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Ascaris Lumbricoides
The infection is usually treated by antiparasitic agents.
The most commonly recommended agents are albendazole and mebendazole
- Albendazole (single dose- 400mg stat)
- Mebendazole (single dose -500mg stat or multiple dose 100mg b.d for 3/7
- Pyrantel pamoate (single dose 10mg/kg)
- Piperazine citrate (single dose 30-70ml stat)
ALL infection must be treated
Recheck after a month – treat again if still +ve
Anthelmintics
Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.
Albendazole (Albenza)
Decreases ATP production in worm, causing energy depletion, immobilization, and finally death.
Mebendazole (Vermox)
Causes worm death by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestine where helminths dwell.
Piperazine citrate
Recommend for GI or biliary obstruction secondary to ascariasis; causes flaccid paralysis of the helminth by blocking response to worm muscle to acetylcholine.
Pyrantel pamoate (Antiminth)
Depolarizing neuromuscular blocking agent; inhibits cholinesterases, resulting in spastic paralysis of worm.
Ivermectin (Stromectol)
Binds selectively with glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, causing cell death.
Levamisole (Ergamisol)
May inhibit worm copulation via agonism of L-subtype nicotinic acetylcholine receptors in male nematode muscles
Other supportive could be Vitamin and nutrient supplements to treat malabsorption or Oral Re-hydration Solution to treat dehydration.
In case there is acute obstruction of the intestine, surgical removal of the worm bolus is required.
3 comments:
How long does it take for a single dose of albendazole 400mg to effectively kill the ascaris parasite?
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