Anti-Parasitic &

Anti-Helminthic
Agents
 OBJEKT
IF
• Menerangkan definisi dan
tindakan ubat ‘Anti-parasitics
& Anti-helminthics’.
• Menerangkan kesan
sampingan ubat.
• Menyatakan contoh, dos dan
cara pemberian ubat.
• Menyatakan indikasi dan
kontraindikasi ubat.
• Menyatakan nasihat yang
relevan semasa penggunaan/
pemberian ubat.
Anti-Parasitic
Agents
 Parasites
• Organisma yang hidup di
dalam atau pada permukaan
organisma yang lain (host).
• ‘Parasites’ biasanya
mendatangkan kesan buruk
atau membunuh ‘host’.
• Contoh-contoh penyakit
yang disebabkan oleh
parasit adalah:
– Amebiasis
– Helminthiasis
 Anti-Parasitic Agent

• Ubat yang digunakan

untuk merawat
jangkitan parasit.
Amebiasis &
Amebicides
 Amebiasis

• Jangkitan yang disebabkan

ameba ‘Entamoeba
histolytica’.
• Terdapat 2 jenis amebiasis
• Intestinal amebiasis
• Extraintestinal amebiasis
• Intestinal amebiasis
• Ameba berada di dalam
usus
• senang dirawat.
• Extraintestinal amebiasis
• Ameba berada di luar usus
(biasanya pada hepar)
• Susah untuk dirawat
 Amebicides

• Ubat yang digunakan untuk

merawat amebiasis.
 Tindakan

• Amebicidal
• Membunuh ameba
 Indikasi Umum

• Untuk merawat
• Intestinal amebiasis
• Extraintestinal amebiasis
 Contoh ubat

• Chloroquine HCl (Aralen)

• Iodoquinol (Yadoxin)
• Metronidazole (Flagyl)
1. Chloroquine HCl 250mg
tablet (Aralen)

Category: C

Indication
• Extraintestinal amebiasis
 Dose

• 160-200mg/day IM (for 10-12

days).
 Kesan sampingan
• Hypotension
• Headache
• Nausea & vomiting
• Diarrhea
• Anorexia
• Abdominal cramp
• Visual disturbances
Contraindications
• Allergic to drugs

Interactions
• Corticosteroids
2. Iodoquinol (Yadoxin)
Category: B

Indication
• Intestinal amebiasis
 Dose

• 650mg tid PO after meal

(for 20 days).
 Kesan sampingan

• Skin eruption
• Nausea & vomiting
• Diarrhea
• Fever & chills
• Abdominal cramp
Contraindications
• Allergic to drugs

Cautious
• Thyroid disease
• Pregnancy
• Lactation
 Interactions
• Corticosteroids
3. Metronidazole 200mg tablet
(Flagyl)
Category: B

Indication
• Intestinal amebiasis
 Dose
• Adult:
• 400-800mg tds PO (for 5-10
days)
• Peads:
• 7.5mg/kg tds PO (for 10 days)
4. Metronidazole 200mg/5ml
suspension (Flagyl)

Category: B

Indication
• Intestinal amebiasis
 Dose
• Peads:
• 7.5mg/kg tds PO (for 7 days)
5. Metronidazole 500mg/100ml
Inj (Metrogyl)

Category: A

Indication
• Intestinal amebiasis
• Adult:
• 500mg IV infusion q 8 hr -
over 20 mins, flow rate
5ml/min (for 7-10 days).
• Peads:
• 7.5mg/kg IV infusion q 8 hr -
over 20 mins, flow rate
5ml/min (for 7-10 days).
 Kesan sampingan
• Headache
• GI disturbances
• Nausea
• Peripheral neuropathy
• Drowsiness & dizziness
• Leucopenia
• Seizure
 Contraindications

• Allergic to drugs
• Pregnancy (1st trimester)
 Cautious
• Blood dyscrasias
• Seizure (sawan)
• Severe hepatic impairment
• Active CNS disease
• Pregnancy
• Lactation
Interactions

• Alcohol
• Warfarin
• Lithium
• Phenytoin
• Cimetidine
 Soalan
1. Berikan definisi Amebicides
agents?
2. Terangkan cara tindakan
Amebicides agents?
3. Senaraikan contoh-contoh ubat
Amebicides?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat
Amebicides?
Helminthiasis &
Anti-Helminth
Helminthiasis

