Anti-Helminthic Drugs

Question 1

Types of Anti-Helminthic Drugs (7)

Answer 1

Mebendazole
Albendazole ( broad spectrum)
Ivermectin (Chemical derivative of Streptomyces (soil microorgan))
Praziquantel
Piperazine
Niclosamide
Pyrantel pamoate

Question 2

MOA of (Mebendazole & Albendazole)

Answer 2

Interfere with cytoskeleton through selective interaction with β-tubulin

Bind to β-tubulin → prevent microtubule assembly
Albendazole also inhibits fumarate reductase in parasites and decreases ATP production

Question 3

PK of Mebendazole

Answer 3

Minimally water soluble Poorly absorbed in GIT
Rapid first pass metabolism in liver

Question 4

PK of Albendazole

Answer 4

Poorly water soluble
Well absorbed in fatty meals
Can penetrate CSF
First pass metabolism in the liver Eliminated from urine and faeces

Question 5

Clinical use of Mebendazole

Answer 5

Intestinal luminal nematode infections, some cestodes, Giardia spp, flukes, trichinella spiralis

Question 6

Clinical use of Albendazole

Answer 6

Roundworms (ascaris, trichuris), hookworm, pinworm, cysticercosis, filaria, cutaneous larva migrans

Drug of choice for intestinal nematodes (better spectrum of activity and pharmacokinetic)

Question 7

AE of Mebendazole

Answer 7

Pregnancy
Abdominal pain, diarrhoea, migration of worm, alopecia

Question 8

AE of Albendazole

Answer 8

Embryotoxic
Abdominal pain, migration of worm, reversible alopecia
Rash, renal toxicity, fever, ICP, leukopenia

DDI
Steroids increase serum levels of albendazole by 50%