Insect Bites, Stings, Pediculosis and Podiatry anki cards

Local Anesthetics Side Effects

-Itching, redness or worsening of dermatitis -Can cause ACD

Exclusions for Self-Treatment of Stings

1. Hives, excessive swellling, dizziness, weakness, nausea, vomiting, difficulty breathing 2. Significant allergic response away from site of sting 3. Previous sting (need to evaluate possible development of hypersensitivity 4. Previous severe reaction to insect bites 5. Personal or family history of significant allergic reaction 6. < 2 years of age

Exclusions for Self-Treatment of Insect Bites

1. Hypersensitivityto bites resulting in systemic symptoms 2. < 2 years of age 3. History of tick bite and systemic effects indicating possible infection 4. Suspected spider bite requiring medical attention 5. Signs of secondary infection of the bite area

Insect Repellant Permethrin Proper Use

Only for clothing and equipment Follow instructionsApply to equipment about 24-48 hours to exposureLet dry

Mosquito transmitted diseases

West Nile Malaria Zika Chikungunya

NonPharm options for warts

•Prevention of HPV spread -Do NOT cut, pick or shave warts/affected areas -Wash hands before and after treating warts -Do NOT use towels on wart infected area then on other body parts -Do NOT share towels, razors, socks, and shoes -Do NOT walk barefoot in public restrooms or public spaces •For patients experiencing discomfort from plantar warts, padding such as lamb's wool or moleskin

DEET < ____ % should be used in children.

30

Duration of Action of DEET 30%

About 5-6 hours

Duration of Action of Picaridin 20%

About 7-8 hours

Permethrin (Nix) MOA

Acts on the nerve cell membrane of lice; causes paralysis and death of the parasite

Topical Antihistamine Side Effects

Additional skin irritation or worsening of dermatitis

Exclusions for Self-Treatment of Warts

Age < 3 (salicylic acid products). Age < 4 years (cryotherapy products). Pregnancy/breast feeding. Mental or physical conditions that limit/prevent following product instructions. Chronic, debilitating conditions that affect sensitivity and/or poor blood circulation to hands and/or feet (eg diabetes, PVD, neuropathy). Immunocompromised patients. Large or multiple warts located on one area of the body. Bleeding, painful, discolored warts. Painful plantar warts. Warts located on the face, breasts, armpits, fingernails, toenails, anus, genitalia, or mucous membranes. Warts that have not resolved after 12 weeks of self-treatment. Salicylic acid: immunosuppressive medications or medications that contradict the use of salicylic acid; salicylate allergy.

Hydrocortisone Dosing

Apply as directed to the bite area 3 or 4 times daily for up to 7.

Local Anesthetics Dosing

Apply up 3 to 4 times daily up to 7 days.

Topical Antihistamine Dosing

Apply up to 3-4 times daily for no longer than 7 days.

Synergized Pyrethrins (RID) MOA

Block nerve impulse, causing the insect's paralysis and death

Avoiding Insect Bites

Cover skin. Avoid swamps, dense woods, and brush. Keep pets free of pests. Remove standing water. Limit time spent outside at dawn or dusk. Use barriers, window scree and netting. Apply insect repellent.

DEET MOA

Exact MOA is unknown Releases vapors that tend to discourage the approach of insects. Does not kill insects.

Insect Repellents

DEET Picaridin IR3535 Oil of lemon eucalyptus, catnip oil, etc Permethrin

Exclusions for Self-Treatment Corn/Callus

Diabetes, peripheral circulatory disease or other medical condition that contraindicates use of foot care products. Lesions hemorrhaging or ozzing purulent material. Anatomic defect or fault in body weight distribution. Extensive or painful, debilitaing corns/calluses on foot. Proper but unsuccessful self-medication attempt. History of rheumatoid arthritis and complaint of painful metatarsal heads or deviation of great toe.

Counseling for Insect Bite Products

Do not apply for longer than 7 days (Except skin protectants) Apply only to the affected area Do not apply under occlusive dressing Do not apply to face, genitalia or skin folds Do not wear rough, irritating clothing over bite area

Hydrocortisone Side Effects

Dry/cracking skin, local irritation

NonPharm options for insect bites/stings

For stings: Remove stinger; scraping the stinger away with the edge of a credit card is effective. Try not to squeeze or rub the stinger; these actions will actually release more venom. Apply antiseptic (eg H2O2 or alcohol). To avoid attracting stinging insects, avoid, perfumes, lotions and brightly colored cloths outdoors; wear shoes outdoors; destroy nests if near home. If you are hypersensitive to stings, wear a bracelet or carry a card showing the nature of the allergy. Apply ice packs in 10 minute intervals (helps decrease absorption and reduce itching, swelling, pain). Avoid scratching. For Insect BitesApply ice packs in 10 minute intervals (helps decrease absorption and reduce itching, swelling, pain). Avoid scratching.

