Medicamentos Antihelmínticos

Descripción General

Clasificación de los LOS Neisseria helmintos

Las diferentes clases de helmintos son:

• Helmintos redondos (nematodos)
• Helmintos planos (platelmintos):
  • Tenias (cestodos)
  • Duelas (trematodos)

Clasificación de los LOS Neisseria medicamentos antihelmínticos

Los LOS Neisseria medicamentos antihelmínticos más utilizados son:

• Agentes nematicidas:
  • Benzimidazoles Benzimidazoles Compounds with a benzene fused to imidazoles. Anthelmintic Drugs
  • Dietilcarbamazina
  • Ivermectina
  • Pamoato de pirantel
• Agentes trematocidas y cestocidas:
  • Praziquantel Praziquantel An anthelmintic used in most schistosome and many cestode infestations. Anthelmintic Drugs
  • Niclosamida (descontinuado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos)

Benzimidazoles

Medicamentos de esta clase

• Albendazol
• Mebendazol
• Triclabendazol

Mecanismo de acción

• Se unen a la tubulina beta libre → evita la polimerización en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum microtúbulos
• Efectos:
  • ↓ Captación de glucosa dependiente de microtúbulos → ↓ producción de ATP → agotamiento de energía
  • Inmovilización del helminto
  • Reproducción interrumpida
  • Muerte

Farmacocinética

• Absorción:
  • Mala absorción por vía oral
  • Absorción ↑ con alimentos (comidas grasas).
• Distribución: alta unión a proteínas
• Metabolismo:
  • Metabolismo de 1er paso en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hígado
  • El albendazol y el triclabendazol tienen metabolitos activos.
• Excreción: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las heces

Indicaciones

El albendazol y el mebendazol tienen actividad frente a un amplio espectro de:

• Nematodos:
  • Ascaris Ascaris Ascaris is a genus of parasitic nematodes. The infection, ascariasis, is most often caused by A. lumbricoides. Transmission occurs primarily via ingestion of water or food contaminated with Ascaris eggs. Most patients with ascariasis are asymptomatic. Ascaris/Ascariasis lumbricoides
  • Ancylostoma duodenale Ancylostoma Duodenale Hookworm Infections y A. caninum
  • Enterobius vermicularis Enterobius Vermicularis Enterobius/Enterobiasis
  • Necator americanus Necator americanus A common parasite of humans in the moist tropics and subtropics. These organisms attach to villi in the small intestine and suck blood causing diarrhea, anorexia, and anemia. Hookworm Infections
  • Strongyloides stercoralis Strongyloides stercoralis A species of parasitic nematode widely distributed in tropical and subtropical countries. The females and their larvae inhabit the mucosa of the intestinal tract, where they cause ulceration and diarrhea. Strongyloidiasis
  • Especies de Toxocara Toxocara A genus of ascarid nematodes commonly parasitic in the intestines of cats and dogs. Toxocariasis
  • Trichinella spiralis Trichinella spiralis A parasite of carnivorous mammals that causes trichinellosis. It is especially common in rats and in swine fed uncooked garbage. Human infection is initiated by the consumption of raw or insufficiently cooked pork or other meat containing the encysted larvae. Trichinella/Trichinellosis
  • Trichuris trichiura
• Trematodos:
  • Clonorchis sinensis (duela hepática china)
  • Opisthorchis viverrini (duela hepática del sudeste asiático)
• Cestodos:
  • Echinococcus Echinococcus Echinococcosis is a parasitic disease caused by Echinococcus tapeworms. Infection most often occurs from the ingestion of Echinococcus eggs in food or water contaminated with dog feces. Signs and symptoms are caused by hydatid cyst development in visceral organs and depend on the species. Echinococcus/Echinococcosis granulosus (tenia del perro)
  • Taenia Taenia Taenia belong to the Cestoda class of helminths. Humans are infected with these tapeworms by eating undercooked beef (T. saginata) or pork (T. solium and T. asiatica). Taeniasis is often asymptomatic, but the ingestion of larvae can cause abdominal discomfort, nausea, and constipation or diarrhea. Taenia/Taeniasis saginata (tenia bovina)
  • Taenia Taenia Taenia belong to the Cestoda class of helminths. Humans are infected with these tapeworms by eating undercooked beef (T. saginata) or pork (T. solium and T. asiatica). Taeniasis is often asymptomatic, but the ingestion of larvae can cause abdominal discomfort, nausea, and constipation or diarrhea. Taenia/Taeniasis solium (tenia porcina)
• Otros:
  • Giardia Giardia A genus of flagellate intestinal eukaryotes parasitic in various vertebrates, including humans. Characteristics include the presence of four pairs of flagella arising from a complicated system of axonemes and cysts that are ellipsoidal to ovoidal in shape. Nitroimidazoles duodenalis
  • Microsporidios

