Antihelminths Flashcards
overall MOA of benzimidazoles
- bind to free beta-tubulin and inhibiting the polymerization of tubulin and microtubule-dependent glucose uptake
indications of albendazole
- neurocysticercosis caused by T. solium
- hydatid disease
AE of albendazole
- dizziness
- vertigo
- increased ICP
- meningeal signs, seizures
CI of albendazole
- pregnancy
indications of mebendazole
- enterobius vermicularis
- trichuris trichiura
- ascaris lumbricoides
- hook worms
AE of mebendazole
- angioedema, SJ syndrome when combined with metronidazole
CI of mebendazole
- pregnancy: embyrotoxic and teratogenic
indications of thiabendazole
- cutaneous larva migrans
- visceral larva migrans (toxocara canis)
- trichinosis
- drinking fruit juice aids in expulsion of worms
AE of thiabendazole
- hepatoxicity and nephrotoxicity
- angioedema
- pruritus
- rash
- SJ syndrome
MOA of ivermectin
- binds to glutamate-gated chloride channels in the nerve and muscle cell
- does not cross the BBB
indications of ivermectin
- onchocerca volvulus
- strongyloidiasis
- onchocerciasis (river blindness)
AE of ivermectin
- dizziness, encephalopathy, headache, hyperthermia, insomnia, seizure, somnolence, vertigo
- ALT/AST increased, bilirubin increased
- Mazzotti reaction - arthralgia, pruritus, rash, synovitus
CI of ivermectin
- meningitis patients
- pregnancy
MOA of diethylcarbamazine
- inhibit arachidonic acid metabolism in filarial mitochondria which enhances destruction by host
indications of diethylcarbamazine
- lymphatic filariasis (Wucheria bancrofti)
- treatment most effect if given with albendazole
AE of diethylcarbamazine
- Mazzotti reaction - aggravation of ocular lesions and hypotension
MOA of pyrantel pamoate
- neuromuscular blocker
indications of pyrantel pamoate
- second line for pinworm, trichuriasis, and roundworm
AE of pyrantel pamoate
- anorexia, N/V/D, transient increase in hepatic enzymes
- category C for pregnancy
indications of praziquantel
- all stages of schistosomiasis, clonorchiasis, opistorchiasis
AE of praziquantel
- CSF reaction syndrome in patients being treated for neurocysticercosis - headaches, seizures, meningismus
MOA of niclosamide
- inhibits mitochondrial anaerobic phosphorylation of ADP in tapeworms
indications of niclosamide
- tapeworms
- diphyloobothrium latum
DOC for neurocysticercosis
- albendazole or praziquantel
DOC for hookworms (A. duodenale or N. americanus)
- mebendazole
DOC for ascaris lumbricoides
- mebendazole
- second line - pyrantel pamoate
DOC for enterobius vermicularis
- mebendazole
- second line - albendazole, thiabendazole, pyrantel pamoate
DOC or trichuris thrichuria
- mebendazole
DOC for visceral larva migrans (toxocara spp)
- thiabendazole
- second line - diethylcarbamazine
DOC for cutaneous larva migrans (ancylostoma braziliense)
- thiabendazole
DOC for strongyloides stercoralis
- ivermectin
DOC for river blindness (onchocerca volvulus)
- ivermectin
DOC for wuchereria bancrofti
- diethylcarbamazine and albendazole
DOC for schistosomiasis
- praziquantel
drugs that can cause Mazzotti reaction
- ivermectin
- diethylcarbamazine (most common)
