml)
  2. Lindane 1% Lotion (60 ml)

VI. Directions for use

  1. Scabies
    1. Apply lotion to skin from neck to toes
    2. Wash off in 6 to 8 hours
    3. Repeat application in 1 week
  2. Lice
    1. Apply Shampoo to dry hair
    2. Massage into hair for 4 minutes before rinsing
    3. Rinse thoroughly and comb with fine tooth comb
    4. Repeat treatment in one week

VII. Adverse Effects

  1. Mechanism
    1. Disrupts axonal Sodium and Potassium flow
    2. Affects both central and peripheral nerves
    3. Higher toxicity in broken skin and young children
  2. Effects: Neurotoxicity
    1. Seizure
    2. Headache
    3. Paresthesias
    4. Incoordination
    5. Tremor
  3. Management of toxicitiy
    1. Skin Decontamination
    2. ABC Management
    3. Seizure control with Diazepam
    4. Intravenous Fluids (D5W) with Thiamine

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Cost: Medications

lindane (on 9/23/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
LINDANE 1% LOTION Generic $1.76 per ml
LINDANE 1% SHAMPOO Generic $1.67 per ml

Ontology: Lindane (C0005038)

Definition (MSHCZE) Organochlorový insekticid, který se užíval proti vším a svrabu. Prokázalo se, že způsobuje rakovinu.
Definition (NCI) The gamma-isomer of benzene hexachloride, a colorless to white colored, synthetic, crystalline solid with a slight musty odor that emits toxic fumes of hydrochloric acid and other chlorinated compounds when heated to decomposition. Lindane is used as an insecticide for hardwood logs, lumber, and crops. Lindane also has topical pediculicide and scabicide activities probably due to its neurotoxic effects. Inhalation exposure to this substance causes severe irritation of the nose and throat, causes anemia, and affects the liver, nervous, cardiovascular, and immune system. Lindane is reasonably anticipated to be a human carcinogen.
Definition (MSH) An organochlorine insecticide that has been used as a pediculicide and a scabicide. It has been shown to cause cancer.
Definition (CSP) gamma isomer of benzene hexachloride, a carcinogenic insecticide more potent than DDT (chlorophenothane); it is used to kill lice and mites, applied topically to the skin.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109) , Hazardous or Poisonous Substance (T131)
MSH D001556
SnomedCT 77496001, 49490007, 333056004
LNC LP15064-6, MTHU002397
English Benzene Hexachloride, gamma-Benzene Hexachloride, gamma-Hexachlorocyclohexane, Hexachlorane, Hexachloride, Benzene, Hexachloride, gamma-Benzene, Hexachlorocyclohexane, Lindane, Cyclohexane, 1,2,3,4,5,6-hexachloro-, (1alpha,2alpha,3beta,4alpha,5alpha,6beta)-, gamma Benzene Hexachloride, gamma Hexachlorocyclohexane, g-Benzene Hexachloride, gamma-HCH, (1alpha,2alpha,3beta,4alpha,5alpha,6beta)1,2,3,4,5,6-Hexachlorocyclohexane, Gammahexachlorcyclohexane, Gammahexachlorocyclohexane, Benzene hexachloride, gamma benzene hexachloride (medication), gamma benzene hexachloride, Lindane [Chemical/Ingredient], lindane products, LINDANE, lindane, Benzene hexachloride (substance), Lindane product, gamma Benzene hexachloride, Lindane product (product), gamma Benzene hexachloride (substance), gamma hexachlor, Lindane product (substance), Gamma hexachlorocyclohexane
Swedish Lindan
Czech hexachlorocyklohexan, lindan, gama-benzenhexachlorid, gama-hexachlorcyklohexan, benzenhexachlorid, hexachloran, lindan (BHC), gama benzene hexachloride, hexachlorcyklohexan
Finnish Lindaani
Russian GEKSAKHLORTSIKLOGEKSAN, LINDAN, BENZOLGEKSAKHLORID, GAMMA-BENZOLGEKSAKHLORID, БЕНЗОЛГЕКСАХЛОРИД, ГАММА-БЕНЗОЛГЕКСАХЛОРИД, ГЕКСАХЛОРЦИКЛОГЕКСАН, ЛИНДАН
Japanese γ-ベンゼンヘキサクロライド, ベンゼンヘキサクロリド, ベンゼンヘキサクロライド, ヘキサクロルシクロヘキサン, リンダン, 六塩化ベンゼン, ヘキサクロロシクロヘキサン, ガンマ-ベンゼンヘキサクロライド
Spanish lindano, lindano, producto (producto), lindano (producto), lindano, producto, hexaclorociclohexano, hexacloruro de benceno, hexacloruro de benceno (sustancia), hexacloruro de gamma benceno (sustancia), hexacloruro de gamma benceno, Hexaclorociclohexano, Hexacloruro de Benceno, Hexacloruro de gammabenceno, Lindano
Polish Gameksan, Lindan, Heksachlorocykloheksan
French Lindane, Hexachlorocyclohexane, Hexachloro-cyclohexane
German Benzen-Hexachlorid, Gamma-Benzen-Hexachlorid, Hexachlorcyclohexan, Lindan
Italian Lindano
Portuguese Hexacloreto de Benzeno, Hexacloreto de gama-Benzeno, Hexaclorocicloexano, Lindano