Efectos adversos

• Cefalea
• Dolor Dolor Inflammation abdominal
• Náuseas y vómitos
• ↑ Enzimas hepáticas
• Neutropenia Neutropenia Neutrophils are an important component of the immune system and play a significant role in the eradication of infections. Low numbers of circulating neutrophils, referred to as neutropenia, predispose the body to recurrent infections or sepsis, though patients can also be asymptomatic. Neutropenia
• Agranulocitosis

Dietilcarbamazina

Mecanismo de acción

• No completamente entendido
• Funciona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum microfilarias (estadio temprano de ciertos nematodos, generalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el sistema circulatorio o tejidos):
  • Las inmoviliza
  • Altera la estructura de superficie → ↑ susceptibilidad a la fagocitosis y destrucción

Farmacocinética

• Absorción:
  • Bien absorbido
  • Rápida
• Distribución: amplia a la mayoría de los LOS Neisseria tejidos (excepto al AL Amyloidosis tejido adiposo)
• Excreción: orina (aproximadamente 50% como medicamento sin cambios)

Indicaciones

La dietilcarbamazina está indicada para las siguientes infecciones por nematodos:

• Filariasis linfática causada por:
  • Wuchereria bancrofti Wuchereria bancrofti A white threadlike worm which causes elephantiasis, lymphangitis, and chyluria by interfering with the lymphatic circulation. The microfilaria are found in the circulating blood and are carried by mosquitoes. Lymphatic Filariasis (Elephantiasis)
  • Brugia malayi
  • Brugia timori
• Loasis (Loa loa)
• Larva migrans visceral ( Toxocara Toxocara A genus of ascarid nematodes commonly parasitic in the intestines of cats and dogs. Toxocariasis spp.)

Efectos adversos

• Cefalea
• Malestar
• Anorexia Anorexia The lack or loss of appetite accompanied by an aversion to food and the inability to eat. It is the defining characteristic of the disorder anorexia nervosa. Anorexia Nervosa
• Náuseas y vómitos
• Reacciones a las microfilarias moribundas:
  • Fiebre
  • Erupción
  • Síntomas gastrointestinales
  • Tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome
  • Dolor Dolor Inflammation torácico
  • Inflamación
  • Prurito
  • Artralgia y mialgia
  • Proteinuria Proteinuria The presence of proteins in the urine, an indicator of kidney diseases. Nephrotic Syndrome in Children
  • Encefalopatía

Ivermectina

Estructura química

• Lactona macrocíclica semisintética
• Derivada de la avermectina (del moho Streptomyces avermitilis Streptomyces Avermitilis Anthelmintic Drugs)
• Lipofílica

Mecanismo de acción

• Se une selectivamente a los LOS Neisseria canales de iones de cloruro activados por glutamato
• ↑ Permeabilidad de la membrana celular a los LOS Neisseria iones de cloruro
• Hiperpolarización → parálisis de los LOS Neisseria organismos

Farmacocinética

• Absorción:
  • Bien absorbida
  • ↑ Absorción con comidas ricas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum grasas
• Distribución:
  • Alta concentración en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hígado y tejido adiposo
  • No cruza la barrera hematoencefálica
  • Alta unión a proteínas
• Metabolismo:
  • Hepático
  • Por las enzimas del citocromo P450
• Excreción: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las heces

Indicaciones

• Nematodos:
  • Ascaris Ascaris Ascaris is a genus of parasitic nematodes. The infection, ascariasis, is most often caused by A. lumbricoides. Transmission occurs primarily via ingestion of water or food contaminated with Ascaris eggs. Most patients with ascariasis are asymptomatic. Ascaris/Ascariasis lumbricoides
  • Onchocerca volvulus Volvulus A volvulus is the twisting or axial rotation of a portion of the bowel around its mesentery. The most common site of volvulus in adults is the colon; most frequently the sigmoid volvulus. Patients typically present with symptoms of bowel obstruction such as abdominal pain, distension, vomiting, and constipation/obstipation. Volvulus (ceguera de los LOS Neisseria ríos)
  • Strongyloides stercoralis Strongyloides stercoralis A species of parasitic nematode widely distributed in tropical and subtropical countries. The females and their larvae inhabit the mucosa of the intestinal tract, where they cause ulceration and diarrhea. Strongyloidiasis
  • Infección por Wuchereria bancrofti Wuchereria bancrofti A white threadlike worm which causes elephantiasis, lymphangitis, and chyluria by interfering with the lymphatic circulation. The microfilaria are found in the circulating blood and are carried by mosquitoes. Lymphatic Filariasis (Elephantiasis) (filariasis linfática)
• Otros:
  • Prevención y control de infecciones por escabiosis
  • Pediculus humanus Pediculus humanus Lice of the genus pediculus, family pediculidae. Pediculus humanus corporis is the human body louse and pediculus humanus capitis is the human head louse. Bartonella capitis (piojos de la cabeza)

Efectos adversos

• Mareo
• Náuseas y vómitos
• Dolor Dolor Inflammation abdominal
• Mialgias
• Prurito
• Erupción
• Síndrome de Stevens-Johnson
• Hipotensión ortostática
• Confusión
• Convulsiones
• ↑ Enzimas hepáticas

