Cestode infestation

Praziquantel (9.124), a synthetic isoquinoline-pyrazine derivative, is effective for the treatment of schistosome infections it is also effective against trematode and cestode infestations. This agent increases membrane permeability to Ca + in the nematode, causing paralysis, dislodgement, and death of the worm. 

Niclosamide, which is not absorbed from the gastrointestinal tract, is the safest effective drug in cestode infestations. It inhibits anaerobic metabolism and glucose uptake in Taenia solium, against which it is highly effective. As lethal doses of niclosamide in adult worms do not destroy the ova, purgation 1 to 2 horns after niclosamide is essential, or the risk of cysUcercosis is likely. 

For many years, niclosamide (Niclocide) was widely used to treat infestations of cestodes. Niclosamide is a chlorinated salicylamide that inhibits the production of energy derived from anaerobic metabolism. It may also have adenosine triphosphatase (ATPase) stimulating properties. Inhibition of anaerobic incorporation of inorganic phosphate into ATP is detrimental to the parasite. Niclosamide can uncouple oxidative phosphorylation in mammalian mitochondria, but this action requires dosages that are higher than those commonly used in treating worm infections. 

Niclosamide (9.122), a salicylamide derivative, is the drug of choice for most tapeworm infestations. Niclosamide inhibits oxidative phosphorylation within the parasite, causing the cestode to be rapidly killed. 

Sidorov, V.S. and Guryanova, S.D. (1981). The content of free amino acids in the liver of burbot and stickleback infested with pleurocercoid cestodes (In Russian). Parasitologiya 15,126-130. 

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