ANTHELMINTIC DRUGS ( antihelmintics)

You should be able to choose drugs of choice for common infection of nematodes, trematodes and cestode

Describe the mechanism of action and major toxic effect of the anthelmintic drugs

Albendazole Mebendazole ( visceral larval migrans) Thiabendazole Praziquantel Diethylcarbamazine citrate Ivermectin ( cotaneous larva migrans, filariasis)

Niclosamide Piperazine citrate Pyrantel pamoat

1.
2. 3.

4.
5. 6.

Albendazole Diethylcarbamazine Ivermectin Benzimidazoles Pyrantel pamoate Piperazine

Mechanism unknown
Clinical use
Filariasis (DOC) Alternative for onchocerciasis

Toxicity: fever,rashes,ocular damage, joint and muscle pain,lymphangitis.

Mechanisms: intensifies GABA-mediated neurotransmission in nematodes Clinical use: Active on most common intestinal worms (except tapeworms), most mites, and some lice. Strongyloides stercoralis, onchocerciasis (DOC). And alternative agent in filariasis Toxicity: fever, headache, dizziness, rashes, pruritus, tachycardia, hypotensi, pain in joints, muscle and lymph glands (Mazzotti reactions)

Albendazole, mebendazole, thiabendazole Inhibit glucose absorption and inbiting microtubule synthesis Poorly absorbed (PO). Active against nematodes (drugs of choice). Toxicity: gastrointestinal irritation, allergic reaction, embryotoxicity

Mechanisms: stimulate nicotinic receptor present at Neuromuscular junction of nematodes. Contraction of muscle occurs depolarization-induced paralysis
Clinical use: drugs of choice for infection due ti hookworm, pinworm and roundworm Tocixity: Nausea, vomiting, deadache, weaknes and neurotoxic effects ...

1.
2. 3.

4.

Praziquantel Bithionol Metrifonate Oxamniquine

1. 2.

3.
4.

Niclosamide Praziquantel Albendazole Mebendazole

Mechanism: increases membrane permeaility to calcium Clinical use: trematodes and cestodes. Drugs of choice in schistomiasis, clonorchiasis, paragonimiasis and in the treatment of cysticercosis Toxicity: Headache,dizziness,malaese, fever, skin rash and G I Tract iritation. Contraindicated in ocular cysticercosis.

 Mechanism

: unknown Clinical use: The drugs of choice for treatment of fascioliasis and an alternative drugs in paragonimiasis Toxicity: nausea, vomiting, diarrhea, abdominal cremps, headache,dizziness,malaese

Mechanism: unccoupling oxidative phosphorilasi or by activating ATPase Clinical : tapeworm infection not for cysticercosis. Active against T. saginata, D. latum, H. Nana, D. caninum, T. solium (risk of autoinfection due to disintegration; prefer praziquantel). Toxicity: headache, GI tract. Fever rash by antigen of parasite.

Anthelmintic Drugs

Drugs active against Nematodes Albendazole Diethylcarbamazine Ivermectin Mebendazole

Drugs active against Trematodes

Drugs active against Cestodes

Praziquantel Bithionol Metrifonate Oxamniquine

Niclosamide Praziquantel Albendazole Mebendazole