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53 Cards in this Set
- Front
- Back
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what are the three major groups of helminths that infect humans?
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nematodes
trematodes cestodes |
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What is the primary goal of antihelminth therapy?
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reduction in the number of adult organisms by chemotherapy since most cannot complete their life cycles in human hosts
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How do antihelminths act?
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In 2 ways - locally to expel from GI and systemically
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List the major antihelminthic classes
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benzimidazoles
ivermectin piperazine pyrantel pamoate diethylcarbamazine doxycycline praziquantel bithionol niclosamide |
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when is albendazole the DOC?
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hydatid disease and cysticercosis
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when is albendazole used?
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most helminth infections
pinworm, hookworm |
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what is the MOA of albendazole?
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inhibitis microtubule synthesis
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when is albendazole use CI?
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in pregnancy and children under 2
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what is albendazole?
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a broad spectrum oral antihelminthic
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how is mebendazole used?
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broad spectrum against nematodes
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what specific infections is mebendazole approved for?
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whipworm
pinworm hookworm roundworm |
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what is the MOA of mebendazole?
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inhibits microtubule synthesis
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when is mebendazole CI?
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in pregnancy
use w/ caution in children under 2 |
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when is mebendazole use cautioned?
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in patients w/ cirrhosis and children under 2
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when is thiabendazole used?
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threadworm
cutaneous larva migrans early thichinosis |
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what is the moa of thiabendazole?
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inhibitis microtubule synthesis
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what is thiabendazole an alternative to?
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ivermectin for strongyloidodis and cutaneous larva migrans
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what are the common adverse effects of thiabendazole?
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dizziness
anorexia nausea, vomiting |
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what are the serious adverse effects of thiabendazole?
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cns disturbances
erythema multiforme stevens-johnson syndrome |
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when is thiabendazole CI?
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pregnancy
kidney disease liver disease |
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when is ivermectin used?
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onchoocercasis
strongyloidiasis scrabies, lice, cutaneous larva migrans, ascaris |
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what is the MOA of ivermectin?
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gaba agonists --> hyperpolarization --> paralysis of worm
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how is ivermectin administered?
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orally - doesnt penetrate CNS
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when is ivermectin CI?
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in patients w/ meninigitis
pregnancy |
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what is the mazotti reaction?
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fever, headache, dizziness, somnolence, hypotension
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when does the mazotti reaction come about?
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when killing microfilaria
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when should ivermectin use be cautioned?
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when used w/ GABAergic enhancers (barbituares, benzodiazepines)
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when is piperazine used?
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alternative for ascariasis
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what is the moa of piperazine?
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gaba agonist
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when is piperazine CI?
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in patients w/ seizure disorders
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what is pyrantel pamoate?
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a broad specturm antihelmintic
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when is pyrantel pamoate used?
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pinworms, roundworms
hookworms |
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what is the PK of pyrantel pamoate?
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poorly absorbed orally --> exerts its effects in GI tract
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what is the moa of pyrantel pamoate?
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depolarizing neuromuscular blocking agent --> release of ACh and inhibition of AChE --> paralyzed worm --> expelled
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what are the AE of pyrantel pamoate?
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nausea, vomiting, diarrhea
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what is diethylcarbamazine?
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drug of choice for filariasis, loiasis, tropical eosinophillia
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how does diethylcarbamazine work?
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interacts w/ arachidonic acid pathway
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what is doxycycline?
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tetracycline antibiotic
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when is doxycycline used as an antihelminth?
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used against wucheria bancrofti and onchocerciasis
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what is the moa of doxycyclin in antihelminths?
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kills wolbachia by killing intracellular bacterial symbiont
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when is praziquantel used?
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DOC for schistosomiasis
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what is the moa of praziquantel?
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increases permeability of cell membrane to Ca --> paralysis --> dislodgement and death
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what are the PK of praziquantel?
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rapidly orally absorbed
distributed into CSF excrteted in urine and bile |
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when is praziquantel CI?
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pregnancy, nursing mothers
treatment of ocular cysticercosis |
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how are helminthi infections of the eye treated?
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surgically
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when is bithionol used?
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doc for fasciolosis
alternative for pulmonary paragonimiasis |
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what is the moa of bithionol?
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inhibition of ETC
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what is niclosamide?
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salicylamide derivative
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when is niclosamide used?
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second line drug for crestode infections
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what is the moa of niclosamide?
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inhibits mitochondrial anerobic phosphorylation of ADP
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how is niclosamide administered?
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w/ a laxative pre-admin to purge the boweel of all dead segments
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what should be avoided w/ admin of niclosamide?
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alcohol
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is niclosamide safe in pregnancy?
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not established.
no established in children under 2 |
