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Anthelmintics: Nursing Pharmacology

Notes

Notes

ANTHELMINTICS
DRUG NAME
albendazole (Albenza), thiabendazole (Mintezol), mebendazole (Vermox), ivermectin (Stromectol), praziquantel (Biltricide), diethylcarbamazine (Hetrazan), pyrantel pamoate (Pin-X)
CLASS
Anthelmintics
MECHANISM OF ACTION
Disrupt metabolic pathways in parasitic worms, killing them
INDICATIONS
Parasitic worm infections (e.g., pinworms, tapeworms, intestinal flukes)
ROUTE(S) OF ADMINISTRATION
PO
SIDE EFFECTS
  • Headaches, drowsiness, dizziness, weakness
  • Gastrointestinal disturbances (e.g., anorexia, nausea, vomiting, diarrhea, cramping)
  • Skin rash, urticaria
CONTRAINDICATIONS AND CAUTIONS
  • Pregnancy
  • Breastfeeding
  • Severe diarrhea
  • Malnourishment
  • Hepatic or renal disease
NURSING CONSIDERATIONS: ANTHELMINTICS
DRUG NAME
albendazole for pinworm infection
ASSESSMENT AND MONITORING
Assess
  • Weight
  • Symptoms: perianal itching, erythema, excoriation, disturbed sleep, irritability, loss of appetite
  • Laboratory test results: CBC, renal and hepatic function
  • Cellophane tape tests: presence of pinworm eggs

Monitor
  • Side effects
  • Therapeutic goals: eradication of pinworm infection, resolution of perianal itching, normal sleep patterns, prevention of infection spread, absence of reinfection
CLIENT EDUCATION
  • Common intestinal infection, especially in children
  • Purpose of medication: eradication of the pinworm infection
  • All members of the household will also be treated
  • Treatment consists of two doses administered two weeks apart
  • Take the medication on an empty stomach, may be crushed or chewed, followed by a glass of water
  • Side effects: headache, abdominal pain, nausea, and vomiting
    • Contact pediatrician if symptoms do not resolve
  • Lifestyle modifications
    • Scrupulous hand hygiene
    • Avoid touching or itching the perianal area
    • Assist child to keep their fingers out of their mouth
    • Keep child's nails trimmed short
    • Clean pajamas, bed linens, and underclothes daily in hot water
    • Showering rather than bathing
    • Avoid co-bathing
    • Disinfect toys, toilets, sinks, and handles
    • Inform school nurse, teachers, daycare staff about the child’s infection and treatment
Transcript

Anthelmintics are a group of medications used to treat intestinal and systemic parasitic worm infections, such as those caused by pinworms, tapeworms, and intestinal flukes.

The most commonly used anthelmintics include albendazole, thiabendazole, ivermectin, praziquantel, diethylcarbamazine, and pyrantel. These medications are taken orally.

Once administered, anthelmintics act in parasitic worms by disrupting metabolic pathways that are required for their normal functioning, ultimately killing the worm.

As far as side effects go, these are typically very few and limited to the duration of treatment. So, clients might experience headaches, drowsiness, dizziness, and weakness.

In addition, anthelmintics may often cause gastrointestinal disturbances, such as anorexia, nausea, vomiting, diarrhea, and cramping. Finally, some clients may develop a skin rash or urticaria.

Now, anthelmintics are contraindicated during pregnancy and breastfeeding. Additional precautions should be taken in clients with severe diarrhea, malnourishment, and hepatic or renal disease.

Alright, when a pediatric client is diagnosed with a pinworm infection caused by Enterobius vermicularis, they can be prescribed an anthelmintic medication, like albendazole.

Before administering the medication, be sure to perform a focused assessment, including their current weight and a description of their symptoms, such as the presence of erythema or excoriation, itching in the perianal area, a report of restless sleep due to itching during the night, as well as irritability and loss of appetite.

Then, review their most recent laboratory test results, including CBC, renal and hepatic function tests. Lastly, review the results of the cellophane tape test confirming the presence of pinworm eggs.

Then, explain to the client and caregiver that pinworms are a common intestinal infection, especially in children, and assure them that albendazole is effective in treating the infection.

In addition, be sure to explain that the infection is easily transmitted, so all members of the household will need to be treated at the same time.

Next, let them know the treatment consists of just two doses administered two weeks apart; and emphasize the importance of completing the full course of medication in order to completely eliminate the parasite.

Advise them to take the medication on an empty stomach, and let them know that the pills can be crushed or chewed and followed by a glass of water, if needed.