Anti-Helminthic Drugs

General All orally administered

• Except for Thiabendazole (orally and topically)

Dosage and length tx depends on drug, [drug], and worm burden

Many of these drugs are completely effective in 1 – 2 doses given in 1 – 2 days

All contraindicated in pregnancy; caution with children

Mechanisms of Action Piperazine = blocks ACh action

Pyrantel Pamoate & Metrifonate = induce ACh release; inhibit AChE

Praziquantel = increases helminth cell membrane permeability to Ca2+

Mechanisms of Action Bithionol = inhibits helminthic

anaerobic metabolism

Diethylcarbamazine Citrate (DEC) = inhibits arachidonic acid metabolism

Benzimidazoles = inhibit helminth microtubule polymerization

Mechanisms of Action Niclosamide = inhibits oxidative

phosphorylation

Ivermectin = stimulates GABA – mediated peripheral nerve signals

Drugs of Choice Ascariasis (Roundworm), Enterobiasis

(Pinworm), Necator Americanus & Ancylostoma Duodenale (Hookworm), Trichiuriasis (Whipworm disease)• Albendazole/Mebendazole

Clonorchiasis (oriental liver fluke)• Praziquantel

Cutaneous Larva Migrans (creeping eruption)• Albendazole, Ivermectin

Diphyllobothriasis (fish tapeworm), Teniasis (Pork/Beef tapeworm)• Praziquantel, Niclosamide

Drugs of Choice Dracunculiasis; Giardiasis;

Entemoeba; trichomoniasis• Metronidazole

Filariasis (elephantiasis)• Diethylcarbamazine Citrate (DEC)

Onchocerciasis (River blindness), Strongyloidiasis (Threadworm disease)• Ivermectin

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