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ANTHELMINTIC
DRUGS
PREPARED BY,
MRS. RIJO LIJO
INTRODUCTION
 Anthelmintics or antihelminthics are a group of antiparasitic drugs
that expel parasitic worms and other internal parasites from the body
by either stunning or killing them and without causing significant
damage to the host.
ALBENDAZOLE
 Albendazole, a broad-spectrum oral anthelmintic agent.
 It is the drug of choice for treatment of hydatid disease and
cysticercosis.
 It is also used in the treatment of pinworm and hookworm, round worm,
whip worm, and thread worm infections.
 One dose treatment is effective against round worm, pin worm and
hook worm infections which are comparable to 3 days treatment with
mebendazole. Three days treatment is necessary for tapeworms
including H. nana.
 It has weak microfilaricidal action.
MECHANISM OF ACTION
 It probably acts by inhibiting microtubule synthesis. Its bind with
parasite ‘β-tubulin’ and inhibit its polymerization.
INDICATION
 Albendazole is administered on an empty stomach when used
against intraluminal parasites but with a fatty meal when used
against tissue parasites.
 Ascariasis, trichuriasis, hookworm and pinworm infections: 400 mg
oral/ adult and children older than 2 years of age (repeated for2-3
days for heavy ascaris infections and in 2 weeks for pinworm
infection).
 Hydatid disease: Adjunct to surgical removal or aspiration of cysts.
400 mg twice daily with meals for one month or longer. Daily
therapy for up to 6 months has been well tolerated.
 Neurocysticercosis: Corticosteroids are given with the anthelmintic
drug to decrease inflammation caused by dying organisms.
Albendazole is given in a dosage of 400 mg twice a day for up to 21
day.
 Other infections: Treatment of cutaneous larva migrans (400 mg daily
for 3 days); visceral larva migrans (400 mg twice daily for 5 days);
microporidial infection (400 mg twice for 2 weeks or longer);
gnathostomiasis (400 mg twice daily for 3 weeks).
PHARMACOKINETICS:
 Albendazole • Pharmacokinetics:
 Albendazole is erratically absorbed after oral
administration, but absorption is enhanced by a high-fat
meal.
 Its metabolized in liver and primarily excreted in urine.
ADVERSE REACTION
 When used for 1-3 days, albendazole is nearly free of significant
adverse effects.
 Mild and transient epigastric distress
 Diarrhea
 Headache
 Nausea
 Dizziness
 Lassitude
 Insomnia.
 In long-term use for hydatid disease, albendazole is well tolerated,
but it can cause:
 Abdominal distress
 Headaches
 Fever
 Fatigue
 Alopecia
 Increases in liver enzymes
 Pancytopenia
SYSTEMWISE ADVERSE REACTION
 Blood and Lymphatic System Disorders: Aplastic anemia, bone marrow
suppression, neutropenia.
 Eye Disorders: Vision blurred.
 Gastrointestinal Disorders: Diarrhea.
 General System Disorders: Asthenia.
 Hepatobiliary Disorders: Elevations of hepatic enzymes, hepatitis, acute liver
failure.
 Musculoskeletal and Connective Tissue Disorders: Rhabdomyolysis.
 Nervous System Disorders: Somnolence, convulsion.
 Renal and Urinary Disorders: Acute renal failure.
 Skin an dSubcutaneous Tissue Disorders: Erythema multiforme,
Stevens-Johnson syndrome.
CONTRAINDICATION
 Pancytopenia
 Bone marrow failure
 Anemia
 Low levels of a type of white blood cell called neutrophils
 Liver problems
 Abnormal liver function tests
 Pregnancy
NURSES RESPONSIBILITY
 Monitor liver enzymes (transaminases) before the start of each treatment
cycle and at least every 2 weeks during treatment.
 Monitor blood counts at the beginning of each 28-day cycle of therapy, and
every 2 weeks while on therapy with ALBENZA in all patients.
 Patients with liver disease and patients with hepatic echinococcosis are at
increased risk for bone marrow suppression and warrant more frequent
monitoring of blood counts.
