DRUGS USED IN WORM INFESTATIONS

MR. ABDOU MARAM

PANNEH(RM ,FWACN

,NT, RN)

INTRODUCTIONDrugs used in the treatment Worm Infestations

can be grouped into three categories: Those used for:Round WormsFlat Worms and Tape Worms

TREATMENT OF NEMATODES (ROUND WORMS)1. DIETHYLCARBAMAZINE tabs

Is used in the treatment of FILARIASIS (imobilize microfilariae)

ADR: Caused by host reaction to the killed organisms.

The severity of symptoms are related to the parasite load and include:

Fever, malaise, rash, myalgias, arthralgias, headache and leukocytosis (antihistamines or steroids ameliorate the symptoms).

CLIENT WITH FILARIASIS

TREATMENT OF NEMATODES (ROUND WORMS)

2. IVERMECTIN 150mcg/kg Drug of choice for the treatment of

ONCHOCERCIASIS (River Blindness) caused by Onchocerca volvulus).

It is also drug of first choice for CUTANEOUS LARVA MIGRANS and STRONGYLOIDES.

The drug is given orally.Contraindicated in pregnancy and meningitis (does

not cross blood-brain barrier, but it is more permeable during meningitis)

The killing of the microfilaria can result in a Mazotti-like reaction (fever, headache, dizziness, somnolence, and hypotension)

CLIENT WITH ONCHOCERCIASIS (River Blindness)

TREATMENT OF NEMATODES (ROUND WORMS)

3. PYRANTEL (Combantrin) tabs 150mgDrug of choice against intestinal nematode

such as:Round worms (Ascaris lumbricoids)Thread worms (Enterobius vermicularis)Hook worms and Trichostrongylus.

TREATMENT OF NEMATODES (ROUND WORMS)

4. MEBENDAZOLE 500mg, 100mg tabs/suspensionEffective against a wide spectrum of nematodes.Drug of choice in the treatment of infections by:Whipworm (Trichuris trichiura), Pinworm (Enterobius vermicularis), Roundworm (Ascariasis lumbricoides)Hookworms (Necator americanus and Ancylostoma

duodenale)Relatively free of toxic effects (abdominal pain, diarrhea)Contraindicated in pregnant women. 

CLIENT INFESTED WITH NEMATODES

TREATMENT OF NEMATODES (ROUND WORMS)

5. THIABENDAZOLE (Mintezol) 500mg tabsEfective against strongyloidiasis caused by:Strongiloides stercoralis(threadworm),Cutaneous larva migrans, and Early stages of Trichinosis (caused by trichinella

spiralis).ADR: Dizziness, anorexia, nausea, vomiting,

CNS symptomatology, erythema multiforme and Stevens-Johnson syndrome.

Contraindicated during pregnancy.

CLIENT WITH LARVA MIGRANS

TREATMENT OF TREMATODES(FLAT WORMS- FLUKES)

PRAZIQUANTEL(Biltricide) 600mg tabs The drug of choice for the treatment of all forms

of SCHISTOSOMIASIS and other trematode infections and for cestode infections like cysticercosis.

ADR: Drowsiness, dizziness, malaise, and anorexia.

Is not recommended for pregnant women or nursing mothers.

Is contraindicated for the treatment of ocular cysticercosis, because of the destruction of the organism in the eye may damage the organ.

CLIENT WITH SCHISTOSOMIASIS

TREATMENT OF CESTODES: (TAPE WORMS)

1. NICLOSAMIDE The drug of choice for most cestode (tapeworm)

infections.The drug is letal for the cestode´s scolex and

segments of cestodes, but not for the ova.A laxative is administered after to oral

administration of niclosamide.This is done to purge the bowel of all dead

segments and so preclude digestion and liberation of the ova, which may lead to cysticercosis.

Alcohol should be avoided.

TREATMENT OF CESTODES: (TAPE WORMS)

2. ALBENDAZOLE (Zentel ) 400mg tabs / syrupEffective against Cestodes such as : Neurocysticercosis and Hydatic disease.ADR: When used in short-course therapy 1-3 days for

nematodal infestations (headache and nauseas)Treatment of hydatic disease 3 months (can appear

hepatotoxicity, agranulosytosis and pancytopenia)  Medical treatment of neurocysticercosis is

associated with inflammatory responses to dying parasites in the CNS, including headache, vomiting, hyperthermia, convulsions and mental changes.

CESTODES IN A CLIENT’S INTESTINE

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WC1H 9JP, UKGoodman and Gilman`s. The pharmacological

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Pharmacology and drug therapy in nursing. J.B Lippicott company. Toronto, USA.

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The Gambia Standard Drug Treatment Manual, MOHSW, Banjul. July 2005

QUESTIONS, CONTRIBUTIONS

, CLARIFICATIONS

& CONSTRUCTIVE

CRITICISMS?????