Toxic Effects of Antiworm or Antihelminthic Drugs

There are a variety of antiworm/antihelminthic drugs used to treat worm infestations/infections. Though the effects and side effects of antiworm/ antihelminthic drugs are well evaluated before the clinical trials but the real time toxic effects with respect to age, sex and associated medication of patients should always be kept in mind. For your benefit, toxic effects of some commonly used antiworm/antihelminthic drugs are summarized below.

1. Piperazine:  Piperazine is considered safe and cheap and widely used in large scale treatment programs for roundworm infestations/infections. It acts by producing a neuromuscular block in Ascaris (roundworm) through anticholinergic action at myoneural junction and decrease the succinic acid production by worm. Piperazine is easily absorbed from the gastrointestinal tract. Around 20% of it is metabolized and rest is excreted in the urine. Its mild side effects are: Intestinal discomfort, dizziness, nausea and vomiting may occur occasionally. Over dose can cause urticaria or allergic respiratory reaction. Severe toxic effects could be referable to the 'central nervous system' (CNS) leading to confusional states, inordination, dropping of objects, vertigo, muscular weakness and myoclonic contractions. Severe epileptic seizures have also been reported. Piperazine should not be prescribed to patients with history of epilepsy, renal or liver disease and neurological disease. Use of piperazine should be avoided during the first trimester of pregnancy.
2. Pyrantel pamoate:  Pyrantel pamoate is highly effective broad spectrum antihelminthic. Pyrantel pamoate induces paralysis of roundworms. It is very effective as single dose therapy with moderate side effects. Adverse reactions such as abdominal disturbance, headache and dizziness occur occasionally.
3. Tetramisole:  Tetramisole is very effective against nematodes especially Ascaris lumbricoides or roundworms. It acts by inhibiting the action of enzyme succinate dehydrogenate in the muscles of Ascaris lumbricoides or roundworms, inhibiting the conversion of fumerate to succinate, resulting in paralysis of muscles of worms. Nausea, vomiting, abdominal disturbance, headache and dizziness are minor side effects of tetramisole.
4. Mebendazole:  Mebendazole is extremely effective and well tolerated broad spectrum antihelminthic like pyrantel pamoate. Cure rates of 100% have been documented in the treatment of roundworm infections. Mebendazole inhibit the glucose intake by worms and thus kill them. Mebendazole also kills the ova of nematodes. Only 5-10% drug is absorbed from intestine and excreted in urine as metabolite. Around 90% of drug is utilized to kill the worms in the intestine. Mebendazole is embryotoxic and teratogenic. Its use should be avoided in children below 2 years of age and during pregnancy.

Risks for a Pregnant Smoker !

The period of gestation, number of pregnancy and general health of a pregnant woman with smoking habit are the important factors which could influence the effect of smoking on the unborn baby. When a pregnant woman smokes, her unborn baby does the same. The carbon monoxide and nicotine are passed onto unborn baby through blood stream. The maternal blood laced with nicotine and enriched with carbon monoxide lessens the oxygen supply and accelerate the heart beat of unborn baby. The child is likely to be premature or under weight. The growth of the toddler would be affected and the child may be more susceptible to infectious diseases. The chances of spontaneous abortions and still-births are three times more in pregnant smoker as compared to non smoker pregnant. The risks are more pronounced in pregnant smokers with anemia and poor nutrition.

A non-smoker pregnant woman, whose husband smokes, would be having identical risks for her unborn baby. In fact a non-smoking wife of a smoker husband thus becomes a non-smoking smoker or passive smoker. Pregnant smokers and the husbands of non-smoker pregnant women should quit smoking for the better outcome of pregnancy and the health of their baby. Excessive smoking during first trimester of pregnancy may lead to abortion. Primigravida women ( women with first pregnancy) would be at more risk as compared to multigravida due to pregnancy associated physiological and metabolic changes as well as psychological and emotional factors.

Tobacco – An addiction forming drug and its implications

A doctor who smokes today must be a fool. There are many medical men who have not made much effort to give up smoking habit though they full knowledge of harmful effects and consequences of smoking. The role of tobacco in producing morbidity and mortality is well known. It is we proved that cigarette smoking is related with higher risk of lung cancer, ischemic heart disease, emphysema and chronic bronchitis. The risk of young one suffering from pneumonia and bronchitis is much higher if the parents smoke. The children of smoking parents also develop the habit of smoking.

