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Introductory Clinical Pharmacology Chapter 16 Antiparasitic Drugs 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) 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 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 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 Copyright © 2008 Lippincott Williams & Wilkins. Examples of Malaria Medications • cloroquine (Aralen) • doxycycline (Vibramycin) • mefloquine (Lariam) - Prevention & Treatment 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 Copyright © 2008 Lippincott Williams & Wilkins. Amebicides: Uses • Metronidazole (Flagyl) used to treat: – Intestinal amebiasis • Chloroquine hydrochloride – Treatment of extraintestinal amebiasis Copyright © 2008 Lippincott Williams & Wilkins. Amebicides: Adverse Reactions • Gastrointestinal adverse effects – Nausea; diarrhea; vomiting; abdominal cramps; anoxeria 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 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 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 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 Copyright © 2008 Lippincott Williams & Wilkins. End of Presentation Copyright © 2008 Lippincott Williams & Wilkins.