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Chapter 96

Chapter 96. Anthelmintics. Helminths. Parasitic worms Helminthiasis – worm infestation Frequently asymptomatic – treatment not always indicated More than 2 billion people affected worldwide (most prevalent in areas with poor sanitation)

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Chapter 96

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  1. Chapter 96 Anthelmintics

  2. Helminths • Parasitic worms • Helminthiasis – worm infestation • Frequently asymptomatic – treatment not always indicated • More than 2 billion people affected worldwide (most prevalent in areas with poor sanitation) • Intestine – most frequent site of infection (others include liver, lymphatic system, blood vessels)

  3. Anthelmintics • Agents against parasitic worms • Classes and common names of parasitic worms • Nematodes (roundworms) • Intestinal, tissue • Cestodes (tapeworms) • Beef, pork, fish • Trematodes (flukes) • Blood, liver, intestinal, lung

  4. Nematode Infestation (Intestinal) • Ascariasis (giant roundworm infestation) • Most prevalent – one of every three people affected worldwide • Serious complications if worms migrate to pancreatic duct, bile duct, gallbladder, or liver • Ancylostomiasis and necatoriasis (hookworm) • Trichuriasis (whipworm) • Strongyloidiasis (threadworm)

  5. Nematode Infestation (Extraintestinal) • Trichinosis (pork roundworm) • Wuchereriasis and brugiasis • Onchocerciasis (river blindness)

  6. Cestode Infestation • Taeniasis (beef and pork tapeworm) • Diphyllobothriasis (fish tapeworm)

  7. Trematode Infestations Schistosomiasis (blood fluke) Fascioliasis (liver fluke) Fasciolopsiasis (intestinal fluke)

  8. Drugs for Helminthiasis • With the exception of thiabendazole, anthelmintic drugs are generally devoid of serious adverse effects.

  9. Drugs of Choice for Helminthiasis • Mebendazole (Vermox) • Albendazole (Albenza) • Thiabendazole (Mintezol) • Adverse effects • GI distress in one-third of patients • Neurologic reactions • Pyrantel (Antiminth) • Praziquantel (Biltricide) • Diethylcarbamazine (Hetrazan) • Ivermectin (Stromectol)

  10. Drugs of Choice for Helminthiasis Diethylcarbamazine (Hetrazan) Ivermectin (Stromectol)

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