antihelminthiques

Antihelminthiques are medicines used to treat infections caused by helminths, including nematodes (roundworms), cestodes (tapeworms), and trematodes (flukes). They work by disrupting essential biological processes in the parasites with the aim of eradicating infection while minimizing harm to the host.

Several classes are used in clinical practice. Benzimidazoles such as albendazole and mebendazole inhibit parasite microtubule formation, reducing glucose uptake and energy production. Macrocyclic lactones such as ivermectin bind to parasite chloride channels, causing hyperpolarization and paralysis. Praziquantel increases calcium permeability of parasite membranes, leading to muscle contraction and parasite death, and is particularly effective against cestodes and trematodes. Niclosamide interferes with energy metabolism in tapeworms, while pyrantel pamoate acts as a depolarizing neuromuscular blocker against nematodes.

Spectrum and use: antihelminthics are chosen based on the suspected or confirmed species, infection burden, and patient factors. Some agents are broad-spectrum for multiple helminths, while others target specific groups. They are usually administered orally, though formulations or co-administration may vary in special situations.

Safety and resistance: adverse effects range from mild gastrointestinal symptoms to dizziness or abdominal pain; rare neurologic or hepatic toxicity can occur, especially with certain drugs and liver impairment. Resistance has been reported in some parasite populations, highlighting the importance of correct indication and dosing, surveillance, and integrated control measures.

Public health and research: mass drug administration programs target endemic infections and aim to reduce transmission, while research continues to improve efficacy, safety, and resistance monitoring.