1. Copyright © 2008 Lippincott Williams & Wilkins. Introductory Clinical Pharmacology Chapter 16 Antiparasitic Drugs

2. Copyright © 2008 Lippincott Williams & Wilkins. Types of Parasitic Infections Helminths –Ringworms, pinworms, hookworms, tapeworms Protozoal/Malarial –Protozoal: Giardia –Malarial: Malaria Amebial –Amebas: intestinal / extraintestinal (ex. Liver)

3. Copyright © 2008 Lippincott Williams & Wilkins. Anthelmintic Drugs: Actions and Uses Albendazole: Interferes with synthesis resulting in death of larva; used to treat larval forms of pork tapeworm; liver, lung, and peritoneum disease caused by dog tapeworm Mebendazole: Blocks glucose uptake by helminth; used to treat whipworm, pinworm, roundworm, American hookworm, and common hookworm Pyrantel: Ability to paralyze helminth; used to treat roundworm, pinworm Thiabendazole: Interrupts the life cycle of the helminth; used to treat threadworm

4. Copyright © 2008 Lippincott Williams & Wilkins. Anthelmintic Drugs: Adverse Reactions Generalized adverse reactions –Drowsiness; dizziness; nausea; vomiting; abdominal pain and cramps; diarrhea Serious adverse effects –Rash

5. Copyright © 2008 Lippincott Williams & Wilkins. Antiprotozoal Drugs: Actions and Uses Actions –Interfere with life cycle of the plasmodium (the pathogen that is transferred from human to human by mosquitoes) –Prevents development of plasmodium –Prevents the mosquito from ingesting the plasmodium Used for the treatment of malaria

6. Copyright © 2008 Lippincott Williams & Wilkins. Examples of Malaria Medications cloroquine (Aralen) doxycycline (Vibramycin) mefloquine (Lariam) - Prevention & Treatment

7. Copyright © 2008 Lippincott Williams & Wilkins. Antiprotozoal Drugs: Adverse Reactions Gastrointestinal reactions –Vomiting; anorexia; abdominal cramping; diarrhea; and nausea Other body system reactions –Headache; dizziness; visual disturbances; hypotension; photosensitivity; cinchonism

8. Copyright © 2008 Lippincott Williams & Wilkins. Amebicides: Uses Metronidazole (Flagyl) used to treat: –Intestinal amebiasis Chloroquine hydrochloride –Treatment of extraintestinal amebiasis

9. Copyright © 2008 Lippincott Williams & Wilkins. Amebicides: Adverse Reactions Gastrointestinal adverse effects –Nausea; diarrhea; vomiting; abdominal cramps; anoxeria

10. Copyright © 2008 Lippincott Williams & Wilkins. Anthelmintic Drugs – Nursing Process: Assessment Preadministration assessment –Diagnosis of helminth infection – examination of stool; weigh patient to determine drug dosage Ongoing assessment –Save and transport all stools passed after intake of drug to laboratory –Acutely ill – monitor vital signs; record fluid intake/output every 4 hours –Observe patient for adverse reactions

11. Copyright © 2008 Lippincott Williams & Wilkins. Anthelmintic Drugs – Nursing Process: Implementation Educating patient and family members –Instruction about taking the drugs as well as the household precautions to be followed until helminth is eliminated; avoid contact w/ infected stool

12. Copyright © 2008 Lippincott Williams & Wilkins. Antiprotozoal Drugs – Nursing Process: Assessment Preadministration assessment –Identify and record vital signs and summary of nature and duration of symptoms; perform laboratory test; evaluate the patient’s physical status Ongoing assessment –Monitor vital signs; observe client for symptoms of malaria; record and report health status to primary health care provider; measure and record fluid intake and output

13. Copyright © 2008 Lippincott Williams & Wilkins. Ambecides – Nursing Process: Assessment Preadministration assessment –Examine stool; investigate travel history; record patient’s vital signs and weight; evaluate general physical status Ongoing assessment –Measure fluid intake and output; observe for signs of dehydration; monitor client’s vital signs every 4 hours

14. Copyright © 2008 Lippincott Williams & Wilkins. End of Presentation