ANTHELMINTIC DRUGS
DRUG
bithionol
(Actamer)
diethylcarbamazine
(Hetrazan)
ivermectin
(Stromectol)
mebendazole
(Antiox)
SPECIFIC ACTION
 Against flukes; treatment of
Paragonimus westermani
 Uncouples parasitic specific
fumarate reductase mediated
oxidative phosphorylation
 Treatment of nematode-filariae
particularly infestations with
Wucheria bancrofti or Loa loa
 sensitizes the microfilariae to
phagocytosis

used mainly in the
treatment of onchocerciasis in
humans, and also for
strongyloidiasis, ascariasis,
trichuriasis and enterobiasis
 selectively binds and with high
affinity to glutamate-gated
chloride ion channels, which
occur in invertebrate nerve and
muscle cells leading to an
increase in the permeability of cell
membranes to chloride ions with
hyperpolarization of the nerve or
muscle cell and, ultimately, death
of the parasite
SIDE EFFECTS
abdominal pain, nausea,
vomiting, headache,
dizziness, diarrhea,
ADVERSE EFFECTS
Anorexia, skin rashes, urticaria,
proteinuria
Headache; joint pain; unusual
tiredness or weakness,
dizziness; nausea or vomiting
Itching and swelling of face,
especially eyes, fever; painful and
tender glands in neck, armpits, or
groin; skin rash
Nausea,
bloating, diarrhea, headache,
lightheadedness, or muscle
aches, dizziness
Pruritus, urticaria, rash, arthralgia,
fever, asthenia, postural
hypotension, tachycardia, edema,
lymphadenopathy, sore throat,
cough, headache, somnolence,
transient eosinophilia, raised liver
enzyme values
 Treatment of giant roundworm,
hookworn, pinworm, whipworm
 acts by destroying the
cytoplasmic microtubules in the
worm's intestinal cells
 blocks the uptake of glucose and
other nutrients resulting in death
diarrhea; stomach pain,
abdominal pain, fever,
vomiting, headache,
tinnitus, numbness, and dizziness.
Potentially Fatal: Myelosuppression
(high doses)
niclosamide
(Niclocide)
oxamniquine
(Vansil)
of the helminth
 active against intestinal
tapeworms
 inhibits oxidative phosphorylation
in mitochondria of the worms
resulting in energy depletion
 treatment of schistosomiasis acts
by DNA binding resulting in
contraction and paralysis of the
worms and eventual detachment
from terminal venules in the
mesentry and death
dizziness,
drowsiness, headache,
sweating, dryness of the
mouth and eyes, and ringing
in the ears
Headache and gastrointestinal
effects such as nausea,
vomiting, and diarrhoea
GI disturbances (e.g. nausea,
retching, abdominal pain),
lightheadedness, pruritus
allergic reaction (swelling of your
lips, tongue, or face; shortness of
breath; closing of your throat; or
hives) seizures, epileptiform
convulsions
piperazine citrate
(Antepar)
GI distress, nausea, vomiting,
 effective against the intestinal
abdominal pain, urticaria,
nematodes roundworm (Ascaris
headache
lumbricoides), pinworm and
threadworm (Enterobius
vermicularis)
 produces a neuromuscular block
resulting in muscle paralysis of the
worms which are consequently
dislodged and expelled in the
faeces
colic, abdominal pain, diarrhoea,
urticaria, skin rashes,
bronchospasm, dizziness,
nystagmus, ataxia, paraesthesia,
myoclonic contractions, choreiform
movements, muscular
incoordination (worm wobble),
confusion, EEG abnormalities,
blurred vision.
Potentially Fatal: Stevens-Johnson
syndrome, bronchospasm and
angioedema
praziquantel
(Biltricide)
 susceptible to trematodes (flukes)
and cestodes (tapeworms)
 increases the cell permeability to
Ca in schistosomes, causing
strong contractions and paralysis
of worm musculature leading to
detachment of suckers from the
blood vessel walls and to
dislodgement
a headache or dizziness,
abdominal upset or
discomfort,a fever, or hives
drowsiness, malaise, shortness of
breath, closing of your throat,
nausea, vomiting, diarrhoea,
urticaria, rashes, pruritus,
eosinophilia
pyrantel pamoate
 effective against roundworms
stomach cramps or
anorexia, nausea, vomiting,
(Combantrin susp)
(Ascaris), threadworms
(Enterobius), hookworms and
Trichostrongylus
 acts by paralysing the worms
which get detached and are
excreted by intestinal peristalsis
pain,bloody
diarrhea,dizziness,drowsiness,
fever, headache,increased
sweating,loss of
appetite,general feeling of
discomfort or illness, nausea
or vomiting
abdominal cramps, drowsiness,
insomnia, diarrhoea, tenesmus,
SGOT elevations, headache,
dizziness, rash, hives, or itching
thiabendazole
(Mintezol)
 against most nematode worms,
larval stages and ova
 inhibits fumarate-reductase
system of worms, hence
interfering with their source of
energy
dizziness, drowsiness,
or headache; numbness;
nausea, vomiting, diarrhea,
upset stomach, or decreased
appetite; unusual urine odor;
fever or chills; ringing in the
ears; blurred vision or dryness
of the eyes; or appearance of
live worms in the mouth or
nose
albendazole
(Adazol)
 exhibits a broad-spectrum
anthelmintic activity (vermicidal,
ovicidal and larvicidal actions)
 inhibits tubulin polymerization in
the parasite and blocks glucose
uptake; energy levels are
reduced resulting to death of the
parasite
 susceptible parasites include
hookworm, roundworm,
threadworm, whipworm,
tapeworm, strongyloides,
opisthorchis and hydatid disease
(Echinococcus)
abdominal pain, nausea, or
vomiting, headache,
dizziness, fever.
GI disturbances; pruritus, skin
rashes; fatigue, drying of mucous
membrane; hyperglycaemia, visual
disturbances; leucopaenia; tinnitus;
hepatic effects; enuresis;
crystalluria; bradycardia;
hypotension. Transient increase in
liver test.
Potentially Fatal: Fatal StevensJohnson syndrome, erythema
multiforme. Toxic epidermal
necrolysis, liver damage
GI discomfort, allergic
reactions(welling of your lips,
tongue, or face; shortness of breath;
closing of your throat; or hives),
pruritus, raised liver enzymes,
alopecia and dry mouth
Potentially Fatal: Bone marrow
depression
mepacrine
 9-aminoacridine antiprotozoal
Abdominal or stomach
cramps; diarrhea; dizziness;
reversible yellow discolouration of
the skin, conjunctiva, urine (on
(Quinacrine)
paromomycin
(Humatin)
agent
 used in the treatment of giardiasis
(as an alternative to the
nitroimidazoles), treatment of
discoid and SC lupus
erythematosus, and prophylaxis
of pneumothorax (as an
sclerosing agent)
 binds to DNA thereby inhibiting
RNA transcription and translation
 an aminoglycoside antibiotic with
antibacterial and antiprotozoal
activity
 acts primarily in the intestinal
lumen
 bactericidal and inhibits protein
synthesis in susceptible bacteria
at the 30S ribosomal unit
fever; headache; loss of
appetite; nausea or vomiting
prolonged use); blue-black
discolouration of the palate and
nails; psychosis, CNS stimulation,
convulsions; ocular toxicity chronic
dermatoses; rarely, liver toxicity and
aplastic anaemia
nausea, diarrhea or stomach
ache
Heartburn,headache, vertigo,
exanthema, rash, pruritus,
steatorrhoea, secondary
enterocolitis, eosinophilia,
ototoxicity