ANTHELMINTIC DRUGS

 You should be  Describe the

able to choose mechanism of
drugs of choice action and major
for common toxic effect of
infection of the anthelmintic
nematodes, drugs
trematodes and
cestode
1. Albendazole
2. Diethylcarbamazine
3. Ivermectin
4. Mebendazole
5. Pyrantel pamoate
6. Piperazine
7. Thiabendazole
 Albendazole, mebendazole, thiabendazole
 Inhibit glucose absorption and inbiting

microtubule synthesis
 Poorly absorbed (PO).
 Active against nematodes (drugs of choice).
 Toxicity: gastrointestinal irritation, allergic

reaction, embryotoxicity
 Mechanism unknown
 Clinical use
◦ Filariasis (DOC)
◦ Alternative for onchocerciasis
 Toxicity: fever,rashes,ocular damage, joint
and muscle pain,lymphangitis.
 Mechanisms: intensifies GABA-mediated
neurotransmission in nematodes
 Clinical use: Active on most common
intestinal worms (except tapeworms), most
mites, and some lice. Strongyloides
stercoralis, onchocerciasis (DOC). And
alternative agent in filariasis
 Toxicity: fever, headache, dizziness, rashes,
pruritus, tachycardia, hypotensi, pain in
joints, muscle and lymph glands (Mazzotti
reactions)
 Mechanisms: stimulate nicotinic receptor
present at Neuromuscular junction of
nematodes. Contraction of muscle occurs
depolarization-induced paralysis
 Clinical use: drugs of choice for infection due
ti hookworm, pinworm and roundworm
 Tocixity: Nausea, vomiting, deadache,
weaknes and neurotoxic effects ...
1. Praziquantel
2. Bithionol
3. Metrifonate
4. Oxamniquine
1. Niclosamide
2. Praziquantel
3. Albendazole
4. Mebendazole
 Mechanism: increases membrane
permeaility to calcium
 Clinical use: trematodes and cestodes.
 Drugs of choice in schistomiasis,
clonorchiasis, paragonimiasis and in
the treatment of cysticercosis
 Toxicity: Headache,dizziness,malaese,
fever, skin rash and G I Tract iritation.
Contraindicated in ocular cysticercosis.
 Mechanism : unknown
 Clinical use: The drugs of choice
for treatment of fascioliasis and
an alternative drugs in
paragonimiasis
 Toxicity: nausea, vomiting,
diarrhea, abdominal cremps,
headache,dizziness,malaese
 Mechanism: unccoupling oxidative
phosphorilasi or by activating ATPase
 Clinical : tapeworm infection not for
cysticercosis. Active against T. saginata,
D. latum, H. Nana, D. caninum, T. solium
(risk of autoinfection due to
disintegration; prefer praziquantel).
 Toxicity: headache, GI tract. Fever rash
by antigen of parasite.
 A nthelm intic Drugs

Drugs active Drugs active Drugs active

against against against
Nem atodes Trem atodes Cestodes

A lbendazole P raziquantel Niclosam ide

Diethylcarbam azine B ithionol P raziquantel
Iverm ectin M etrifonate A lbendazole
M ebendazole O xam niquine M ebendazole