Anti-Helminths

Question 1

Name the Anti-Helminths.

Answer 1

1. Mebendazole (Vermax)—most important
2. Pyrantel pamoate (Antiminth)
3. Thiabendazole (Mintezol)
4. Ivermectin (Stromectol)
5. Praziquantel (Biltricide)
6. Niclosamide

Question 2

Which drugs work against Nematodes?

Answer 2

1. Mebendazole (generally a DOC)
2. Pyrantel pamoate
3. Thiabendazole
4. Ivermectin (Stromectol)

Question 3

What drug works against Trematodes?

Answer 3

Praziquantel

Question 4

Which agent works against Cestodes?

Answer 4

Niclosamide

Question 5

What is the most common cause of Pinworms?

Answer 5

Enterobius vermicularis

Question 6

What type of worm will eat through your lungs?

Answer 6

Roundworm

Caused by: Ascaris lumbricoides

Question 7

What are the 2 hookworms?

Answer 7

Necator americanus

Ancylostoma duodenale

Question 8

What are the DOC for Nematodes?

Answer 8

1. Mebendazole

2. Pyrental pamoate

Question 9

What is the DOC for the Nematode-whipworm: Trichuris trichuria?

Answer 9

Mebendazole

Question 10

What is the DOC for the Nematode-threadworm: Strongyloides stercoralis?

Answer 10

Thiabendazole

Question 11

What is the DOC for the Nematode-trichinosis: Trichinella spirals? What is the limitation to this treatment?

Answer 11

EARLY STAGES: Thiabendazole

Question 12

Where can you find infections of a “true roundworm”?

Answer 12

Mouth and anus

Question 13

What is the DOC for flatworms-flukes:
Schistosoma japonicum
S. mansoni
S. haematobium?

Answer 13

Praziquantel

Question 14

What is the DOC for the Cestodes-tapeworms: Taenia solium

Taenia saginata?

Answer 14

Niclosamide

Question 15

What is the MOA of Mebendazole?

Answer 15

binding to & interfering with the synthesis of the parasite’s microtubules & by glucose uptake

Question 16

What are the contraindications of Mebendazole?

Answer 16

Pregnancy: it is embryo toxic and teratogenic

Question 17

What will increase the oral absorption of Mebendazole?

Answer 17

If taken with a high fat meal

Question 18

What are some typical adverse effects of Mebendazole?

Answer 18

Abdominal pain and Diarrhea

Question 19

What is the DOC for roundworm Ascaris lumbricoides?

Answer 19

Pyrantel pamoate

Question 20

What is another indication of Pyrantel pamoate besides roundworm?

Answer 20

Hookworm and pinworm

Question 21

What is the MOA of Pyrantel pamoate?

Answer 21

depolarizing block of neuromuscular transmission, causing persistent activation of the parasite’s nicotinic receptors causing:  spastic paralysis (Ca floods the “muscle” of the worm and it cannot move ultimately getting excreted in feces

Question 22

What are the Contraindications of Pyrantel pamoate?

Answer 22

None

Question 23

What are the adv eff of Pyrantel pamoate?

Answer 23

Mild GI effects

Question 24

What is the DOC for:

1. Strongyloides stercoralis
2. Cutaneous larval migrans (creeping eruption)
3. Early stages or trichinosis (Trichinella spiralis)

Answer 24

Thiabendazole

Question 25

What is the MOA of Thiabendazole?

Answer 25

affects microtubular aggregation

Question 26

What is nice about Thiabendazole?

Answer 26

It has rapid oral absorption

Question 27

What are the adverse eff of Thiabendazole?

Answer 27

GI:, anorexia, N/V CNS: dizziness Erythema multiforme, Stevens-Johnson syndrome

Question 28

What is the MOA of Ivermectin?

Answer 28

targets glutamate-gated chloride channels | Increases chloride influx- paralyzes worm

Question 29

What is used to treat: Onchocerca – River Blindness- Mexico, South America, tropical Africa?

Answer 29

Ivermectin

Question 30

Asthma (adverse eff so yes, causes it!) Mazotti-like reaction (fever,headache, somnolence,hypotension- from killing worm) Stevens-Johnson Syndrome What drug is responsible?

Answer 30

Ivermectin

Question 31

What 2 drugs cause Stevens-Johnson syndrome?

Answer 31

Ivermectin | Thiabendazole

Question 32

What are the Contraindications of Ivermectin?

Answer 32

Pregnancy | Meningitis

Question 33

What is the DOC for flukes (Schistosoma)- which infect tissues and also effective against tapeworms (Tania)?

Answer 33

Praziquantel

Question 34

Which drug has this MOA? Increases cell membrane permeability to calcium causing contracture & paralysis of parasite?

Answer 34

Praziquantel

Question 35

How is Praziquantel administered?

Answer 35

Rapidly absorbed orally

Question 36

What are some common adv effects of Praziquantel?

Answer 36

drowsiness, dizziness, malaise, anorexia, GI upset

Question 37

What drug is contraindicated in pregnancy, lactation, and ocular cysticercosis?

Answer 37

Praziquantel

Question 38

``` What anti-worm agent has drug interactions with: dexamethasone, phenytoin, carbamazepine, cimetidine ```

Answer 38

Praziquantel

Question 39

What anti-worm agent stimulates Ca--NOT nicotinic receptors and thus leads to contraction of the worm?

Answer 39

Praziquantel

Question 40

What is the DOC for most cestode (tapeworm) infections?

Answer 40

Niclosamide

Question 41

Which anti-worm agent has this MOA? blocks ATP synthesis or increases ATPase hydrolysis

Answer 41

Niclosamide

Question 42

What is nice about Niclosamide absorption?

Answer 42

It is rapidly absorbed orally

Question 43

What anti-worm agent should you avoid ETOH within 1 day of?

Answer 43

Niclosamide