In this Chapter:
33.1. Drugs used for the treatment of intestinal helminthiasis
33.2. Drugs used for the treatment of extraintestinal helminthiasis
The incidence of helminthic1 infections in people is very high. Owing to biological features and localization of the causative helminths, a clinical picture of the resultant diseases (helminthiasis) may vary from an asymptomatic course to anemia, damage to the liver, eyes and blood vessels.
According to the main localization in the human body, intestinal and extraintestinal helminthiasis are distinguished. Their infecting parasites may be roundworms (nematodes), tapeworms (cestodes) and flukes (trematodes).
The treatment of helminthiasis consists of the eradication of helminths from the body. Since each antihelmintic drug is active only against definite helminths, the causative parasit should be identified before treatment is started.
33.1. DRUGS USED FOR THE TREATMENT OF INTESTINAL HELMINTHIASIS
The main drugs used to treat intestinal nematodosis - ascariasis - are mebendazole (vermox), pyrantel pamoate, levamisol (decaris).
Being a derivative of imidazole, mebendazole shows a suppressive action against most nematodes (it is especially effective against trichocephalosis, ascariasis and enterobiosis). It inhibits glucose utilisation in helminths and paralyses them. It provides baneful influence on the ova of whipworm, ascarides and ancylostomes. It is poorly absorbed from the gut (10%). Nevertheless, when given in high doses, it may be used in the treatment of extraintestinal helminthiasis -
trichinellosis and echinococcosis. The preparation is rapidly metabolised in the liver. Mainly the kidneys within 24-48 h excrete the metabolites. The drug is well tolerated. Adverse reactions are rare (occasional gastrointestinal distress, headache, allergic skin reaction, abdominal pains, etc.).