Anthelmintic drugs

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Anthelmintic drugs

  • 2. INTRODUCTION  Anthelmintics or antihelminthics are a group of antiparasitic drugs that expel parasitic worms and other internal parasites from the body by either stunning or killing them and without causing significant damage to the host.
  • 3.
  • 4. ALBENDAZOLE  Albendazole, a broad-spectrum oral anthelmintic agent.  It is the drug of choice for treatment of hydatid disease and cysticercosis.  It is also used in the treatment of pinworm and hookworm, round worm, whip worm, and thread worm infections.  One dose treatment is effective against round worm, pin worm and hook worm infections which are comparable to 3 days treatment with mebendazole. Three days treatment is necessary for tapeworms including H. nana.  It has weak microfilaricidal action.
  • 5. MECHANISM OF ACTION  It probably acts by inhibiting microtubule synthesis. Its bind with parasite ‘β-tubulin’ and inhibit its polymerization.
  • 6. INDICATION  Albendazole is administered on an empty stomach when used against intraluminal parasites but with a fatty meal when used against tissue parasites.  Ascariasis, trichuriasis, hookworm and pinworm infections: 400 mg oral/ adult and children older than 2 years of age (repeated for2-3 days for heavy ascaris infections and in 2 weeks for pinworm infection).  Hydatid disease: Adjunct to surgical removal or aspiration of cysts. 400 mg twice daily with meals for one month or longer. Daily therapy for up to 6 months has been well tolerated.
  • 7.  Neurocysticercosis: Corticosteroids are given with the anthelmintic drug to decrease inflammation caused by dying organisms. Albendazole is given in a dosage of 400 mg twice a day for up to 21 day.  Other infections: Treatment of cutaneous larva migrans (400 mg daily for 3 days); visceral larva migrans (400 mg twice daily for 5 days); microporidial infection (400 mg twice for 2 weeks or longer); gnathostomiasis (400 mg twice daily for 3 weeks).
  • 8. PHARMACOKINETICS:  Albendazole • Pharmacokinetics:  Albendazole is erratically absorbed after oral administration, but absorption is enhanced by a high-fat meal.  Its metabolized in liver and primarily excreted in urine.
  • 9. ADVERSE REACTION  When used for 1-3 days, albendazole is nearly free of significant adverse effects.  Mild and transient epigastric distress  Diarrhea  Headache  Nausea  Dizziness  Lassitude  Insomnia.
  • 10.  In long-term use for hydatid disease, albendazole is well tolerated, but it can cause:  Abdominal distress  Headaches  Fever  Fatigue  Alopecia  Increases in liver enzymes  Pancytopenia
  • 11. SYSTEMWISE ADVERSE REACTION  Blood and Lymphatic System Disorders: Aplastic anemia, bone marrow suppression, neutropenia.  Eye Disorders: Vision blurred.  Gastrointestinal Disorders: Diarrhea.  General System Disorders: Asthenia.  Hepatobiliary Disorders: Elevations of hepatic enzymes, hepatitis, acute liver failure.
  • 12.  Musculoskeletal and Connective Tissue Disorders: Rhabdomyolysis.  Nervous System Disorders: Somnolence, convulsion.  Renal and Urinary Disorders: Acute renal failure.  Skin an dSubcutaneous Tissue Disorders: Erythema multiforme, Stevens-Johnson syndrome.
  • 13. CONTRAINDICATION  Pancytopenia  Bone marrow failure  Anemia  Low levels of a type of white blood cell called neutrophils  Liver problems  Abnormal liver function tests  Pregnancy
  • 14. NURSES RESPONSIBILITY  Monitor liver enzymes (transaminases) before the start of each treatment cycle and at least every 2 weeks during treatment.  Monitor blood counts at the beginning of each 28-day cycle of therapy, and every 2 weeks while on therapy with ALBENZA in all patients.  Patients with liver disease and patients with hepatic echinococcosis are at increased risk for bone marrow suppression and warrant more frequent monitoring of blood counts.