Contraindicaciones

• Extrema precaución en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños: ↑ riesgo de efectos sobre el SNC
• Evitar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el embarazo

Interacciones medicamentosas

El aumento de la actividad de GABA GABA The most common inhibitory neurotransmitter in the central nervous system. Receptors and Neurotransmitters of the CNS puede ocurrir con:

• Barbitúricos
• Benzodiacepinas
• Ácido valproico

Pamoato de Pirantel

Mecanismo de acción

• Funciona principalmente contra organismos luminales
• Actúa como bloqueador neuromuscular despolarizante → paraliza los LOS Neisseria helmintos → expulsión:
  • Causa liberación de acetilcolina
  • Inhibe la colinesterasa

Farmacocinética

• Absorción: mala absorción oral
• Excreción: heces

Indicaciones

El pamoato de pirantel se usa para los LOS Neisseria nematodos intestinales, que incluyen:

• Ascaris Ascaris Ascaris is a genus of parasitic nematodes. The infection, ascariasis, is most often caused by A. lumbricoides. Transmission occurs primarily via ingestion of water or food contaminated with Ascaris eggs. Most patients with ascariasis are asymptomatic. Ascaris/Ascariasis lumbricoides
• Ancylostoma duodenale Ancylostoma Duodenale Hookworm Infections
• Enterobius vermicularis Enterobius Vermicularis Enterobius/Enterobiasis
• Necator americanus Necator americanus A common parasite of humans in the moist tropics and subtropics. These organisms attach to villi in the small intestine and suck blood causing diarrhea, anorexia, and anemia. Hookworm Infections
• Trichostrongylus spp.

Efectos adversos

• Cólicos abdominales
• Diarrea
• Náuseas y vómitos
• Cefalea
• Mareo

Contraindicaciones

• Enfermedad hepática grave (usar con precaución)
• Hipersensibilidad conocida

Praziquantel

Mecanismo de acción

• ↑ Permeabilidad celular al AL Amyloidosis calcio → entrada de calcio descontrolada → contracción muscular y parálisis
• Vacuolización y desintegración del tegumento

Farmacocinética

• Absorción: bien absorbido
• Distribución:
  • Unido a proteínas
  • Atraviesa la barrera hematoencefálica
• Metabolismo:
  • Metabolismo extenso de 1er paso
  • Hepático
• Excreción: orina (aproximadamente 99% como metabolitos)

Indicaciones

El praziquantel Praziquantel An anthelmintic used in most schistosome and many cestode infestations. Anthelmintic Drugs se usa para muchas infecciones por trematodos y cestodos:

• Trematodos:
  • Schistosoma Schistosoma Schistosomiasis is an infection caused by Schistosoma, a trematode. Schistosomiasis occurs in developing countries with poor sanitation. Freshwater snails are the intermediate host and are transmitted to humans through skin contact with contaminated fresh water. The clinical presentation occurs as a result of the host’s immune response to antigens from the eggs. Schistosoma/Schistosomiasis spp.
  • Clonorchis sinensis
  • Opisthorchis viverrini
• Cestodos:
  • Taenia Taenia Taenia belong to the Cestoda class of helminths. Humans are infected with these tapeworms by eating undercooked beef (T. saginata) or pork (T. solium and T. asiatica). Taeniasis is often asymptomatic, but the ingestion of larvae can cause abdominal discomfort, nausea, and constipation or diarrhea. Taenia/Taeniasis spp.
  • Diphyllobothrium Diphyllobothrium Diphyllobothriasis represents an intestinal parasitic infection caused by the cestode Diphyllobothrium. Diphyllobothriasis is acquired by ingestion of late larvae in undercooked or raw fish. The clinical presentation of diphyllobothriasis varies from asymptomatic, nonspecific symptoms to intestinal obstruction, and/or vitamin B12 deficiency. Dibothriocephalus/Diphyllobothriasis latum
  • Echinococcus Echinococcus Echinococcosis is a parasitic disease caused by Echinococcus tapeworms. Infection most often occurs from the ingestion of Echinococcus eggs in food or water contaminated with dog feces. Signs and symptoms are caused by hydatid cyst development in visceral organs and depend on the species. Echinococcus/Echinococcosis spp.

Efectos adversos

• Mareo
• Cefalea
• Somnolencia
• Urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives)
• Dolor Dolor Inflammation abdominal
• Náuseas
• Fiebre
• Arritmias cardíacas
• Leve ↑ enzimas hepáticas
• Exacerbación de anomalías neurológicas ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con infección del SNC, como neurocisticercosis)

Contraindicaciones

• Hipersensibilidad conocida
• Cisticercosis ocular (la destrucción del parásito puede causar daños oculares irreparables)
• Utilizar con precaución en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con:
  • Enfermedad hepática grave
  • Bloqueo auriculoventricular
  • Arritmias