01-Jun-21
Introduction
• Cestodes- true tapeworms
• Taeniacides: Anticestodal (Antitapeworms) drugs that
cause the death of the tapeworm in situ are referred to
Anticestodal Drugs as taeniacides e.g. Dichlorophen
• Taeniafuge: Compounds that cause or facilitate
tapeworm expulsion are termed taeniafuge e.g.
Arecoline HBr
Dr Mazhar Ul Haq • They interfere with the ability of the tapeworms to
Dr Asif Riaz maintain their position in the digestive tract by
mucosal attachment of the scolex & by undulation
• The administration of taeniafuge is generally
accompanied by purgation
1 2
Background Natural organic compounds
• Undulation: Action of moving smoothly up and down • Earliest drugs
• Destrobilization: Some drugs merely remove the
proglottids & soma but leave the scolex intact • Plant origin
• This is unsatisfactory in antiparasitic action • Examples include
• As cestodes scolex is capable of regeneration an entire • Pomegranate, Pumpkin seeds, Cucurbitine,
organism
Male fern extract, Arecoline, Nicotine sulfate,
• Successful antitapeworm treatment is complete
removal of the parasite Kamomela
• The usual interval from destrobilization to potency is
approx 3 weeks
3 4
Inorganic compounds Synthetic Organic Compounds
• Tin dust, Lead arsenate, CuSO4, KMnO4 • Bunamidine HCl was developed in 1960s
• For long time, lead arsenate (often mixed with • Available as tablets
Phenothiazine) was used to treat tapeworm • Requires fasting before treatment
infections in sheep • Used in cestode infection in dogs & cats
• Due to low safety margin, no longer used • Bunamidine Hydroxynaphtrate – oral
• CuSO4 drench used to control stomach worms suspension
• KMnO4 is used for the control of parasitic • Effective against Moneizia infection in small
infestations in fish ruminants
5 6
1
01-Jun-21
Niclosamide Dichlorophen
• Widely been used for treatment of Cestodes in dogs & • 1st synthetic anticestodal drug (1946)
cats (1960-1980)
• Administred after 12 h fasting
• Used as taeniacide in veterinary medicine for
• A laxative is required before Niclosamide many years (dogs & cats)
• A purgative is required 2 h after Niclosamide in simple • Widely used in small ruminants for Moneizia
stomach and 4 h in ruminants expansa in sheep
• Inhibition od parasites mitochodrial anerobic • For dogs & cats used with Toluene
phosphorylation of ADP
• Has inconsistent efficacy against Dipylidium spp. • Successfully removes 95% of ascarids
• Not ovicidal • Has been superceded by Praziquantel &
• Dog@50mg/Kg PO repeat after 1 week Niclosamide
7 8
Resorantel Bithionol
• Anticestodal drug for ruminants • A phenolic compound, Agrochemical(pKa4.82)
• Has been used for tapeworms in dog, cat &
• Highly effective against Moniezia spp. In both poultry
sheep & cattle • Also used for rumen flukes of sheep, goat and
• Resorantel and Oxyclosanide are drug of cattle
choice against adult and immature rumen • Readily absorbed from GIT & widely distributed
throughout the body
flukes • Withdrawn from the market after finding it a
• Also has efficacy against rumen flukes when potent photosensitizer caused serious skin
used @ 65mg/Kg PO disorders
9 10
Praziquantel Praziquantel …
• Novel anthelmintic with excellent activity against • Has a significant 1st pass effect
a wide spectrum of adult & larval cestodes of
animals and humans • Crosses BBB- an asset for larval stages
• Effective against all species of schistosomes • Quickly metabolized to inactive form in liver
pathogenic to humans
• Sparingly soluble in H2O • Renal excretion is the main route of
• Soluble in most organic solvents elimination
• Quickly & almost completely absorbed from GIT • increased F value once co-administered with
after oral administration Albendazole
• Css is achieved in 30-120 min in dogs
11 12
2
01-Jun-21
Mechanism of Action Clinical Use
• Primary effect is instantenous • In dog/cat @5mg/Kg PO @5.8mg/Kg SQ
• Rapid & sustained tetanic contraction of parasitic
musculature • Cat @12mg/Kg Spot-on
• Rapid vacoulization of the syncytial tegument • For lung flukes @25mg/Kg SID for 3 cons. Days
• Increase visible blobs above tegument surface
• Vacoulization of tegument is restricted to anterior • In combination with Febantel (Paste) and
region of strobila of tapeworm Pyrantel (Tablets)
• Metabolic changes include decrease in glucose uptake,
glycogen storage, ATP content & lactate release • Praziquantel (1-1.5mg/Kg) + Febantel (10-
• All effects are thought to be mediated by release of 15mg/Kg) used in the traetment of GI
intracelluar stored Ca++ nematodes & Cestodes for 3 consecutive days
13 14
Clinical Toxicities/Adverse Effects
• A triple combination of Praziquantel, Pyrantel • Wide margin of safety ~10x
& Oxantel is marketed as broad spectrum • Safe in breeding and pregnancies
dewormer for dogs & cats • Contraindicated for ocular Cysticercosis –
• Other combinations include Praziquantel plus destruction of organism may damage eye
Oxibendazole, Mebendazole & Fenbendazole • Contraindicated in puppies <4wks, kitten<6wks
• A recent combination of Praziquantel with • Vomiting is frequent after PO
Emodepside as broad spectrum anthelmintic • Transient injection site pain is frequent after IM
for cats
15 16
Epsiprantel Comparison
• Cestocidal compound chemically related to
Praziquantel
• Used specifically for treatment of tapeworms in
dogs & cats
• Causes tegumental damage in both adult& larva
• Fasting before administration is not necessary
• Poor GI absorption, high conc. Fecal elimination
• Practically insoluble in water
• Systemic availability after PO is negligible
• Dog @5.5mg/Kg [email protected]/Kg
17 18
