Anti-Helmentics

Question 1

o MOA: Benzimidazole class. Inhibits microtubule synthesis in nematodes. May also have larvicidal or ovicidal effects in different helminthic infections
o Indications:
• Broad spectrum. Drug of choice for hydatid disease and cysticercosis Preferred over praziquantel b/c of its shorter course, cheaper and better penetration into the subarachnoid space.
• Off label uses: pinworm and hookworm infections, ascariasis, trichuriasis and strongyloidiasis
o Pregnancy implications - Teratogenic in lab animals. Do not use during pregnancy and avoid pregnancy for 1 month following completion of pregnancy
o Precautions: No safety info in kids

Answer 1

Albendazole (Albenza) (C) PO

Question 2

o MOA – Blocks glucose uptake and their nutrients in susceptible adult intestine-dwelling helminthes
o Indications – Treatment of pinworms, whipworms, roundworms and hookworms
o Pregnancy implications – Relative contraindication
o Precautions – No safety info in kids

Answer 2

Mebendazole (Vermox) (C) (PO)

Question 3

o MOA – paralyzes nematodes and arthropods by intensifying GABA-mediated transmission of signals in peripheral nerves
o Indications – Drug of choice for strongyloidiasis and onchocerciasis. Alternate drug for other helminthic infections.
o Precautions – Mazotti Reaction in pts w/ onchocerciasis. (Mazotti reaction includes fever, h/a dizziness, somnolence, weakness, rash, increased pruritis, diarrhea, joint and muscle pain, hypotension, tachycardia, - use steroids
o ADRs: fatigue, dizziness, gi effects, rash

Answer 3

Ivermectin (Stromectol) (C) PO