This presentation was used for lecture class of BSc Nursing First year

1. Anthelminthic & Anti-
Protozoal Drugs
Dr. Pravin Prasad
M.B.B.S., MD Clinical Pharmacology
Lecturer, Lumbini MedicalCollege &TH
12 April 2019 (29 Chaitra 2075)
Friday

2. By the end of this class, BSc. Nsg. I
year students will be able to:
Classify anthelminthic and anti-protozoal
drugs
Explain the mechanism of action of
albendazole and metronidazole
List the uses and adverse effects of
albendazole and metronidazole

3. Anthelminthic drugs
These drugs are active against helminths
(worms)
Acts by:
Kills the worm (Vermicidal)
Expels the worm (Vermifuge)
Classified on the basis of organism
susceptible

4. Anthelminthic drugs: classification
For roundworm, hookworm, pinworm
Albendazole, mebendazole, pyrantel
pamoate, piperazine, levamisole
For threadworm
Ivermectin, albendazole
For whipworm, Trichinella spiralis
Albendazole, Mebendazole

5. Anthelminthic drugs: classification
For Filariasis
Diethylcarbamazine, Ivermectin,
Albendazole
ForTapeworm
Praziquantel, Niclosamide,Albendazole
For Hydatid disease
Albendazole, Mebendazole

6. Albendazole
Broad spectrum anthelmintic
Acts by:
Binds to microtubular protein β-tubulin of
the parasite
Inhibits polymerization of microtubules
Microtubules gradually lost and
paralysed

7. Albendazole
Additional actions:
Blocks glucose uptake by parasite
Depletes glycogen stores by inhibiting
mitochondrial enzymes

8. Albendazole: Uses
Drug of choice:
Roundworm (Ascaris lumbricoides)
Hookworm (Ancyclostoma duodenale)
Tapeworm (Neurocysticercosis)
Pinworm (Enterobius vermicularis)
Hydatid disease (Echinococcous sps.)
Cutaneous larva migrans (Ancyclostoma
caninum)
Trichinella spiralis

9. Albendazole: Uses
Alternative drug for:
Threadworm (Strongyloides stercoliasis)
Whipworm (Trichuris trichiura)
Filaria (Wuchereria bancroftii, Brugia
malayi)
Tapeworm (Taenia sps., Hymenolepsis
nana)

10. Albendazole: Side effects
Excellent tolerability
Gastrointestinal side effects:
Nausea, diarrhoea, abdominal pain
Dizziness
On prolonged use:
Headache, fever, alopecia, jaundice,
neutropenia

11. Anti-protozoal drugs
These agents are active against protozoa
Unicellular
Non-photosynthetic
Belongs to the phylum Protozoa
Acts by killing the organism
Classified according to the organism
susceptible and site of action

12. Anti-protozoal drugs: Classification
Anti-amoebic drugs
Tissue amoebicides, Luminal amoebicides
Drugs for giardiasis
Metronidazole, Nitazoxanide, Quiniodochlor,
Furazolidine
Drugs for trichomonas
Metronidazole, Diiodohydroxyquin, Quiniodochlor,
Povidone-iodine
Drugs used in Leishmaniasis
Amphotericin B, Miltefosine, Sodium
stibogluconate,Paromomycin

13. Anti-amoebic drugs: Classification
Tissue amoebicides:
For intestinal + extraintestinal amoebiasis
Nitroimidazoles (-dazole)
Metronidazole,Tini-, Secni-, Orni-,
Satrani-

14. Anti-amoebic drugs: Classification
Tissue amoebicides:
For intestinal + extraintestinal amoebiasis
Alkaloids:
Emetine, Dihydroemetine

15. Anti-amoebic drugs: Classification
Tissue amoebicides:
For intestinal amoebiasis only
Chloroquine

16. Anti-amoebic drugs: Classification
Luminal amoebicides:
Amides
Diloxanide furoate, Nitazoxanide
8-hydroxyquinolines
Quinidochlor, Iodoquinol
Antibiotics
Tetracyclines, Paromomycin

17. Metronidazole
Broad spectrum amoebicidal drug
Not effective in aerobic bacteria and
aerobic environment

18. Metronidazole
Acts by:
Enters into cells by diffusion
Gets reduced to highly reactive nitro
radical
Competes with biological electron
acceptors for electrons generated by
pyruvate oxidation (PFOR pathway)
Cells become energy deficient and dies

19. Metronidazole: Uses
Amoebiasis (Entamoeba histolytica)
Giardiasis (Giardia lambia)
Trichomonas (Trichomonas vaginalis)
Anaerobic bacterial infection
Pseudomembranous enterocolitis
Acute necrotizing ulcerative gingivitis
(Trench mouth)
H. pylori gastritis

20. Metronidazole: Adverse effects
Frequent and unpleasant, but not serious
Anorexia, nausea, metallic taste,
abdominal cramps
Thrombophlebitis of injected vein
Dilute solution properly
Allergic reactions

21. Metronidazole: Adverse effects
Frequent and unpleasant, but not serious
Headache, glossitis, dryness of mouth
and impairment of concentration
Peripheral neuropathy and CNS effects on
prolonged administration
Seizures in high dose
Leukopenia on repeated doses

22. Conclusion
Anthelminthic and anti-protozoal drugs are
mainly classified on the basis of organism
susceptible
Albendazole acts by paralysing the
helminths
Metronidazole acts by making the protozoa
energy deficient

23. Conclusion
Albendazole is used as alternative drugs for
threadworm, whipworm and filaria
Metronidazole is active against anaerobic
organisms
Both drugs are well tolerated
Gastro intestinal side effects are common
for both

24. Any queries??
Lets have a break
With this, we have completed HIS-2
Next class will be taken by Dr. Naresh
Thank you!!