Permethrin (Nix) Indication

Head lice

Synergized Pyrethrins (RID) Indications

Head, body, pubic lice

Exclusions for Self-Treatment Pediculosis

Hypersensitivity to chrysanthemums, ragweed, or pediculicide ingredients. Presence of secondary skin infection in lice-infested area. < 2 years of age for pyrethrins < 2 months of age for permethrins Lice infestation of eyelids or eyebrows Pregnancy/breast feedging. Presence of active tumors. Regional resistance to pediculicides.

Synergized Pyrethrins (RID) Adverse Effects

Irritation, erythema, itching and swelling

Salicylic acid MOA (12%, 15%, 17%, 40%)

Keratolytic agent; slowly destroys the virus-infected cells

Tick transmitted diseases

Lyme's Disease Rocky Mountain Spotted Fever

DEET Counseling

Read and follow all directions. Do not apply product over cuts, wounds, or irritated skin. Do not apply product to hands or near eyes and mouth of young children. Do not allow young children to apply this product. Use just enough repellent to cover exposed skin and/or clothing. Apply the sunscreen first, followed by the repellent, when sunscreen needs to be used in conjunction with a repellent. Do not use product under clothing. Avoid over application of this product. After returning indoors, wash treated skin with soap and water. Wash treated clothing before wearing it again. Product may damage synthetic fibers and plastics. Use of this product may cause skin reactions in rare cases. Do not spray product in enclosed areas. To apply to face, spray product on hands first, and then rub on face. Do not spray product directly onto face.

Skin Protectants Indication

Reduce inflammation and irritation

Local Anesthetics Indication

Relief of itching, irritation, and pain caused by insect bites

Avoiding Insect Bites

Salicylic acid 17% or less DMEP (dimethyl ether; propane) Nitrous oxide

Plantar wart treatment

Salicylic acid 40% Dimethyl ether; propane (DMEP) Nitrous oxide

Hydrocortisone Indication

Temporary relief of minor insect bites

Topical Antihistamine Indication

Temporary relief of pain and itching related to minor insect bites

Permethrin (Nix) Adverse Effects

Transient pruritus, burning, stinging, and irritation to scalp

Synergized Pyrethrins (RID) Instructions for use:

•Apply to dry hair including behind ears, back of neck or other affected area. •Apply for 10 minutes •Then, wet hair, lather and rinse. Can shampoo like normal afterwards •Comb with lice comb •Repeat in 9 days (2 treatment needed)

NonPharm options for corns/calluses

•Daily foot soak -Warm water for ~5 min -Followed by gentle skin removal •In shoe cushioning pads •Appropriate fitting shoes

Permethrin (Nix) Instructions for Use

•Wash hair (do not use conditioner); towel dry •Apply to damp hair for 10 minutes, then rinse with warm water and towel dry. •Follow with combing with lice comb. •Retreatment not needed. But may repeat treatment in 9 days (7-10 days, 9 days optimal) if active lice detected. •An alternate treatment schedule on days 0, 7, and 13 to 15 has been proposed on the basis of the longest possible life cycle of lice for this and other nonovicidal agents (eg, pyrethrins plus piperonyl butoxide

NonPharm options for pediculosis

•Wash hairbrushes, combs, and toys of infested patients in water at a temperature of 130°F (39.4°C) or higher for 10 minutes. •Use water at a temperature of 130°F (39.4°C) or higher to wash the clothes, bedding, and towels of infested patients. Dry the items on the hottest dryer setting that the fabric permits. •Objects or clothing that cannot be washed should be sealed in plastic bags for the length of the louse's life cycle (2 weeks) so that it is unable to feed on a host. •Avoid close physical contact with an infested patient; do not share articles such as combs, brushes, towels, caps, and hats. •Vacuum living areas thoroughly and regularly during treatment period. •Visually inspect the hair and scalp before, during, and after treatment for evidence of lice or nits. •Use a nit comb diligently to remove nits. •Comb the hair in segments. (Individual hairs can be trimmed if nit removal proves difficult.)