] is active against intestinal nematodes. The drug is an alternative to mebendazole or albendazole for infestations with hookworms or pinworms.
Mechanism of Action
Pyrantel is a depolarizing neuromuscular blocking agent that causes spastic paralysis of intestinal parasites. The paralyzed worms are cleared in the feces.
Pharmacokinetics
Pyrantel is poorly absorbed, and plasma levels remain low. Most of an administered dose is excreted unchanged in the feces.
Adverse Effects
Serious reactions are rare. The most common effects are GI reactions (nausea, vomiting, diarrhea, stomach pain, cramps). Possible central nervous system effects include dizziness, drowsiness, headache, and insomnia.
Praziquantel
Target Organisms
Praziquantel [Biltricide] is very active against flukes and cestodes (tapeworms), and is the drug of choice for tapeworms, schistosomiasis, and other fluke infestations.
Mechanism of Action
Praziquantel is readily absorbed by helminths. At low therapeutic concentrations, the drug produces spastic paralysis, causing detachment of worms from body tissues. At high therapeutic concentrations, praziquantel disrupts the integument of the worms, rendering the parasites vulnerable to lethal attack by host defenses.
Pharmacokinetics
Praziquantel is rapidly absorbed from the GI tract. The drug undergoes extensive hepatic metabolism, followed by excretion in the urine. The half-life is short (about 1.5 hours).
Adverse Effects
Praziquantel is relatively free of toxicity. Transient headache and abdominal discomfort are the most frequent reactions. Drowsiness may occur, and hence patients should avoid driving and other hazardous activities.
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