Antihelminthics Flashcards
What are Nematodes
Roundworms
Complete digestive system
What are Trematodes
Flatworms
What are Cestodes
Flat and segmented
No digestive system so attach to host intestine
What are the Antihelminthics
Albendazole Mebendazole Thiabendazole Ivermectin Piperazine Pyrantel pamoate Diethylcarbamazine Doxycycline Praziquantel Bithionol Niclosamide
What are the Benzimidazoles
Albendazole
Mebendazole
Thiabendazole
Benzimidazoles and pregnancy
Category C
Contraindicated
Which Antihelmenthics inhibit MT synth and glucose uptake
Albendazole
Mebendazole
Which Antihelminthic inhibits MT aggregation
Thiabendazole
Which Antihelminthics are GABA agonists
Ivermectin
Piperazine
Which Antihelminthic is a depolarizing parasite Neuromuscular blocker
Pyrantel pamoate
What do you give for cestodes
Albendazole
What are cestodes that Albendazole can kill
Cysticercosis
Taenia solium
Visceral larva migrans
Echinococcus granulosis
What can happen when you treat with Albendazole
Dying parasites ignite an inflammatory response in the CNS
How do you enhance Albendazole absorption
Give with high fat meals
What are the Albendazole AE
HA, nausea
Hepatotoxicity
Agranulocytosis
Pancytopenia
What does Mebendazole act on
Whipworm [Trichuris trichiura]
Pinworm [Enterobius vermicularis]
Hookworms [N.americanus, A. duodenale]
Roundworm [Ascariasis lumbricoides]
How do you improve Mebendazole absorption
High fat meal
When should you use Mebendazole with caution
Cirrhosis
What are the Mebendazole AE
Abd pain
Diarrhea
HA
Dizziness
What is the most toxic Benzimidazole
Thiabendazole
What do you use Thiabendazole for
Threadworm (Strongyloides)
CLM
Early trichinosis
How do you improve Thiabendazole absorption
High fat meal
What are the Thiabendazole AE
Dizziness/Seizures
Erythemia multiforme
Stevens-Johnson
Hoe does Ivermectin work
Cl- influx
Hyperpol muscle/nerve
What is Ivermectin DOC for
Onchocerca volvulus (river blindness)
CLM
Strongyloides
Does Ivermectin cross BBB
No
What must you avoid with Ivermectin
Other GABAergics
What is the main Ivermectin AE
Mazotti-like reaction
What is the Mazzotti-like reaction
Fever
Dizziness
Somnolence
Hypotension
What are the Ivermectin contraindications
Pregnancy
Meningitis
What is Piperazine used for
Alternative for pinworm, roundworm
When is Piperazine contraindicated
Seizure disorders
What is Pyrantel pamoate given for
Roundworm
Pinworm
Hookworm
Pyrantel pamoate AE
N/V/D
DOC lymphatic filariasis, loiasis, tropical EOS
Diethylcarbamazine
DOC sheep liver fluke (fasciola hepatica)
Bithionol
DOC Schistocomiasis
Praziquantel
How does Diethylcarbamazine work
Immobilize microfilariae rendering them susceptible to host defenses
What do you coadminister Diethylcarbamazine with
Antihistamines or Steroids
What are the Diethylcarbamazine AE
Fever, myalgia, rash, leukocytosis
Which antihelminthic is a Tetracycline
Doxycycline
What is Doxycycline used for
Wuchereria bancrofti
Onchocerciasis
How does Praziquantel work
Increased Ca permeability
Muscle paralysis
Vessel detachment
What else does Praziquantel work on
Trematodes: C. sinensis ,P. westermani
Cestodes: D. latum, T. solium, Saginata
What is the DOC for cysticercosis (T. solium)
Albendazole
Where is Praziquantel excreted
Urine and bile
When is Praziquantel contraindicated
Pregnancy
Ocular cysticercosis
What are the Praziquantel AE
Drowsiness, Dizziness
Malaise, anorexia
P450 interactions
Which Antihelminthic inhibits parasitic ETC
Bithionol
What is the alternative Tx for pulmonary paragonimiasis
Bithionol
How does Niclosamide work
Inhibit mito ADP phosphorylation
What is the 2nd line for cestodes
Niclosamide
What is Niclosamide lethal to
Scolex not ova
What do you pretreat with for Niclosamide
Laxative to get rid of the ova
What should you avoid with Niclosamide
Alcohol for 1 day