mechanism of action of avermectin class drugs broad spectrum anthelmintic

1. IVERMECTIN
ABHIJITH SP
CVAS POOKODE

2. INTRODUCTION
• Ivermectin is a medication used to treat many types of parasitic infestations.
• Ivermectin was discovered in 1975 and came into medical use in 1981.
• It is on the World Health Organization's List of Essential Medicines.
• This includes head lice, scabies, strongyloidiasis, trichuriasis, ascariasis,
and lymphatic filariasis.
• It can be taken by mouth or applied to the skin for external infestations.
• Use in the eyes should be avoided.
24-09-2020ABHIJITH SP CVAS POOKODE 2

3. CLASS
• It belongs broad spectrum Anthelmintics group.
• Class is Avermectins.
• Brand name: Soolantra, Stromectol, Sklice
24-09-2020ABHIJITH SP CVAS POOKODE 3

4. EXAMPLES
• Ivermectin
• Abamectin
• Doramectin
• Eprinomectin
24-09-2020ABHIJITH SP CVAS POOKODE 4

5. MOA
• 1.Alters chloride ion permeability which leads to paralysis and death
• 2.GABA Agonist activity
• 3.Kills microfilariae and impairs filarial reproduction and leads to
MAZZOTTI REACTION, severe inflammatory response with fever,
chills, swollen lymph nodes, arthralgias and other symptoms.
24-09-2020ABHIJITH SP CVAS POOKODE 5

6. Mazzotti Reaction
• The Mazzotti reaction, first described in 1948, is a symptom complex seen in patients after undergoing
treatment of nematode infestation, particularly with the medication diethylcarbamazine (DEC).
• Mazzotti reactions can be life-threatening, and are characterized by fever, urticaria, swollen and tender lymph
nodes, tachycardia, hypotension, arthralgias, edema, and abdominal pain that occur within seven days of
treatment of microfilariasis. The Mazzotti reaction correlates with intensity of infection; however, there are
probably multiple infection intensity-dependent mechanisms responsible for mediating this complex
reaction.
• The phenomenon is so common when DEC is used for the treatment of onchocerciasis that this drug is the
basis of a skin patch test used to confirm that diagnosis. The drug patch is placed on the skin, and if the
patient is infected with the microfilaria of O. volvulus, localized pruritus and urticaria are seen at the
application site.
• Drug of choice-Ivermectin.
24-09-2020ABHIJITH SP CVAS POOKODE 6

7. 24-09-2020ABHIJITH SP CVAS POOKODE 7

8. CLINICAL USE
• Used in
• 1.Ascaris lumbricoides
• 2.Enterobius vermicularis
• 3.Onchocerca volvulus (First choice)
• 4.Strongyloides stercoralis
• 5.Trichuris trichura
• 6.Scabies and External parasites
• 7.Heartworm infestation.
24-09-2020ABHIJITH SP CVAS POOKODE 8

9. 24-09-2020ABHIJITH SP CVAS POOKODE 9

10. TIPS
• Coolie, Shelties, Australian Shepherds, and English and Old English
Sheepdogs breed is sensitive to ivermectin.
• Ivermectin is one of the most commonly used heartworm prevention
medications used for dogs.
• It is present in many different heartworm products, including Heartgard
Plus®, Iverhart Plus®, Iverhart Max®, Tri-Heart® and others.
24-09-2020ABHIJITH SP CVAS POOKODE 10

11. THANK YOU