3.18 Antihelmintics

There are two major groups of parasitic helminths in the human body: roundworms (Nematoda) and flatworms (Platyhelminthes). See Figure 3.13 for images of a tapeworm and a guinea worm.^[1] Of the many species that exist in these groups, about half are parasitic, and some are important human pathogens.

Mechanism of Action: Because helminths are multicellular eukaryotes like humans, developing drugs with selective toxicity against them is extremely challenging. Despite this, several effective classes have been developed. Many anthelmintic medications work by preventing microtubule formation within the parasitic cell, compromising glucose uptake. Others work by blocking neuronal transmission within the parasite, subsequently causing starvation, paralysis, and death of the worms. Additionally, many antihelminths inhibit ATP formation and impair calcium uptake, inducing paralysis and death.^[2]

Indications: Anthelmintic medications target parasitic helminths.^[3]

Nursing Considerations: Prolonged therapy using antihelmintic medication can result in liver damage and bone marrow suppression.

Side Effects/Adverse Effects: Side effects include GI upset, nausea, vomiting, diarrhea, and loss of appetite. Adverse effects of antihelmintic medications include hepatic effects and bone marrow suppression.

Health Teaching & Health Promotion: Clients on antihelmintic drug therapy should receive special instruction to ensure rigorous hygienic precautions to minimize the risk of reinfection. They should also wash all bedding, linens, towels, and clothing following treatment to minimize reinfection risk.^[4]

Now let’s take a closer look at the medication grid on mebendazole in Table 3.18.^[5] 

Table 3.18 Mebendazole Medication Grid