Intestinal worm elimination

Albendazole selectively blocks glucose uptake and depletes glycogen stores. ATP formation is thus inhibited. It should be administered on an empty stomach for intraluminal parasites and with a fatty meal for tissue parasites. It is metabolized to an active sulfoxide metabolite resulting in very low Albendazole blood levels. Albendazole sulfoxide is excreted in the urine with an elimination half-life of about 8 h. Used for 1-3 days in doses recommended for intestinal worms the incidence of adverse effects is similar in treatment and control groups. Hepato-toxicity may occur, especially after the higher doses that are needed for hydatid disease. Also alopecia has been reported. 

This is a traditional infusion used to eliminate intestinal worms. For malaria, it should be twice as strong, and the dosage doubled. It is very bitter. 

J It is not easy for us to recapture the elation of thirty years ago when, suddenly, it became possible to eliminate intestinal worms with a single dose of a remedy completely free from side effects. Until then, santonin and male fern, drugs which made the patient quite ill, had to be preceded and followed by vigorous purges and often the whole cycle needed repeating. 

Levamisole hydrochloride is used in the treatment of helminth infections and as an adjuvant in malignant disease. It is active against intestinal nematode worms and appears to act by paralyzing and eliminating susceptible worms. It has proven valuable in the treatment of ascariasis and hookworm infections. The use of levamisole should be avoided in patients with preexisting blood disorders. 

Both tetramisole and levamisole are also potent inhibitors of fumarate reductase in the mitochondria of nematodes and f. hepatica. Since fumarate reductase plays a crucial role in the energy production in helminths, the inhibition of this enzyme would cut-off worm s energy supply and eventually cause its paralysis. The paralysed worm is no longer able to hold its position in the gut against intestinal peristalsis and, therefore, is soon eliminated with the faecal stream [31,58,61,62]. 

The life cycles of both species of hookworm are similar. The adult worms live in the small intestine attached to the mucosa. The females liberate eggs, which are eliminated in the feces and develop into larvae. Infective larva enter the host in contaminated food or water or penehate the skin, where a papular eruption with locahzed edema and erythema can result. 

Some members of the orthosomycins, a group of compounds known for their antibiotic activity, showed activity against intestinal nematodes [429], The nucleoside peptide aspiculamycin (250), isolated from Strepto-myces toyocaensis, at 50 mg/kg, completely eliminated Aspicularis tetra-ptera and Syphacia obvelata (pinworm) from the intestinal tract of infected mice [430]. The related compound (251) has been claimed to show nematocidal activity towards B. lignicolus [431]. Anthelmycin (252) (hikizimycin) has been found to be effective against pinworms, round-worms and whipworms [432]. 

---