Ontology: Hydrocarbons, Chlorinated (C0020247)

Definition (NCI) Organochlorines are a group of compounds belonging to the chlorinated hydrocarbon pesticides (as aldrin, DDT, or dieldrin). These compounds are believed to associated with many cancers, especially with breast cancer.
Definition (CSP) organic compound that contains carbon and hydrogen, with chlorine atoms substituting for one or more hydrogens.
Definition (MSH) Hydrocarbon compounds with one or more of the hydrogens replaced by CHLORINE.
Concepts Organic Chemical (T109)
MSH D006843
SnomedCT 56181003
LNC LP14503-4, MTHU003714
English Chlorinated Hydrocarbons, Hydrocarbons, Chlorinated, Chlorine Compounds, Organic, Compounds, Organic Chlorine, Organic Chlorine Compounds, chlorohydrocarbon, ORGANOCHLORINE CPDS, Hydrocarbons, Chlorinated [Chemical/Ingredient], chlorinated hydrocarbon, chlorohydrocarbons, chlorinated hydrocarbons, Hydrocarbons.chlorinated, Chlorohydrocarbons, Chlorinated hydrocarbon, Chlorinated hydrocarbon (substance), Chlorinated hydrocarbon, NOS, Compounds, Organochlorine, Organochlorine Compounds, Organochlorine Compound, Organochlorines
Swedish Kolväten, klorerade
Czech uhlovodíky chlorované
Finnish Kloorihiilivedyt
Russian KHLORIROVANNYE UGLEVODORODY, UGLEVODORODY KHLORIROVANNYE, УГЛЕВОДОРОДЫ ХЛОРИРОВАННЫЕ, ХЛОРИРОВАННЫЕ УГЛЕВОДОРОДЫ
Japanese 塩素化炭化水素, 炭化水素-塩素化
Italian Composti organici del cloro, Composti organoclorici, Idrocarburi clorinati
Croatian Not Translated[Hydrocarbons, Chlorinated]
Polish Chloropochodne węglowodorów
Spanish hidrocarburo clorado (sustancia), hidrocarburo clorado, Hidrocarburos Clorados
French Hydrocarbures chlorés
German Chlorierte Kohlenwasserstoffe, Kohlenwasserstoffe, chlorierte
Portuguese Hidrocarbonetos Clorados

Ontology: Kwell (C0591692)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D001556
English pediculicides gamma benzene hexachloride (kwell), gamma benzene hexachloride (Kwell), Kwell
Czech Kwell