Chapter 13: Anthelmintic Agents

The text details the two primary categories of human-infecting helminths: nematodes (roundworms), which include Ascaris (the most globally prevalent), pinworms (the most common in the United States), hookworms, whipworms, and threadworms; and platyhelminths (flatworms), encompassing cestodes (tapeworms) and flukes, which cause diseases like schistosomiasis. Helminthic infections are differentiated into intestine-invading and tissue-invading types, such as trichinosis and filariasis, which can seriously damage organs like the lungs, liver, and central nervous system (CNS). Anthelmintic drugs, including albendazole, ivermectin, mebendazole (the prototype drug), praziquantel, and pyrantel, are highly specific and interfere with metabolic processes unique to the worm, such as blocking glucose uptake (mebendazole) or increasing membrane permeability leading to muscular paralysis (praziquantel). While mebendazole and pyrantel are minimally absorbed, limiting systemic side effects, absorbed agents require careful monitoring, as systemic adverse effects can include headache, rash, and malaise, with severe toxicity potential (e.g., renal failure, bone marrow depression) noted for albendazole. Crucial nursing considerations involve comprehensive patient teaching, focused on non-drug interventions like strict personal hygiene, daily laundering of bed linens and undergarments, and regular disinfection of toilet areas to prevent the highly contagious spread and reinfection, alongside providing psychological support to patients dealing with the anxiety of a worm infestation diagnosis. Contraindications include pregnancy and lactation, and caution is advised for older adults who may be more susceptible to CNS and GI effects.