C H A P T E R 1 3
Anthelmintic agents
187
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Anthelmintic drugs affect metabolic processes that
are either different in worms than in human hosts
or are not found in humans. These agents all cause
death of the worm by interfering with normal
functioning.
■■
Proper hygiene and sanitation processes are an
important part in preventing the spread of helminths,
including good hand hygiene, and preparation and
storage of food.
CHAPTER SUMMARY
■■
Helminths are worms that cause disease by invading
the human body. Helminths that affect humans
include nematodes (round-shaped worms) such as
pinworms, hookworms, threadworms, whipworms
and roundworms; and platyhelminths (flatworms),
which include tapeworms and flukes.
■■
Pinworms are the most frequent cause of helminth
infection in Australia and New Zealand, and
KEY POINTS
of the correct cause and use of the appropriate
drug
.
■
■
Administer the complete course of the drug
to
obtain the full beneficial effects
. Ensure that
chewable tablets are chewed. Give the drug with
food if necessary, but avoid giving the drug with
high-fat meals, which might interfere with drug
effectiveness.
■
■
Monitor hepatic and renal function before and
periodically during treatment
to allow for early
identification and prompt intervention if signs of
failure due to albendazole administration occur
.
■
■
Provide comfort and safety measures if CNS
effects occur (e.g. side rails and assistance with
ambulation in the presence of dizziness and
weakness)
to protect the person from injury
.
Provide oral hygiene and ready access to bathroom
facilities as needed
to cope with GI effects
.
■
■
Provide small, frequent, nutritious meals if GI
upset is severe
to ensure adequate nutrition
.
Monitor nutritional status and arrange a dietary
consultation as needed. Taking the drug with food
may also decrease GI upset.
■
■
Instruct the person about the appropriate dosage
regimen and other measures
to enhance knowledge
about drug therapy and to promote compliance
.
■
■
Provide the following teaching:
–– Take safety precautions, including changing
position slowly and avoiding driving and
hazardous tasks, if CNS effects occur.
–– Take the drug with meals and try small, frequent
meals if GI upset is a problem.
–– Identify the importance of strict hand washing
and hygiene measures, including daily laundering
of underwear and bed linens, daily disinfection
of toilet facilities and periodic disinfection of
bathroom floors (see Box 13.3).
–– Report fever, severe diarrhoea or aggravation of
condition, which could indicate a resistant strain
or non-effective therapy, to a healthcare provider.
Evaluation
■
■
Monitor response to the drug (resolution of
helminth infestation and improvement in signs and
symptoms).
■
■
Monitor for adverse effects (changes in orientation
and affect, nutritional state, skin colour and
evidence of lesions, hepatic and renal function and
reports of abdominal discomfort and pain).
■
■
Evaluate the effectiveness of the teaching plan
(person can name the drug, dosage, possible
adverse effects to watch for and specific measures
to help avoid adverse effects).
■
■
Monitor the effectiveness of comfort and safety
measures and compliance with the regimen.
Managing pinworm infections
Infestation with worms can be a frightening and
traumatic experience for most people. Seeing the worm
can be an especially difficult experience. Some worm
infestations are not that uncommon in Australia and New
Zealand, especially infestation with pinworms.
Pinworms can spread very rapidly among children in
schools, summer camps and other institutions. Once the
infestation starts, careful hygiene measures and drug
therapy are required to eradicate the disease. After the
diagnosis has been made and appropriate drug therapy
started, proper hygiene measures are essential. Some
suggested hygiene measures that might help to control
the infection include the following:
• Keep the child’s nails cut short and hands well scrubbed
because reinfection results from the worm’s eggs being
carried back to the mouth after becoming lodged under
the fingernails when the child scratches the pruritic
perianal area.
• Give the child a shower in the morning to wash away
any ova deposited in the anal area during the night.
• Change and launder undergarments, bed linen and
pyjamas every day.
• Disinfect toilet seats daily and the floors of bathrooms
and bedrooms periodically.
• Encourage the child to wash hands vigorously after
using the toilet.
• It is important to reassure individuals and families
that these types of infections do not necessarily reflect
negatively on their hygiene or lifestyle. It takes a
coordinated effort among health personnel, families
and individuals to control a pinworm infestation.
Individual and family teaching
BOX 13.3