Cigarette smoking carries special risks for women. Smoking during pregnancy has been observed to retard fetal growth. The habit may also lead to genetic disorders in babies born to smoker mothers. Spontaneous abortion rate is higher in women who smoke. However, outcome of pregnancy is not affected if smoking is given up as early as possible after conception. Smokers are more susceptible to infectious diseases also. There are many chemical substances in the smoke of cigarette and biri, but nicotine, carbon monoxide and tar are most harmful and hazardous for health. The tobacco that is not smoked but chewed or left in the mouth or snuffed is called smokeless tobacco. Smokeless tobacco is no alternative to smoking and is equally harmful. Chewable tobacco leads to tooth decay and mouth cancer.

A smoker who can not quit smoking is essentially an addict. Youngsters develop tobacco addiction during pre-teen years as they are not aware of its harmful effects and consequences. Youngsters fall prey to seductive advertising and sales promotion drives. More than one billion kilograms of tobacco is produced and consumed world wide every year. Around 40% of males above the age of 15 years smoke cigarettes or chew or eat tobacco. Around 3 million people die of tobacco-related diseases, worldwide yearly. The incidence of cancer of mouth, esophagus and the pharynx is 10 times higher in smokers as compared to non-smokers. Biri smoking carries a higher risk of lung cancer than cigarette smoking due to higher amount of tar sucked by the smokers.

Tobacco reduces the effectiveness/efficiency of a wide range of drugs used for the treatment of various ailments. The efficiency of analgesics, anti-asthmatic and anti-coagulants has been found to be reduced. Cigarette smoking increases the risk of cardiovascular diseases in women taking oral contraceptives. Female smokers are at higher risk if their blood pressure and cholesterol levels are high. Be determined to quit smoking for the sake of your own health and for the health of your family. Smoking is a slow-motion suicide attempt. If you are not able to quit smoking through determined will power, consult your physician and take de-addiction therapy and counseling.

Anti-thyroid Drugs: Precautions in Pregnancy, Lactation and Asthma

The thyroid gland of our body controls the body metabolism through its iodine containing hormones. Normal thyroid gland is not palpable but the enlarged thyroid gland could be felt in front of the neck and may be associated with non-toxic or toxic goitre. Goitrous gland may have normal function or under function (hypothyroidism) or over function hyperthyroidism). The exophthalmic goitre is known as Graves's disease and in this
disease the eye balls protrude due to thyrotoxicosis.

The compounds used as anti-thyroid drugs include carbimazole and propylthiouracil. Anti-thyroid drugs inhibit the formation of thyroxine and triiodothyronine (T3) in the thyroid gland. Propylthiouracil also retard the peripheral conversion of thyroxine into triiodothyronine (T3). The same drugs are also used for the treatment of thyrotoxicosis and preparation for thyroidectomy. Anti-thyroid drugs may suppress the bone marrow so blood cell counts are advisable at regular intervals during the course of treatment. Pregnant and/or lactating patients with thyrotoxicosis need to consult the endocrinologist and to reduce the dose to minimum. Patients with tracheal obstruction or asthma also need extra care during the treatment of hyperthyroidism or thyrotoxicosis. Anti-thyroid drugs may cause nausea, gastro-intestinal upset, thyroid enlargement, agranulocytosis, granulocytopenia ( low count of neutrophils and eosinophils), leucopenia (low count of white blood cells) and thrombocytopenia low count of platelets); that is why regular blood counts are advisable. Self-treatment of hyperthyroidism or thyrotoxicosis is not advisable, as it needs investigative follow up. However, carbimazole oral drug is started with a dose of 15-45mg daily in divided doses depending on the severity of the disease and maintenance dose could be 2.5-25mg daily for 12 months. For thyroidectomy preparation, the dose may be 15-45mg daily in divided doses for 2-4 weeks depending on the severity of the disease.

To know more about thyroid gland and its functions-click here: http://ntips4u.blogspot.com/2009/07/thyroid-gland-and-its-functions.html