Tapeworm infection, treatment

Nuts have many uses, both industrial and domestic. For instance, the ivory nut, or tagua, is a source material for the manufacture of buttons and turnery articles. The kola nut supplies ingredients for popular cola beverages in the United States (see Carbonated beverages). StTychnos nux-vomica provides the important medicine and poison, strychnine. The areca or betel nut is chewed by the Indian and Malayan people as a narcotic a slice of the nut is placed in a leaf of the pepper plant Piper betle) together with a pinch of lime the mixture is an acrid, astringent narcotic that dyes the mouth red, blackens and destroys the teeth. The areca nut contains, among other alkaloids, arecoline, an active anthelminthic widely used in veterinary practice for the treatment of tapeworm infections. 

Tapeworm infections (T. saginata and T. solium) are treated with praziquantel 5 to 10 mg/kg as a single dose (use the same dose for adults and pediatric patients).3 The treatment for cysticercosis and neurocysticercosis may include surgery, anticonvulsants (neurocysticercosis can cause seizures), and anthelmintic therapy. The anthelmintic therapy of choice is albendazole 400 mg twice daily for 8 to 30 days. The pediatric dose of albendazole is 15 mg/kg (maximum 800 mg) in two divided doses for 8 to 30 days. The doses for both adults and pediatric subjects can be repeated if necessary. Praziquantel is an alternative therapy.3... 

Niclosamide is a second-line drug for the treatment of most tapeworm infections, but it is not available in the USA. 

Most patients treated with niclosamide for H diminuta and Dipylidium caninum infections are cured with a 7-day course of treatment a few require a second course. Praziquantel is superior for Hymenolepis (dwarf tapeworm) infection. Niclosamide is not effective against cysticercosis or hydatid disease. 

Bithionol is used for the treatment of tapeworm infections in poultry, and tapeworm and rumen fluke infections in sheep, cattle, and goats. An oral dose of approximately 200 mg/kg bw is used in sheep and goats, whereas two treatments, 4 days apart, of 200 mg/kg bw are used for chickens. Tlie drug is administered to poultry with tire feed, whereas to other animals it is administered in the form of gelatin capsules, tablets, or boluses. 

Adult tapeworm infections in humans are usually treated with praziquantel (Table 12.4), but with adult Taenia solium there may be neurological side effects if patients are also infected with cysts, so niclosamide, that has no effect on the cysts, is the preferred treatment (Garcia et a/., 2003). 

Drug of choice for the treatment of most tapeworm infections. 

Dichlorophen is an antihelminthic drug that was used in the treatment of tapeworm infections but has been superseded by praziquantel and niclosamide. It also has antifungal and antibacterial activity and has been used topically in the treatment of fungal infections and as a germicide in soaps and cosmetics (1). 

Clinical use Niclosamide is one of two drugs of choice (with praziquantel) for infections caused by beef, pork, and fish tapeworm infections. However, it is not effective in cysticer-cosis (for which albendazole or praziquantel is used) or hydatid disease caused by Echinococcus granulosus (for which albendazole is used). Scoleces and cestode segments are killed, but ova are not. Niclosamide is effective in the treatment of infections due to small and large intestinal flukes. 

D) The drug is equivalent in efficacy to niclosamide in the treatment of tapeworm infections... 

Quinacrine was initially approved in the 1930s as an antimalarial drug. In addition it has been used for treating tapeworm infections, giardiasis (an intestinal parasite) treatment. 

YomesariiE) (XXXVI), employed in the treatment of tapeworm infections, on the metabolism of the rat tapeworm, Rymenolepis dlmlhuta, was comparedi Niclosamide appears to have a greater effect on the process of energy production in tapeworms. 

This dmg was used prior to the availabiUty of niclosamide and is considered less satisfactory for the treatment of tapeworms than niclosamide (24). It causes more side effects and produces severe nausea. Quinacrine, however, is preferred by some clinicians for the treatment of Taenia solium infection because, unlike niclosamide, it expels the worms intact, thus reducing the theoretical risk of cysticercosis (25). 

Agents used in the treatment of cestodal infections include praziquantel (see Section Vll.a.l), niclosamide and the benzimidazoles such as albendazole and mebendazole (see Section vn.b.l). Niclosamide and praziquantel are effective against Taenia solum (pork tapeworm). Taenia saginata (beef tapeworm). Taenia latum (fish tapeworm) and Hymenolepis nana (dwarf tapeworm). Praziquantel is a second choice drug after albendazole for cys-ticercosis caused by Taenia solum. Albendazole and mebendazole are alternatives. 

Although relatively high doses (4 6 kGy) are required to kill food-borne parasites, much lower doses are adequate to prevent their reproduction and maturation resulting in loss of infectivity. Table 6 summarizes the effect of ionizing radiation on the most important parasites that may be associated with fishery products and meats [38]. Thus the parasitic roundworm Trichinella spiralis, which causes trichinosis, the pork and beef tapeworms, the protozoon in pork responsible for toxoplasmois, and various flukes that infest fish, can be rendered noninfective by low-dose radiation treatment. Doses of... 

Clinical Use. Paromomycin (Humatin) is an aminoglycoside antibacterial (see Chapter 33) that is used primarily to treat mild to moderate intestinal infections (amebiasis).51 This drug may also be used as an adjunct to other amebicides during the treatment of more severe protozoal infections. Paromomycin is also effective against some bacteria and tapeworms, and may be used as a secondary agent in certain bacterial or helminthic infections. This drug is administered orally. 

Albendazole (Albenza) is primarily used to treat infections caused by the larval form of certain cestodes (tapeworms). These infections often cause cysts (hydatid disease) in the liver, lungs, and other tissues albendazole is used as an adjunct to the surgical removal of these cysts or as the primary treatment if these cysts are inoperable. This drug is also effective against many gastrointestinal roundworms and hookworms, and is typically used as a secondary agent if other anthelmintics are not effective in treating these infections. 

The salicylanilide drugs have been widely used to treat intestinal tapeworm and liver fluke infections in humans and animals. Their use in the treatment of hydatid diseases, schistosomiasis and nematode infections is limited [11]. 

Answer D. Praziquantel is the drug of choice for treatment of all fluke (trematode) infections and most tapeworm (cestode) infections. Its antihelminthic action derives from an increase in membrane permeability to Ca, which results in contraction, followed by paralysis, of worm musculature. Mebendazole also has antihelminthic activity, hut it is restricted to the nematodes. The other drugs listed are antiprotozoals. 

Paromomycin, an aminoglycoside with antibacterial and amebicidal properties, is indicated in the treatment of acute and chronic intestinal amebiasis, of tapeworm (fish, beef, pork, and dog) infections in patients who cannot take praziquantel or niclosamide, and as an adjunctive regimen in the management of hepatic coma. 

Low doses of praziquantel can be used successfully to treat intestinal infections with adult cestodes (e.g., a single oral dose of 25 mg/kg for H. nana and 10—20 mg/kg for D. lamm, T. sagi-nata, or T. soUum). Retreatment after 7—10 days is advised for individuals heavily infected with H. nana. While albendazole is preferred for therapy of human cysticercosis, the tissue infection with intermediate cyst larvae of T. soUum, prolonged high-dose therapy with praziquantel remains an alternative treatment. Neither the cystic nor alveolar hydatid diseases caused by larval stages of Echinococcus tapeworms respond to praziquantel here, too, albendazole is effective. 

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