Anthelmintic Drugs: Classification, Mechanism, Uses, Adverse Effects, Dosage, Contraindications & Drug Interactions

 ANTHELMINTIC DRUGS

1. Definition

• Drugs used to destroy or expel parasitic worms (helminths) from the body.

2. Classification

A. Nematodes (Roundworms):
Piperazine, Diethylcarbamazine, Pyrantel pamoate, Mebendazole, Albendazole

B. Cestodes (Tapeworms):
Niclosamide, Praziquantel

C. Trematodes (Flukes):
Praziquantel, Albendazole

 3. Major Drugs

a. Piperazine

• MOA: Paralyzes worms by blocking acetylcholine.
• Use: Ascariasis (roundworm).
• Adverse: Nausea, dizziness.
• Dose: 75 mg/kg once daily (2 days).
• Contraindication: Epilepsy.
• Interaction: None major.

b. Diethylcarbamazine (DEC)

• MOA: Immobilizes microfilaria.
• Use: Filariasis.
• Adverse: Fever, rash (due to dying parasites).
• Dose: 6 mg/kg/day × 12 days.
• Contraindication: Pregnancy.

c. Pyrantel Pamoate

• MOA: Depolarizing neuromuscular blocker.
• Use: Roundworm, pinworm.
• Adverse: GI upset, headache.
• Dose: 10 mg/kg single dose.

d. Mebendazole

• MOA: Inhibits microtubule formation → blocks glucose uptake.
• Use: Broad-spectrum (roundworm, hookworm).
• Adverse: Abdominal pain.
• Dose: 100 mg twice daily × 3 days.

e. Niclosamide

• MOA: Inhibits oxidative phosphorylation in tapeworm.
• Use: Tapeworm.
• Dose: 2 g single dose.

f. Praziquantel

• MOA: Increases calcium permeability → paralysis.
• Use: Tapeworm, fluke.
• Adverse: Abdominal pain, dizziness.
• Dose: 40 mg/kg single dose.

g. Albendazole

• MOA: Inhibits microtubule polymerization.
• Use: Broad-spectrum anthelmintic.
• Adverse: Nausea, hepatic enzyme rise.
• Dose: 400 mg single dose.

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