HELMINTHICIDES (antihelminthica; synonym anthelmintic means) — himoterapevtichesky means for treatment of the diseases caused by helminths and their larvae.
In modern medical practice as P. villages use hl. obr. the synthetic substances relating to phenolic compounds, napr, diphezyl, Naftamonum (see), phenasal (see), etc.; to chlorinated hydrocarbons, napr, hloksit (see), etc., and also to other classes of chemical connections, napr, quinacrine (see), Aminoacrichinum (see), levamisole (see), piperazin (see), ditrazin (see), etc. From organic compounds of antimony as P. villages use antimonyl-sodium tartrate (see). Some P. of page — a plant origin, napr, drugs of a men's fern (see. Fern men's ), emetine (see), seeds of pumpkin. As villages sometimes use P. oxygen (see).
On the mechanism of action on helminths P. of page it is possible to divide into several groups. Some P. of page are all-cellular poisons with the expressed narcotic properties (hloksit), others — break function of neuromuscular system of helminths, rendering cholinomimetic (ditrazin, Kombantrinum), antikholinesterazny (emetine) or holinoblokiruyushchy (piperazin) action. It is also possible to allocate
P. the pages paralyzing neuromuscular system of preferential flat worms, destroying them cover fabrics or secretory system (drugs of a men's fern, phenasal); the drugs operating with hl. obr. on power processes, napr, strengthening aerobic breath (oxygen), suppressing glycolysis (antimonyl-sodium tartrate, levamisole), oppressing aerobic breath and breaking absorption of carbohydrates (Vanquinum). However this classification is conditional since the principles and mechanisms of effect of many drugs need specification.
Sometimes P. pages divide by the principle of localization of helminths in an organism into drugs for treatment of helminthoses went. - kish. a path and drugs for treatment of fabric helminthoses. But for many modern P. such differentiation is impossible for page.
P.'s classification by the village by the main orientation of effect of drugs on various classes of helminths is more acceptable. On this classification of P. of page divide into the drugs used for treatment trematodoz (see), tsestodoz (see) and nematodoses (see). However there is a number P. of the page having efficiency concerning helminths of different classes. It is reasonable to page to consider such P. as special group of drugs of a wide range of antivermicular action.
Among P. of the pages applied to treatment trematodoz, allocate two groups of drugs. To the first group the drugs used for treatment of trematodoz of a liver — an opisthorchosis, a clonorchosis and a fascioliasis, concern to the second — the drugs used for treatment of shistosomoz. Most widely apply to treatment of trematodoz of a liver hloksit. Upon termination of treatment hloksily appoint cholagogue means and carry out repeated duodenal sounding for removal of the dead and partially damaged trematodes that significantly complicates treatment. At shistosomoza use hl. obr. antimonyl-sodium tartrate and emetine hydrochloride. But these drugs, as a rule, cause heavy by-effects in this connection in modern practice for treatment of trematodoz the villages of a broad spectrum of activity (e.g., a prozikvantel) having protivotrematodny action use more effective and less toxic P. more often.
The items of page applied to treatment tsestodoz (a teniarinkhoza, a teniosis, a diphyllobotriasis and a hymenolepiasis) were effective and for treatment of trematodoz of intestines (a metagonimosis, a nanofiyetoz, etc.). Extract of a men's fern, phenasal, quinacrine and Aminoacrichinum concern to this group P. of page. Extract of a men's fern is highly effective at all intestinal tsestodoza, but is very toxic and demands special training of patients for treatment in this connection this drug can be used only in the conditions of a hospital. Quinacrine and Aminoacrichinum — low-active P. of page therefore in modern medical practice are used seldom, especially after implementation of phenasal. Phenasal differs in high performance at tsestodoza and trema doses of intestines and does not demand special training of patients for treatment. Phenasal can be applied in a combination with extract of a men's fern, quinacrine. It must be kept in mind, however, that safety of use of phenasal at a teniosis is not finalized since at use of this drug there is a destruction of proglottids of a pork tapeworm that can lead to autoinvasion and development of cysticercosis.
To P. the page applied at nematodoses, piperazin, levamisole, oxygen, Vanquinum, Kombantrinum, Naftamonum, diphezyl, Vermoxum, ditrazin, etc. belong. Piperazin is effective at an ascaridosis and an enterobiosis, does not demand use of purgatives, malotoksichen that allows to use it for mass deworming. Oxygen is used sometimes for treatment of an ascaridosis and a trichuriasis. Levamisole is one of the most effective P. of page at an ascaridosis. At an enterobiosis it is possible to use Vanquinum, but on portability and efficiency preference should be given to Kombantrinum which usually does not cause by-effects. Kombantrinum is effective also at an ascaridosis and ankilostomidoza. At a dochmiasis use Naftamonum which, in the absence of other P. of page, it is possible to apply also at an ascaridosis and a trichuriasis. However at a trichuriasis diphezyl is more effective drug, close to Naftamonum, and at a necatoriasis and a strongyloidosis — thiabendazole which is effective also at a trichinosis. Thiabendazole in an early stage of a trichinosis since it suppresses reproductive ability of intestinal trichinellas is especially effective. This drug use also for therapy of larvaceous nematodoses, in particular a toksokaroz. At a trichuriasis sometimes apply dithiazanine. However it can cause heavy side effects. Apply to treatment of filariases ditrazin. The by-effects observed at use of this drug arise in connection with mass destruction of microfilarias and a sensitization of an organism of the patient to products of their destruction.
The page of a broad spectrum of activity can carry Vermoxum which was offered as P. to page for therapy of nematodoses in the beginning to P. It is applied at nematodoses went. - kish. a path, especially at a trichuriasis. It is effective also at all stages of development of a trichinosis, at a dracunculosis and larvaceous nematodoses. It is established that Vermoxum has a nek-swarm activity at trematodoza of a liver and tsestodoza.
Bibliography: Clinical pharmacology, under the editorship of V. V. Zakusov, page 550, M., L978; A. I Moles. Biological bases of classification of antgelmintik, Medical pas-razitol., t. 39, No. 4, page 483, 1970; it, New anthelmintic Pyrantelum, in the same place, t. 42, No. 3, page 348, 1973; it, Bases of experimental therapy of helminthoses, M., 1973; Moles A. I., Bayandin D. G. and Chernyaeva A. I. Mebendazol (Vermoxum) — new anthelmintic of a broad spectrum of activity, Medical parazitol., t. 47, No. 2, page 48, 1978; The Medicines used at parasitic diseases under the editorship of A. I. Krotov, page 85, M., 1979; Seubert T., P oh Ike R. a. Loe-b i with h F. Synthesis and properties of praziquantel, novel bread spectrum anthelmintic with excellent activity against Schistosomes and Cestodes, Experientia, v. 33, p. 1036, 1977.
A. I. Krotov.