Ascaris Lumbricoides Medication

  • Author: Aaron Dora-Laskey, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Apr 4, 2012
 

Medication Summary

Benzimidazoles are effective for the treatment of intestinal ascariasis, although some authors recommend against their use in the first year of life and during pregnancy due to their teratogenic effects in animal studies. The most commonly recommended agents are albendazole and mebendazole. Ivermectin and pyrantel pamoate are alternatives, the latter having been suggested for pregnant patients in whom benzimidazoles are contraindicated. An anthelmintic agent from China, tribendimidine (at a dose of 300 mg), has been shown to be as efficacious as albendazole.[12, 13]

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Anthelmintics

Class Summary

Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.

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Albendazole (Albenza)

 

Decreases ATP production in worm, causing energy depletion, immobilization, and finally death.

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Mebendazole (Vermox)

 

Causes worm death by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestine where helminths dwell.

Piperazine citrate

 

Recommend for GI or biliary obstruction secondary to ascariasis; causes flaccid paralysis of the helminth by blocking response to worm muscle to acetylcholine.

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Pyrantel pamoate (Antiminth)

 

Depolarizing neuromuscular blocking agent; inhibits cholinesterases, resulting in spastic paralysis of worm.

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Ivermectin (Stromectol)

 

Binds selectively with glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, causing cell death.

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Levamisole (Ergamisol)

 

May inhibit worm copulation via agonism of L-subtype nicotinic acetylcholine receptors in male nematode muscles.

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Contributor Information and Disclosures
Author

Aaron Dora-Laskey, MD  Clinical Assistant Professor, Department of Emergency Medicine, Wright State University, Boonshoft School of Medicine

Aaron Dora-Laskey, MD, is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Ugo Anthony Ezenkwele, MD, MPH  Assistant Professor of Emergency Medicine, Department of Emergency Medicine, New York University School of Medicine/Bellevue Hospital Center

Ugo Anthony Ezenkwele, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, National Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Eric L Weiss, MD, DTM&H  Medical Director, Office of Service Continuity and Disaster Planning, Fellowship Director, Stanford University Medical Center Disaster Medicine Fellowship, Chairman, SUMC and LPCH Bioterrorism and Emergency Preparedness Task Force, Clinical Associate Progressor, Department of Surgery (Emergency Medicine), Stanford University Medical Center

Eric L Weiss, MD, DTM&H is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, American Medical Association, American Society of Tropical Medicine and Hygiene, Physicians for Social Responsibility, Southeastern Surgical Congress, Southern Association for Oncology, Southern Clinical Neurological Society, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark Louden, MD, FACEP  Assistant Medical Director, Emergency Department, Duke Raleigh Hospital

Mark Louden, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jon Mark Hirshon, MD, MPH  Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine

Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the medical review of this article by Joseph U Becker, MD.

References

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Adult Ascaris lumbricoides.
Life cycle of Ascaris lumbricoides.
Ascaris lumbricoides egg.
Adult Ascaris lumbricoides in biliary system.
The roundworm Ascaris lumbricoides causes ascariasis. Worms can reach 10-30 cm in length. Clinical disease results from effects of pulmonary larval migration, intestinal obstruction, or migration through the biliary tree.
Ascaris lumbricoides egg in feces (formalin-ethyl acetate sedimentation method).
Endoscopic retrograde cholangiogram shows long, linear, filling defect in common bile duct. Image courtesy of Medscape.com.
 
 
 
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