Term
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Definition
| Broad spectrum antihelminthic drug that is absorbed erratically. Its absorption is improved by fatty foods. There is extensive first pass metabolism in the liver. It works by inhibiting microtubule polymerization by binding to parasite B-tubulin. The parasite becomes immobilized and dies. It is generally well tolerated. Short term it causes GI problems and dizziness. Long term it will elevate liver transaminases and cause jaundice. Contraindicated in children under 2, pregnant women and cirrhosis. |
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Term
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Definition
| Canine tapeworm, echinococcus, will cause larval infection contracted from eggs in canine feces. It can develop slowly and form cyst in the liver or lungs. Rupture of the cyst will lead to anaphylaxis and infection obstructions. Remove it surgically and use albendazole before, during and after surgery. |
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Term
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Definition
| Infection with cysticeri, an encysted larval form of swine tapeworm, can occur in any tissues. You contract the disease by eating T. solium eggs. Involvement in the CNS leads to neurocysticercosis. Treatment of neurocysticercosis using albendazole is controversial as inflammatory reactions form around the dying parasites. Corticosteroids alone may be as effective as albendazole. Albendazole is contraindicated in acute cysticercotic encephalitis/intracranial hypertension. |
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Term
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Definition
| Caused by exposure to dog or cat hookworm larvae. They penetrate the skin forming red, snake like eruptions progressing at one end. The larva usually die with or without treatment, but may cause a painful itch or infection. In this case treat with albendazole. It is common on beaches. |
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Term
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Definition
| Occurs when preschool children eat dirt and ingest egges from toxcara, an animal roundworm. It will cause abdominal pain, hepatomegaly, splenomegaly, rash and rales. Inflammatory reaction in organs and tissues may occur. Treat with albendazole. |
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Definition
| Mostly caused by wuchereria bancrofti. There will be massive swelling from an obstruction of a lymph vessel. Treat with diethycarbamazine. |
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Term
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Definition
| An antihelminthic drug that is fairly stable so it can be added to table salt. It is rapidly absorbed by the intestines. It is contraindicated in oncocerciasis. Dicarbamazine works by immbolizing microfilariae increasing the worm's susceptibilty to the host defense. You will need to minimize inflammatory reactions from dying parasites. |
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Term
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Definition
| Drug of choice for onchocerciasis and strongyloidiasis. Ivermectin is given orally, and rapidly absorbed. There is wide tissue distribution, but it enters the eye slowly and with a limited extent. It is metabolized by the liver. The mechanism of action is by intensifying GABA transmission in nematode peripheral nerves leading to paralysis. Avoid other drugs that enhance GABA transmission like barbiturates. Don't use in pregnancy and in children under 5. |
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Term
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Definition
| River blindness. Treat with Ivermectin. An annual mass treatment can be done to reduce transmission. Monthly doses may be given upon infection and then once a year for 10 years. Corticosteroids can be given in the microfilarie are in the eyes. In onchocerciasis ivermectin has an antimicrofilaricidal effect so it won't kill adults worms, but will block the egress of microfilariae from adults. |
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Term
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Definition
| Antihelminthic drug taken orally and absorbed rapidly. It is metabolized in the liver, excreted by the kidney and in the bile. It will enter the cerebrospinal fluid poorly. Absorption is increased with a carbohydrate rich meal and cimetidine. Bioavailability is decreased with phenytoin, carbamazeoine, and corticosteroids. It works by increasing Ca permeability leading to the paralysis, dislodgement and death of cestodes and trematodes. Used in schostosomiasis, liver flukes, and adult tapeworms. Dying immature worms in schistosomiasis will exacerbate the condition. It is contraindicated in hepatic/renal disease, young children, pregnancy, and ocular cysticercosis. |
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Term
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Definition
| Broad spectrum antihelminthic that is a drug of choice for pinworms, ascaris, trichostrongylus and hookworm infections. It is used in heavy worm burden patients. It has poor oral absorption and thus targets intestinal helminths. Given as a single dose. It is a neuromuscular blocking agent that elevates ACh and activates nicotinic receptors to paralyze worms and allow for expulsion. It may cause GI problems. Do not give to patients with liver problems, pregnancy, or children under 2. |
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