Table 7-4 Anti-Parasite Drugs |
| Name | | Mechanism of Action | | Comment |
| Pyrethrin | | Natural extract of chrysanthemum; neurotoxic to lice (not ovicidal) | | Contraindicated (CI) if allergy to chrysanthemums |
| Permethrin | | Synthetic pyrethrin; disables nerve cell Na+ transport channels in parasites → resulting in paralysis | | Pediculicidal and ovicidal
2 strengths: 1% (OTC), 5% (Rx)
CI: allergy to chrysanthemums |
| Lindane | | Chlorinated hydrocarbon; blocks neural transmission by interfering with GABA → respiratory/muscular paralysis in parasites | | Used for scabies, pubic lice, head lice, and body lice
SE: ICD, CNS symptoms (i.e., seizures) |
| Malathion | | Organophosphate cholinesterase inhibitor | | Flammable; used in scabies, head lice |
| Ivermectin | | Blocks glutamate-gated chloride channels → paralysis of parasite | | Used for strongyloidiasis, onchocerciasis, Norwegian scabies |
| Crotamiton | | Scabicide; unknown mechanism | | SE: contact dermatitis |
| Precipitated sulfur (6%) | | Unclear mechanism of action | | Treatment for scabies in pregnant women and infants < 2 years of age |
| Thiabendazole, Albendazole | | Inhibits fumarate reductase (helminth-specific enzyme) | | Used in cutaneous larva migrans SE: dizziness, drowsiness, jaundice |
| Na+ stibogluconate, meglumine antimoniate | | Pentavalent antimonial; unclear mechanism | | Treatment for leishmaniasis SE: pancreatitis, hepatitis, renal failure, prolong QT interval |
| Pentamidine | | Inhibits protozoal DNA/RNA/phosopholipid/ protein synthesis | | Used for trypanosomiasis and leishmaniasis |
| Diethylcarbamazine (DEC) | | Piperazine derivative, unknown mechanism
{Mazzotti reaction patient with onchocerciasis treated with DEC → fever, hypotension, tachycardia} | | Used for filariasis, onchocerciasis |
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