• Jangkitan dalam usus yang

disebabkan oleh helminths
(cacing).
 Roundworm Threadworm

Tapeworm Hookworm

• Contoh-contoh helminth
(cacing):
– Round worm (cacing gelang)
– Hook worm (cacing kerawit)
– Thread worm (cacing benang)
– Tape worm (cacing pita)
Anti-Helminthic agents

• Ubat yang digunakan untuk

merawat jangkitan helminth
dalam usus.
 Tindakan
• Membunuh helminth
(vermicide)
• Menyebabkan paralysis pada
otot helminth supaya mudah
disingkirkan malalui feces
(vermifuge)
General Indication

• Merawat jangkitan
helminth.
 Contoh ubat

• Albendazole (Zentel)
• Mebendazole (Vermox)
• Pyrental Pamoate
(Combantrin)
• Thiabendazole (Mintezol)
1. Albendazole 200mg tablet
(Zentel)
Category: C
 Indication
• Tape worm (cacing pita)
• Round worm (cacing
gelang)
• Hook worm (cacing
kerawit)
• Thread worm (cacing
benang)
 Tindakan

• Vermicides.
• Mengganggu pembentukan
microtubule parasit &
menyebabkan kematian
larva.
 Dose

• Adult & peads > 2 yrs:

• 2 tabs (400mg) as a single
dose
• Peads 1-2 yrs:
• ½ of adult dose
2. Albendazole 200mg/5ml
suspension (Zentel)

Category: C
 Dose

• Adult & peads > 2 yrs:

• 10ml (400mg) as a single
dose
• Peads 1-2 yrs:
• ½ of adult dose
 Kesan sampingan

• Liver dysfunction
• Abdominal pain
• Nausea & vomiting
• Headache
• Dizziness
 Contraindications
• Allergic to drugs
• Pregnancy

Cautious
• Hepatic impairment
• Lactation
 Interactions

• Dexamethasone &
Cimetidine
• Meningkatkan kesan
sampingan albendazole
2. Mebendazole (Vermox)
Category: C

Indication
• Round worm (cacing gelang)
• Hook worm (cacing kerawit)
• Thread worm (cacing benang)
 Tindakan
• Vermicides
• Menghalang pengambilan
glucose oleh parasit.
• Ini mengurangkan
kandungan glycogen yang
diperlukan untuk pembiakan
& survival.
 Dose

• 100mg bid (on morning &

evening) for 3 consecutive
days
Kesan sampingan

• Abdominal pain
• Diarrhea
Contraindications

• Allergic to drugs
• Pregnancy
 Interactions
• Carbamazepine
• Mengurangkan paras serum
mebendazole
 3. Pyrental Pamoate
(Combantrin)
Category: C

Indication
• Round worm (cacing gelang)
• Hook worm (cacing kerawit)
 Tindakan
• Vermifuge
• Melumpuhkan (paralyses)
otot-otot helminth
• Helminth will release its grip
on intestinal wall
• Kemudian disingkirkan
malalui feces
 Dose

• Adults & Peads > 2 yr:

• 10mg/kg as a single dose for
3 consecutive days
• Max: 1g/day
 Kesan sampingan
• Anorexia
• Abdominal cramp
• Nausea & vomiting
• Diarrhea
• Rash
• Headache
• Drowsiness & dizziness
 Contraindications
• Allergic to drugs

Cautious
• Hepatic impairment
• Pregnancy
• Anemia
Interactions
• Not found
4. Thiabendazole (Mintezol)
Category: C

Indication
• Thread worm
(cacing benang)
 Tindakan

• Vermicide
• Menghalang penghasilan
telur atau larva helminth
• Maka ubat ini mengganggu
kitar hidup helminth
 Dose

• < 150 lb (< 68.18kg):

• 10mg/lb per dose PO
• Max: 3g/d
• > 150 lb (> 68.18kg):
• 1.5g/dose PO
• Max: 3g/d
 Kesan sampingan

• Allergic reactions
• Drowsiness
• Dizziness
Contraindications
• Allergic to drugs

Cautious
• Hepatic/ renal
impairment
• Pregnancy
Interactions
• Not found
 Soalan
1. Berikan definisi Anti-Helminthic
agents?
2. Terangkan cara tindakan Anti-
Helminthic agents?
3. Senaraikan contoh-contoh ubat
Anti-Helminthic?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat Anti-
Helminth?