– Attach to intestinal wall and feed off blood – From contaminated food and water • Whipworms – Attach to abdominal wall, inject digestive fluid into tissue to liquefy it, then suck up the liquid – Females lay 10,000 eggs/day and adults can live many years – Eggs can live 3 weeks off host and be transmitted by inanimate objects • Schistosomiasis – Transmission: contaminated fresh water – Severe systemic effects: – Fever, chills, cough, muscle aches – Eggs can be found in brain, spinal cord and cause seizures and paralysis Tapeworms (Cestodes) • General – Most small but can grow up to 30 feet long – Lay 1,000,000 eggs per day – Heads hook into intestine, rest of body is only for reproduction – If body breaks off, can fully regenerate – Often find worm segments in the feces – Larvae can migrate to other parts of the body – Can live for > 25 years • Types – Pork Tapeworms – Fish Tapeworms – Dog Tapeworms Treatment
Mebendazole (Vermox®) and Albendazole (Albenza®) – Work by depriving worms of glucose needed for survival- starves them to death – Effective against most worms – Oral dosing typically range from 1 dose (most common) to 3 days, depending on agent used and type of infection – ADRs • Abdominal pain • Hepatotoxicity • Neutropenia Mebendazole Pyrantel (Antiminth®, Pin-X®) – Causes paralysis of the worm – Oral dosing typically range from 1 dose to 3 days, depending on cause of infection – ADRs • GI: diarrhea, nausea, cramping • Dizziness/drowsiness • Headache – Contraindicated in patients with liver disease Ivermectin (Stromectol®) – Works by paralyzing worms and slow rate of reproduction – Taken as a single dose on an empty stomach – May be accompanied by a corticosteroid to prevent inflammation caused by death of the worms – ADRs • Nausea and diarrhea • Dizziness • Swelling of hands, feet, ankles • Skin rash / itching
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- Winter '17