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Pharma 3 > Anthelminthic Drugs > Flashcards

Anthelminthic Drugs Flashcards

1
Q

Basic Concepts: Helminths and Anthelminthic Drugs

A

Round worms or flat worms
Group of biologically diverse creatures
Anthelminthic drugs act via ‘lumically’ or systemically

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2
Q

Roundworms: Subtypes

A

Geohelminths

Filiarial nematodes

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3
Q

Geohelminths

Parasites

A 
Ascaris Lumbricoides (round worm)
Hookworm
Whipworm
Enterobius vermicularis (pinworm)
Trichinella Spiralis
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4
Q

Geohelminths

Ascaris Lumbricoides

A

Infection via injected food or soil with embryonated eggs

Larvae–> via duodenal wall–> bloodstream–>liver–> heart–>lung: grows. Cough–> GIT–> male and females meet–> eggs

Eggs passed on via feces

Symptoms
coughing pneumonia dyspnea haemoptysis
fever
splenomegaly obstruction appendicitis

Treatment
   Albendazole 
   Mebendazole
   Pyrantel pamote (CI: obstruction!)
   Levamisole
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5
Q

Geohelminths

Hookworm

A

Larvae live in soil, warm and humid places; infect via skin penetration

Eggs are passed on via feces (dogs, rabbits); humans are dead ends

Itchy rash at site of entry
coughing, fever, anemia

Treatment
Albendazole
Mebendazole

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6
Q

Geohelminths

Whipworm

A

Diag via microscope

Ingestion of embyronated eggs–> larvae hatch in intestine–> penetrate mucosa. Adults + in large intestine

Passed on via feces

Treatment
Albendazole
Mebendazole

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7
Q

Geohelminths

Pinworm: Enterobius vermicilaris

A

Most common in temperate climate

Ingestion of embryonated eggs–> hatch in small intestine–> migrate to perianal region–< lay eggs

Heavy itching in perianal region esp at night
Can–>peritonitis if worms go exploring

Albendazole
Mebendazole
Pyrantel pamote

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8
Q

Geohelminths

Trichinella Spiralis

A

Prevention: thoroughly cook food

Ingestion of undercooked meat–>mature parasites get to stomach–>lay eggs–> tissue invasion from stomach–> move into skeletal muscles and heart

Marked muscle pain and weakness
cardiac problems
increased CK

Albendazole
Mebendazole
Analgesics

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9
Q

Filarial Nematodes

Parasites

A

Wuchereria Bancofti
Loa Loa
Dracunculus medinensis

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10
Q

Filarial Nematodes

Wuchereria Bancofti

A

AKA elephantiasis

Bites of infected mosquitos–> adults enter lymphatics-> produced sheathed filariae–> damage lymphatics

Usually asymptomatic
Lymphatic inflammation
Fever

Ivermectin; can be in combo with Albendazole
Diethylcarbamazine

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11
Q

Filarial Nematodes

Loa Loa

A

Tissue migrating filarial parasite

Bite of infected horse fly–> adults get into SC tissue–> sclera
Adults produce microfilaria–> lymphatics, blood, sputum

Symp:
Eye worm
SC swelling

Ivermectin
Diethylcarbamazine

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12
Q

Filarial Nematodes

Dracunculus medinensis

A

Drinking of unfiltered water containing larvae
Worms can migrate into skin

–> extraction by slowly pulling it out

No pharmacological therapy (required)

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13
Q

Flat Worms: Subtypes

A

Tapeworm –> able to fertilise themselves

Flukes

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14
Q

Tapeworm

Taenia Solium

A

Ingestion of undercooked infected pork
–>maturation in intestines–>adult worms produce proglottis–>release of eggs
Eggs develop into oncospheres–>penetrate muscle and brain.

Symptoms
Usually asymptomatic
anaemia, malnutrition, cysticerci
muscle pain

Albendazole
Parziquantel

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15
Q

Tapeworm

Echinococcus

A

Types: cystic and alveolar

Ingestion of eggs from dog feces
–> development of cysts in body

Symp depends on localisation of cyst
   liver--> jaundice, abdominal pain
   lungs--> SOB, coughing, chest pain
   brain--> neurological sympt
   anaphylactoid reaction

Albendazole (slow th to decrease substance release)
Mebendazole
Surgical removal of cyst

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16
Q

Flukes

Fasciola Hepatica

A

Live in human liver, mainly bile duct and gall bladder

Infection via undercooked water plant food
Passed on via feces

Praziquantel
Ivermectin

17
Q

Anthelminthics: Drug List

A 
Benzimidazoles: Albendazole, Mebendazole...
Diethylcarbamazine
Ivermectin
Praziquantel
Niclosamide
Pyrantel Pamoate
Levamisole
18
Q

Benzimidazoles

Albendazole
Mebendazole
Thiabendazole

A

Wide Spectrum

MoA: selective toxicity via high affinity to b tubulin
binds b tubulin–> inhibits microtubule polymerisation->
immobilisation -> impaired glucose and nutrient uptake

Pharmacokinetics
Erratic GIT absorption, better with fat rich diet
larger intraluminal than systemic effect due to
extensive pre systemic elimination

SE (mild except for thiabendazole)
nausea
anorexia

Uses
   Ascaris Lumbricoides
   Hook worm
   Whip worm
   Pin worm
   Trichinella spiralis 
   Wuchereria brancofti
   Taenia solium
   Echinococcus
19
Q

Diethylcarbamazine

A

MoA
causes organelle damage–> apoptosis

SE : due to destruction of parasites
Lymphangitis
Lymphoid abscess

Uses
Wuchereria brancofti
Loa Loa

20
Q

Ivermectin

A

MoA: selectivity due to glutamate gated Cl channels (not present in humans)
–> hyperpolarisation–> flaccid paralysis

Low GIT absorption
Extensive PPB
Extensive biotransformation by CYP system

SE: due to toxic substances released from dying parasite
Itching
Edema
Headache

Uses
Wuchereria brancofti
Fasciola hepatica

21
Q

Praziquantel

A

Wide spectrum

MoA
–> Ca release from IC stores–> paralytic muscle contrac.

Rapid GIT absorption, extensive hepatic biotransformation

Also useful in extraluminal parasites

SE: due to destruction of helminth
Abdominal pain
Nausea
Headache

Uses
Taenia solium
Fasciola Hepatica

22
Q

Niclosamide

A

MoA
uncouples oxidative phosphorylation
inhibits qlycosylation

Minimal GIT absorption–> remains intraluminal
also means that SE are minimal

Uses
Tapeworm
(((CI in taenia solium as results in release of eggs)))

23
Q

Pyrantel Pamoate

A

Wide spectrum

MoA
depolarising NM block–> paralysis (flaccid then spastic)

Intraluminal action

Single dose sufficient in some cases

Uses
Ascaris Lumbricoides (not in obstruction)
Enterobius vermicularis

24
Q

Levamisole

A

MoA

Nicotinic R agonist–> spastic paralysis in parasites

Pharma 3 (14 decks)

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