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
| Class/Subclass | Prototype/Generic | Nursing Considerations | Therapeutic Effects | Side/ Adverse Effects |
|---|---|---|---|---|
| Antihelmintic | mebendazole | Contraindicated during pregnancy; may cause fetal harm
To help prevent reinfection: -Wash hands and fingernails with soap often during the day, especially before eating and after using the toilet -Wash all fruits and vegetables thoroughly or cook them well -Wear shoes to prevent exposure |
Elimination of worms | In prolonged treatment:
-Hepatic effects -Bone marrow suppression |
Critical Thinking Activity 3.18
Using the above grid information, consider the following clinical scenario question:
A mother reports that her four-year-old son had a worm in his stool this morning. They live on a dairy farm. She reports that her son enjoys being in the barn during chore time, and it is common for the livestock to develop “worms.” Mebendazole was prescribed. What patient teaching should the nurse provide to the child and the mother?
Note: Answers to the Critical Thinking activities can be found in the “Answer Key” section at the end of the book.
- This work is a derivative of “Taenia saginata adult 5260 lores.jpg” and “Dracunculus medinensis.jpg” by Centers for Disease Control and Prevention and is licensed under CC0 ↵
- This work is a derivative of Microbiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax.org/books/microbiology/pages/1-introduction ↵
- This work is a derivative of Microbiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax.org/books/microbiology/pages/1-introduction ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