Lindane

Third-line topical Antiparasitic Agent (other agents are preferred)
1. Scabies
2. Lice

Carcinogenic
Much greater risk of toxicity (esp. neurotoxicity) than with other agents
CNS toxicity 2-4 fold over Permethrin
1. Seizure risk in epileptics and children

Organochlorine similar to DDT
1. Used as an Insecticide for hardwood logs and on crops
2. Lindanes use as a topical pediculicide and scabicide is related to its neurotoxic effects in these Parasites
Organochlorine Agents
1. Chlorobenzilate
2. Dicofol
3. Dienochlor
4. Endosulfan
5. Lindane

Quantity
1. Adult (and child age >6 years): 30 to 60 ml
2. Child age <6 years: 30 ml
Scabies
1. Apply lotion to skin from neck to toes
2. Wash off in 8 to 12 hours
3. May repeat application in 1 week
4. Treat all family members
Lice
1. Apply Shampoo to dry hair
2. Massage into hair for 4 minutes before rinsing
3. Rinse thoroughly
4. Comb with fine tooth comb to remove nits
5. Repeat treatment in one week

Neurotoxicity
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. Findings
  1. Seizure
  2. Headache
  3. Paresthesias
  4. Incoordination
  5. Tremor
  6. Deaths have occurred
Other adverse effects (large exposures, ingestions)
1. Nose and throat irritation (inhalational exposure)
2. Anemia
3. Hepatotoxicity
4. Arrhythmia
5. Skin Irritation (topical)
6. Carcinogenic
Management of toxicitiy
1. Skin Decontamination
2. ABC Management
3. Seizure control with Diazepam
4. Intravenous Fluids (D5W) with Thiamine