ALBENDAZOLE - MOA
inhibits microtubule synthesis in nematodes, thus irreversibly impairing glucose uptake.
ALBENDAZOLE - Indication
approved for the treatment of hydatid disease and cysticercosis.
also used for pinworms, Ascariasis, trichuriasis, strongyloidiasis, and hookworms.
**Broad spectrum antihelmenthic
ALBENDAZOLE - Contraindications
Relatively contraindicated in pregnancy
ALBENDAZOLE - Adverse effects
- When used for 2-3 days it is nearly free of adverse effects
- Long-term treatment is associated with:
- liver toxicity
- and pancytopenia
ALBENDAZOLE - Drug interactions
Dexamethasone, cimetidine, and praziquantel will increase the serum concentration of the active metabolite of Albendazole.
DIETHYLCARBAMAZINE CITRATE - MOA
Mechanisms of action
–immobilizes microfilariae and alters their surface structure displacing them from tissues and making them more susceptible to destruction by host defenses.
DIETHYLCARBAMAZINE CITRATE - Indications
DOC for filariasis, loiasis, and tropical eosinophilia
Adverse Reactions / Toxicity
- –headache, dizziness, nausea, and vomiting.
- –Adverse reactions also occur as a result of the release of proteins from dying microfilariae or adult worms.
- (fever, malaise, headache, joint pain)
–use with caution in patients with hypertension or renal disease
IVERMECTIN - MOA
It intensifies GABA-mediated neurotransmission in nematodes and causes immobilization.
IVERMECTIN - Indications / DOC
DOC for strongyloidiasis
(threadworm) and onchocerciasis
- alternative treatment for filariasis
- Can also be used to control scabies,
- lice, cutaneous larva migrans, and ascariasis.
IVERMECTIN - Toxicity?
- Selective toxicity results because in humans, GABA is a neurotransmitter only in the CNS
- and ivermectin does not cross the blood-brain barrier.
IVERMECTIN - Adverse Reactions / Toxicity
In onchocerciasis treatment, the Mazzotti reaction occurs which is due to the killing of microfilariae
Mazzotti reaction - fatigue, dizziness, nausea, and vomiting, abdominal pain, and rashes.
What drug causes a reaction known as Mazzotti reaction?
IVERMECTIN - Contraindications
The drug should not be given to patients with an impaired blood-brain barrier (meningitis and African sleeping sickness).
IVERMECTIN - Drug interactions
Avoid using with other drugs that enhance GABA transmission such as benzodiazepines, barbiturates, and valproic acid.
MEBENDAZOLE (VERMOX) - MOA
Inhibits microtubule synthesis in nematodes, thereby irreversibly inhibiting glucose uptake.
MEBENDAZOLE (VERMOX) - Indications
approved for the treatment of Ascariasis, trichuriasis, hookworm, and pinworms
MEBENDAZOLE (VERMOX) - Contraindication
MEBENDAZOLE (VERMOX) - Toxicity?
–neutropenia and hepatitis when taken for a long period of time
MEBENDAZOLE (VERMOX) - Interactions
–Cimetidine will increase mebendazole levels
Metrifonate - MOA
- Organophosphate compound,
- Inhibits acetylcholinesterase,Paralyzes adult worms
Metrifonate - Indication
Used to treat Schistosoma haematobium
Metrifonate - Side effects
Cholinergic side effects:
intestinal cramping, blurred vision, slow heart beat, muscle weakness, muscle cramps, and muscle pain, convulsions, weak breathing, inability to breath, increased stomach acid and saliva, nausea and vomiting, dizziness, drowsiness, and headache
Metrifonate - Contraindications
- Should not be used in pregnancy or after
- exposure to insecticides
Niclosamide - MOA
Mech of action
– inhibition of oxidative phosphorylation or stimulation of ATPase
Niclosamide - Indications
Second line treatment for tapeworm infections
Niclosamide - Side effects
– NVD and abdominal discomfort
Oxamniquine - Indications
Alternative to praziquantel for Schistosoma mansoni infections
Oxamniquine - Adverse effects
– dizziness, headache, drowsiness, NVD, abdominal cramps,
Oxamniquine - Contraindication
pregnancy and HX of seizures
PIPERAZINE - MOA
Mechanisms of action
causes paralysis of ascaris by blocking acetylcholine at the myoneural junction
PIPERAZINE - Indications
–Not used for other helminth infections
PIPERAZINE - Contraindications
- patients with impaired renal or hepatic function
PIPERAZINE - Adverse effects
PIPERAZINE - Drug interactions
Antagonistic with pyrantel pamoate
PRAZIQUANTEL - MOA
Mechanisms of action
–Increases the cell permeability to calcium in schistosomes; causes strong contractions and paralysis of worm musculature leading to detachment of suckers from the blood vessel walls and to dislodgement
PRAZIQUANTEL - Indications
- intestinal trematodes,
- and tapeworms
–FLUKES of ALL kinds
What medicine can cause ocular cysticercosis?
What is ocular cysticercosis?
Ocular cysticercosis result from a worm larvae developing in the eye.
What are the treatment considerations concerning ocular cysticercosis?
If medication (Praziquantel) is taken for a worm in the eye the inflammatory response to the dead worm is worse than leaving the worm alive.
PRAZIQUANTEL - Contraindications
- hypersensitivity to the drug,
- ocular cysticercosis,
- spinal cysticercosis
PRAZIQUANTEL - Toxicity
PRAZIQUANTEL - Interactions
- Alcohol increases CNS depression,
- cimetidine increases praziquantel levels
PYRANTEL PAMOATE - MOA
- Stimulates nicotinic receptors present at
- neuromuscular junctions of nematodes
- Contraction of muscles occurs followed by
- a depolarization-induced paralysis.
PYRANTEL PAMOATE - Indications
- broad-spectrum anthelminthic for treating pinworms,
- and Trichostrongylus orientalis.
PYRANTEL PAMOATE - Toxicity / Adverse effects
- GI distress,
- and weakness
PYRANTEL PAMOATE - Contraindications
relatively contraindicated in pregnancy and liver disease
PYRANTEL PAMOATE - Drug Interactions
–piperazine antagonizes the effect of pyrantel pamoate.
THIABENDAZOLE - Indications
- strongyloidiasis, cutaneous larva migrans,
- visceral larva migrans, dracunculosis,
- trichinosis, and mixed helminthic infections
THIABENDAZOLE - Contraindications
THIABENDAZOLE - MOA
Mechanisms of action
–inhibits helminth-specific mitochondrial fumarate reductase
THIABENDAZOLE - Toxicity / Adverse effects
- abdominal pain,
- liver failure,
- and Stevens-Johnson syndrome
THIABENDAZOLE - Interactions
Increases serum theophylline concentrations