Ivermectin Effects on Caenorhabditis elegans (C.elegans) Moyosore Olagoke Ivermectin C.elegans.
Ivermectin use in Scabies.ppt
-
Upload
truongkiet -
Category
Documents
-
view
235 -
download
2
Transcript of Ivermectin use in Scabies.ppt
![Page 1: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/1.jpg)
PRESENTER
DR. MD. ABDAL MIAHASSISTANT PROFESSOR
DERMATOLOGY & VENEREOLOGYMYMENSINGH MEDICAL COLLEGE,
MYMENSINGH
![Page 2: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/2.jpg)
CHAIRED BY
DR. MD. SHAHAB UDDIN AHMED CHOWDHURYAssociate Professor & Head
Department of Dermatology & VenereologyMymensingh Medical College, Mymensingh.
![Page 3: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/3.jpg)
TODY’S TOPIC IS
IVERMECTINUSE IN SCABIES
Source: American Family Physician (Review Journal)Sept 15, 2003, V-68, P-1089-92
![Page 4: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/4.jpg)
Scabies is a skin disease caused by infestation with the mite female gravid sarcoptes scabiei var hominis. Scabies has been a problem for humans since before the first millennium and was reported by the earliest writers who described mankinad’s health problems. It is estimated that there may be 300106 cases of scabies worldwide each year. Mostly, scabies is treated with topical scabicides, which needs to be used over whole or nearly whole skin surface, which is a difficult process.
INTRODUCTION
![Page 5: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/5.jpg)
So, non compliance or improper use of topical scabicides can result in scabies as a public health problem. So, the time honored demand was for systemic alternative. Now, oral ivermectin has appeared as an effective and cost-comparable alternative to topical agents in the treatment of scabies infection.
![Page 6: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/6.jpg)
![Page 7: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/7.jpg)
DIAGNOSIS OF SCABIES
The diagnosis of scabies usually is clinical but may be confirmed by microscopic identification of female mite, eggs and scybala in skin scrapings.
Key points for the diagnosis of scabies are the following:
![Page 8: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/8.jpg)
1. Morphology of skin lesions (i.e. type of eruptions)–Pathognomonic lesion– Linear burrows.
Nonspecific- Papular or papulovesicular or vesiculo-pustular lesions.Excoriations and ulcerations.Urticarial lesions- rarely.
![Page 9: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/9.jpg)
2. Typical distribution–Common sites (irrespective of age and sex).
Finger-webs, flexor surfaces of wrists, flexor surfaces of elbows, axillae, umbilicus, waistband, gluteal crease.
Male- genitaliaFemale- breasts (Areola and Nipple) Infants and young children-
Scalp, face, palms and soles
![Page 10: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/10.jpg)
![Page 11: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/11.jpg)
3. Pruritus– Usually intense, disproportionate to the amount of eruptions, worse at night and pleasant in quality.
4. Positive history in skin contacts.5. Definitive diagnosis rests on identification
of the mites or its products.Useful diagnostic methods:a) Direct examination of skin scrapings
under low power objective.b) Dermoscopy.c) PCR.
![Page 12: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/12.jpg)
TREATMENT
A. Treatment of patients: It includesi) Treatment of complicationsii) Symptomatic treatment andiii) Specific treatment with scabicides.
![Page 13: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/13.jpg)
Topical and systemic scabicides:a. Topical scabicides include
– Precipitated sulfur 6% or 7% in petroleum jelly– Benzyl benzoate emulsion 25%– Monosulfiram- a 25% solution– 1% Gamma benzene hexachloride (lindane)– Malathion 0.5%– Crotamiton 10%
b. Systemic scabicide- oral ivermectin 200 gm/kg- Single dose, may have to be repeated.
B. Treatment of contacts.C. Trcatment of house-hold utensils.
![Page 14: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/14.jpg)
IVERMECTIN First it was developed in the 1970s as a
veterinary treatment for animal parasites. It is a member of a family of macrolytic
lactones, the avermectins. It has broad spectrum activity against
parasites such asFDA approved- Strongyloidiasis
Onchocerciasis.Not FDA approved-Filariasis
Cutaneous larva migrans.Scabies.Pediculosis etc.
An estimated 6 million people world-wide have taken ivermectin for various parasitic infestations.
![Page 15: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/15.jpg)
Since 1993, it has been successfully used in different countries to treat human scabies that is resistant to treatment.
Some of the study results are shown below:
Study No. of patients Cured (%) Not Cured (%)1 26 96.15 3.852 11 100 003 100 83 174 11 (with AIDS) 70*
>90**30*
<10**
![Page 16: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/16.jpg)
Many other studies done by different groups such as Glaziou P et al, Dunne CL et al, Kar SK et al, Shouela EN et al, Madan V et al, Usha V et al also confirmed the efficiency of ivermectin as a treatment of scabies infection.
![Page 17: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/17.jpg)
SAFETY OF IVERMECTIN:Adverse effects such as anorexia, nausea, vomiting, rash, headache, dizziness, arthralgia, itching, eosinophilia, abdominal pain, fever, tachycardia etc may occur but occur very infrequently. No serious drug-related adverse events or significant drug interactions have been reported.
But its safety in young children and pregnant women– not established.
![Page 18: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/18.jpg)
A comparison of ivermectin with 5% permethrin is shown below:
Drug Efficacy Adverse effects
Cost Use in children
In pregnancy
Nursing women
Ivermectin 83-100% anorexia, nausea,
vomiting, rash,
headache, dizziness, arthralgia,
itching, eosinophilia, abdominal pain, fever, tachycardia
etc
Tk. 40*Tk. 80**
Safety not proved in children
<15 kg or <5 years
C Not recommended
Permethrin 91-98% Pruritus, burning, stinging
Tk. 40*Tk. 80**
Safe in children
2 months
B Not recommended
![Page 19: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/19.jpg)
Superiority of ivermectin over others:1. Easy route of administration– oral.2. Dose convenience– only single dose.3. Efficacy– very high- 98-100%.4. Safe– very infrequent side effects and not a
single major adverse event over 6 million users.
5. Cost effective.
So, many authors and publications consider it to be the treatment of choice.
![Page 20: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/20.jpg)
CONCLUSION Oral ivermectin, because of its single oral dosing, very high efficacy and safety, and low cost, may replace the other topical agents in the treatment of scabies. It may be particularly useful in the treatment of severely crusted scabies lesions in immunocompromised patients or when topical therapy has failed or application of topical agents is logistically difficult (e.g. large institutional outbreaks or mentally impaired patients).
![Page 21: Ivermectin use in Scabies.ppt](https://reader034.fdocuments.net/reader034/viewer/2022042600/5895a7651a28ab9d4e8bcddd/html5/thumbnails/21.jpg)
MESSAGE
We know the cause We know the mode of transmission We have multiple weapons to fight against
this mite. But this mite is winning the battle
affecting 300 million peoples each year around the globe.
So, IVERMECTIN may be the best weaponto win this battle.