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© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Fundamentals of Pharmacology for Veterinary Technicians Chapter 15 Antiparasitics
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Basic Terminology Endoparasites live within the body of the host and cause internal parasite infections Ectoparasites live on the body surface of the host and cause external parasite infestations
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Endoparasites Helminths are divided into two major groups: –Nematodes: cylindrical, nonsegmented worms commonly called roundworms –Platyhelminths: flattened worms that are subdivided into two groups: Cestodes (tapeworms) Trematodes (flukes) Anthelmintics kill worm parasites –Antinematodals –Anticestodals –Antitrematodals
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Antinematodals Benzimidazoles: work by interfering with energy metabolism of the worm Always read the label to determine which parasites the drug is effective against Recognize by –azole ending in drug name –Thiabendazole: has antifungal and anti-inflammatory effects as well –Oxibendazole: liver toxicity in dogs –Mebendazole: liver toxicity issues –Fenbendazole: wide spectrum of activity; given for three consecutive days –Febantel: a probenzimidazole that is metabolized in the animal to a true benzimidazole
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Antinematodals Imidazothiazoles –Work by stimulating the nematode’s cholinergic nervous system, leading to paralysis of the parasite (therefore, not ovicidal) –Effective against ascarids, strongyles, whipworms, and hookworms –An example is levamisole Tetrahydropyrimidines –Mimic the action of ACh and cause paralysis of the worm –Effective against ascarids, pinworms, strongyles, and hookworms –Examples include pyrantel pamoate, pyrantel tartrate, and morantel tartrate
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Antinematodals Organophosphates –Inhibit cholinesterase activity, causing ACh to remain active in the neuromuscular junction of the parasite –Are neurotoxic to parasites; some cause neurologic side effects in the host –Both endoparasitic and ectoparasitic –Narrow range of safety; not for use in heartworm- positive dogs –Effective against bots and a variety of nematodes –Examples include dichlorvos and coumaphos Piperazine –Blocks neuromuscular transmission in the parasite –Effective only against ascarids
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Antinematodals Avermectins (macrocyclic lactones) –Bind to certain chloride channels in the parasite nerve and muscle cells, causing paralysis and death of the parasite –The representative of this group is ivermectin, used for a wide variety of endo- and ectoparasites May be combined with other antiparasitic agents to broaden its spectrum of activity –Used for heartworm prevention –Another example in this group is moxidectin –Not effective against cestodes or trematodes
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Anticestodals Praziquantel –Works by increasing the cestode’s cell membrane permeability (this disintegrates the worm’s outer tissue covering) –Works on all cestode species (also used to eliminate fleas) Epsiprantel –Causes disintegration of the cestode –Effective against Taenia and Dipylidium, but not Echinococcus Fenbendazole –Covered previously –Effective against Taenia species
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Antitrematodals Clorsulon –Works by inhibiting the trematode’s enzyme systems for energy production –Effective against Fasciola hepatica Albendazole –Interferes with the energy metabolism of the worm (also effective against some nematodes) Praziquantel –Covered previously –Also effective against lung trematodes in dogs and cats
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Anticoccidials Coccidiosis is a protozoal infection that causes intestinal disorders Anticoccidial drugs are coccidiostats (do not actually kill the parasite, so hygiene is crucial) Sulfadimethoxine –Reduces the number of oocysts shed, thus reducing spread of disease Others (work mainly by affecting the protozoan’s metabolism) –Nicarbazine –Amprolium –Monensin –Decoquinate –Robenidine
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Antiprotozoals Giardiosis is a protozoal disease caused by the parasite Giardia lamblia –Antiprotozoal drugs Metronidazole (enters the protozoal cell and interferes with its ability to function and replicate) Fenbendazole (covered previously) Albendazole (covered previously) –Vaccine Blood protozoan Babesia sp. is transmitted by ticks –Imidocarb has cholinergic effects on the protozoan –Tick prevention
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Treatment of Heartworm Disease Heartworm disease is caused by the filarial nematode Dirofilaria immitis Three stages of management of heartworm disease –Preventing third-stage larvae from reaching maturity (preventative) –Adulticide therapy –Eradication of circulating microfilariae after infection
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Treatment of Heartworm Disease Preventing third-stage larvae from reaching maturity (preventative) –Daily oral preventative Diethylcarbamazine (DEC) –Given during mosquito season and two months after –Patient must be heartworm negative –Once-monthly oral preventatives Ivermectin Milbemycin –Once-monthly topical preventative Selamectin –Six-month injectable preventative Moxidectin
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Treatment of Heartworm Disease Adulticide therapy –Melarsomine Given in the epaxial muscles Less toxic than former drug (thiacetarsamide) Side effects include nephrotoxicity and hepatotoxicity Eradication of circulating microfilariae after infection –Ivermectin (given at higher dose as a microfilaricide) –Milbemycin –Levamisole (infrequently used)
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Ectoparasite Treatment Ectoparasites can be controlled using a variety of different drugs in a variety of different formulations –Sprays –Dips –Pour-ons –Shampoos –Dusts or powders –Foggers –Oral products –Spot-ons –Injectables See Table 15-4 for forms of ectoparasites and their advantages/disadvantages
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Chemicals Used for Ectoparasite Treatment The chemicals used in ectoparasite treatment are summarized in Table 15-5 Always read product labels to determine what safety procedures to follow May need protective clothing May need special disposal techniques Proper ventilation is crucial Keep and refer to MSDS prior to use and if signs of toxicity occur in the animal
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Chemicals Used for Ectoparasite Treatment –Pyrethrins and pyrethroids –Insect growth regulators –Chitin synthesis inhibitors –Neonicotinoid –Carbamates –OPs –Formamidines –Synergists –Imidacloprid –Imidacloprid + permethrin –Lime sulfur –Fipronil –Repellents –Rotenone –Ivermectin –Selamectin –D-limonene
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