Pyrantel Piperazine

Ascariasis Ascaris lumbricoides Santonin, piperazine, pyrantel, le-vamisole, thiabendazole, mebendazole, albendazole... 

Thiabendazole, cambendazole, par-bendazole, mebendazole, flubenda-zole, flubendazole, fenbendazole, oxfendazole, albendazole, febantel, thiophanate, tetramisole, levamisole, piperazine, pyrantel, morantel, di-chlorovos, metrifonate, haloxon, cou-maphos, crufomate, closantel, disophenol, ivermectin... 

D. In the United States intestinal helminths produce mild disease with nonspecific findings. Piperazine or pyrantel pamoate may be used for the treatment of ascariasis. Mebendazole is an effective drug to be taken for 3 days. Thiabendazole is not used in this condition but is used commonly in strongyloidiasis. Albendazole at a single dose of 400 mg is the preferred mode of therapy. It is a... 

Ascaris lumbricoides (roundworm) Albendazole or pyrantel pamoate or mebendazole Ivermectin, piperazine... 

Infestations with parasitic worms and flukes are widespread both in humans and in animals, and their treatment requires drugs that act in a different manner from antibacterial and antiprotozoal agents. It is desirable for worms to be expelled from the body intact since the presence of dead worms in the tissues can provoke severe reactions. Such reactions are seen when filarial worms which circulate in the blood and lymph are killed by diethylcar-bamazine (264). Intestinal worms may be expelled when they are paralyzed by neuromuscular blockers such as piperazine citrate or pyrantel (265), or their metabolism may be disrupted by the anthelmintic drugs tetramisole and thiabendazole (266) which inhibit fumarate reductase, or mebendazole (267) which prevents glucose uptake by the worms. The anthelmintic activity of tetramisole is due to its laevo isomer levamisole (186). The dextro isomer has antidepressant activity. 

Ascariasis (roundworm) Albendazole, mebendazole, pyrantel pamoate Piperazine citrate... 

Piperazine Concomitant administration of piperazine and pyrantel should be avoided, since therapy becomes ineffective. Also, adverse effects of phenoth-iazines may be potentiated if the drug is taken with piperazine. 

Ascnn.isis Astons JiimhrtcorfJes levamisole, rnebendazoic. pyrantel, piperazine or albendazole ... 

Piperazine can antagonize the antihelminthic efficacy of pyrantel and vice versa (16). 

Pin worm infection Enterobius vermicularis Piperazine, pyrvinium pamoate pyrantel, thiabendazole, albendazole, mebendazole... 

This drug has been in clinical use for over 35 years. Even today it is recommended as a drug of choice for treating roundworm infection in many countries of the world due to its low cost, high activity and practically no toxicity. Tih the advent of modern anthelmintics like pyrantel pamoate and mebendazole, piperazine was used as the drug of choice for treating roundworms (Ascaris lumbricoides), and pin-worms (Enterobius vermicularis) in adults and children [52]. 

More effective, less toxic compounds largely have replaced older ascaricides. Mebendazole, pyrantel pamoate (Antiminth, others), and albendazole are preferred agents. Piperazine also is effective but is used less often because of occasional neurotoxicity hypersensitivity reactions. Cure with any of these drugs is achieved in nearly 100% of cases, and all infected persons should be treated. Mebendazole and albendazole are preferred for therapy of asymptomatic to moderate ascariasis. Both of... 

Transient and mild GI symptoms occasionally are observed, as are headache, dizziness, rash, and fever. Pyrantel pamoate use in pregnant patients and children <2 years of age is not recommended. Because pyrantel pamoate and piperazine are mutually antagonistic in their neuromuscular effects on parasites, they should not be used together. 

Piperazine and ivermectin (not listed in the question) both cause muscle paralysis in nematodes by acting through GABA receptors. Pyrantel pamoate relaxes muscles by blocking nicotinic receptors. Diethylcarbamazine also causes muscle relaxation, but the mechanism is un-... 

Other Diethylcarbamazine, Ivermectin, Levamisole, Niclosamide, Oxamniquine, Piperazine, Praziquantel, Pyrantel... 

Pyrantel acts as an anthelmintic because it depolarises the neuromuscular junctions of some intestinal nematodes causing the worms to contract. This paralyses the worms so that they are dislodged by peristalsis and expelled in the faeces. Piperazine also paralyses nematodes but it does so by causing hyperpolarisation of the neuromuscular junctions. These two pharmacological actions oppose one another, as was shown in two in vitro pharmacological studies. Strips of whole Ascaris lumbricoides, which... 

In practical terms this means that piperazine does not add to the anthelmintic effect of pyrantel on Ascaris as might be expected, but opposes it. For this reason it is usually recommended that concurrent use should be avoided, but direct clinical evidence confirming that combined use is ineffective seems to be lacking. It seems reasonable to extrapolate the results of these studies on Ascaris lumbricoides (roundworm) to the other gastrointestinal parasites for which pyrantel is used, i.e. Enterobius ver-micularis (threadworm or pinworm), Ancylostoma duodenale, Necator americanus (hookworm) and Trichostrongylus spp. However, no one seems to have studied this. 

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