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Ivermectin is authorised in the world under the following brand names: Ivermectin B1, Ivermectin-luminol, Mectizan, Stromectol.

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Nematodes

Nematodes (roundworms) are nonsegmented, tapered, bilaterally symmetrical, cylindrical organisms that have complete digestive tracts and reproduce sexually. Although > 500,000 species of nematodes have been described, only a small number are commonly encountered as human parasites. Most nematodes have complex life cycles, sometimes involving several larval forms and intermediate hosts or free-living stages. The pathogenic nematodes may be categorized as primarily intestinal or extraintestinal tissue parasites (Box 1).

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Since neurocysticercosis is a neurological infection, it is not surprising that when treating it with any drug some of the neurological reactions to that drug (or to the death of the parasite) are particularly pronounced. For example, with a dose of 1.5 mg/kg continued for some time in cases of neurocysticercosis, a majority of patients initially develop intolerance in the form of headache, vomiting, fever, and occasionally diplopia and meningeal irritation.

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Albendazole has been used in the treatment of human hookworm and trichuriasis. In a mass-treatment report from Western Australia 295 individuals in a remote rural area were treated with albendazole 400 mg/day for 5 days because of possible Giardia lamblia and hookworm infections. The 37% prevalence of Giardia fell to 12% between days 6 and 9, but rose again to 28% between days 18 and 30. The effect on hookworms (Ankylostoma duodenale) was more pronounced and more sustained with a reduction of the pretreatment prevalence of hookworm infections from 76% before treatment to 0% after 3^1 weeks.

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Emesis, ataxia, and mydriasis are cardinal signs of ivermectin toxicity. The safety, tolerability, and pharma-cokinetics of escalating high-dose ivermectin have been studied in 68 healthy subjects in a randomized, double-blind, placebo-controlled study in the following doses: Ivermectin was generally well tolerated. Quantitative pupillometry ruled out any mydriatic effect of ivermectin.

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Nitrofurantoin is a synthetic nitrofuran that belongs to a group of organic substances characterized by a heterocyclic ring consisting of four carbon atoms and one oxygen atom. Its mechanism of action is not understood. Nitrofurans enter bacterial cells and interact with several enzymes; thereby inhibiting bacterial growth. Nitrofurantoin is active against many Gram-positive and Gram-negative bacteria.

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Except for cardiovascular collapse in anaphylactic shock, adverse cardiovascular events seem to be extremely rare with nitrofurantoin. In experimental animals, cardiotoxic effects have been described. Acute respiratory reactions to nitrofurantoin include dyspnea, cough, interstitial pneumonitis, and pleural effusion, while interstitial pneumonitis and fibrosis are common chronic reactions. Nitrofurantoin causes acute lung injury more often than any other drug.

Parasitic Infections

Most infectious agents fulfill the definition of a parasite: an organism that grows, feeds, and shelters on or in a different organism and contributes nothing to the host. However, medical science has created the classification “parasite” to include a complex group of nonfungal eukaryotic human pathogens. Unlike fungi, parasites have no cell wall and are often motile.

Intestinal Helminths

Infections are often asymptomatic. In the immuno-compromised host, Strongyloides can progress to a fatal hyperinfection syndrome. Helminths include the roundworms (nematodes), flukes (trematodes), and tapeworms (cestodes). These parasites are large, ranging in size from 1 cm to 10 m, and they often live in the human gastrointestinal tract without causing symptoms.

Dosage forms of Ivermectin:
Stromectol 3 mg tablet Ivermectin powder Stromectol 20 3 mg tablet Box

Synonyms of Ivermectin:

22,23-Dihydroxy-avermectin B, 22,23-Dihyroavermectin B1, 5-O-demethyl-22,23-dihydro-avermectin A1a

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Therapeutic classes of Ivermectin:

Anthelmintics, Antinematodal Agents, Antiprotozoal Agents

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