Drugs vs Helminths Flashcards
Microtubule inhibitors
Albendazole (larvididal and ovicidal, inhibits microtubule synthesis)
Mebendazole (ovicidal, inhibits glucose uptake)
Thiabendazole (ovicidal, inhibits fumarate reductase)
Drug of choice of hydatid disease
Albendazole
*praziquantel may be used as an adjunct to albendazole in hydatid disease
Other uses for albendazole
Cysticercosis (larval stages of T solium)
angiostrongylus cantonensis
Capillaria philippinensis
S/e albendazole
Reversible leukopenia, BM suprression
Drug of choice for whipworm
Mebendazole
Drug of choice for trichinosis
Mebendazole/albendazole (Belizario)
- Thiabendazole is no longer used d/t its s/e
- backup for strongyloidiasis
- s/e: sjs, hepatotoxic
MOA of DEC
Immobilizes microfilariae (by an unknown mechanism) and alters their surface structure —> more susceptible to host defense mechanisms
Uses of DEC
Doc: filariasis
Backup: onchocerciasis —> may cause mazzotti
Moa of ivermectin
Intensifies GABA-mediated neurotransmission in nematodes
“Ivermec-dream”
Uses of ivermectin
DOC: strongyloidiasis
Onchocerciasis (mazzotti
Cutaneous larva migrans
Filariasis (bacup)
Pyrantel pamoate MOA
Stumlates nicotinic receptors at NMJ of nematodes. Causes depolarizatioan-induced paralysis
DOC for pinworm
Mbendazole 100mg single dose
or albendazole 400mg PO single dose (Belizario)
*Pyrantel pamoate is considered a secondary drug (Belizario)
Albendazole notes
Improved penetration (>praziquantel) of the subarachnoid space in neurocysteicercosis Should nOT be given to patients with cirrhosis
Ivermectin notes
Contraindicated in pregnancy and children < 5y/o
Avoid concomitant use of ivermectin with other drugs that enhance GABA (barbiturates, BZDs, etc)
Pyrantel pamoate notes
C/i in px with hepatic dysfunction
Drugs vs trematodes and cestodes
Praziquantel
Niclosamide
Praziquantel MOA
Increases membrane permeability to calcium —> paralysis
Praziquantel notes
C/i in ocular cysticercosis (may cause irreparable eye damage)
Used with corticosteroids in treating neurocysticercosis
May be used as an adjunct to albendazole in hydatid disease
MOA of niclosamide
Uncouples oxidative phosphorylation or by activating ATPases
Use of niclosamide
Alt for cestode infections
Niclosamide notes
Kills scolices and cestode segments but has NO EFFECT on ova
Avoid ethanol consumption for 48 hours upon drug administratiotn
