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Ivermectin may be applied topically or by bath if an amphibian is too small for oral or injectable administration. A combination of pyrantel pamoate and praziquantel (Drontal) has been used, and the dosage is determined by the amount of pyrantel pamoate. A typical dose is 5 to 10 mg/kg PO repeated every 7 days for 28 days. Pyrantel pamoate is an excellent choice for eliminating nematodes if the amphibian may be orally medicated. Kevin Wright, in Current Therapy in Reptile Medicine and Surgery, 2014 Pyrantel Pamoate 180 The related drug oxantel has recently been demonstrated to enhance the activity of albendazole against T. 179 Pyrantel has been shown to increase theophylline levels. Reported side effects are usually limited to anorexia, nausea, vomiting, abdominal cramps, and diarrhea. It has minimal toxicity at doses used to treat intestinal helminth infection. Safety in pregnancy and children younger than 2 years has not been established.
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It is usually effective in a single dose. The absorbed portion is metabolized and excreted in urine. 177,178 Pyrantel pamoate is poorly absorbed from the intestine more than 85% of the dose is passed unaltered in feces. 176 Resistance is associated with a modification of the nicotinic receptor. Pyrantel acts by targeting the nicotinic acetylcholine receptor on the surface of nematode somatic muscle, thereby depolarizing the neuromuscular junction of the nematode, resulting in irreversible paralysis and natural expulsion of the worm. Pyrantel pamoate is used to treat intestinal nematode infections, particularly hookworm and Ascaris infection but is ineffective in trichuriasis. Moore, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), 2015 Pyrantel Pamoate Pyrantel pamoate, which causes depolarization and increased spike frequency in worm muscle cells, should not be given with piperazine, which causes hyperpolarization and a reduction in spike frequency. Pyrantel pamoate and its analogs act by causing depolarizing neuromuscular blockade and by blocking acetylcholinesterase, which result in spastic paralysis and muscle contracture, respectively, and allow expulsion of the worms. Oxantel pamoate, an m-oxyphenol derivative, can be given in a single dose for Trichuris spp. lumbricoides, eosinophilic enterocolitis caused by Ancylostoma caninum, hookworm, the acanthocephalan Moniliformis moniliformis and Trichostrongylus spp. 1,2,64,65 It is considered by many to be the treatment of choice for E. Pyrantel pamoate, a tetrahydropyrimidine that was originally developed as a veterinary anthelmintic, has a broad range of activity in humans. Fleckenstein, in Infectious Diseases (Fourth Edition), 2017 Pyrantel Pamoate
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Pyrantel pamoate should not be administered concurrently with piperazine.į. If absolutely necessary, it can be used after the first trimester of pregnancy.
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Few data exist on use in pregnancy, and pyrantel pamoate is nonembryotoxic in animals. Although no specific data exist on its use in children younger than 2 years of age, no age-related problems have been documented. Pyrantel pamoate should be used with caution in people with hepatic dysfunction. Because of poor absorption from the gastrointestinal tract, side effects are restricted to infrequent occurrence of abdominal pain, diarrhea, dizziness, insomnia, rash, and headache. Paralyzed worms are expelled with intestinal peristalsis. The agent is nonvermicidal but causes depolarizing neuromuscular blockade of helminth musculature. Pyrantel pamoate is ineffective for trichuriasis. A single-dose regimen is sufficient for ascariasis and trichostrongylosis, but one dose daily on 3 consecutive days is required for hookworm infection. This drug has been supplanted by the benzimidazoles, except for its continued popularity for the treatment of enterobiasis. Pyrantel pamoate, a broad-spectrum anthelmintic drug, is available only as an over-the-counter oral suspension in the United States. Ryan, in Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), 2018 Pyrantel Pamoate.