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Treatment of tissue helminthiases



Treatment of patients with tissue helminthiases, regardless of severity, is carried out in a hospital. In the acute period of the disease, with severe forms of trichinosis, toxocariasis, cysticercosis, complicated forms of echinococcosis (rupture or suppuration of an echinococcal cyst), bed rest is prescribed. A complete diet enriched with vitamins is shown.

Etiotropic therapy. It is indicated for all forms of tissue helminthiases, however, the spectrum of effective antiparasitic agents is extremely narrow, of which albendazole, mebendazole and praziquantel are used in the Russian Federation.

Universal and one of the most effective means is NEMOZOL (albendazole preparation).

The drug has a wide spectrum of anthelmintic activity, which is especially important for mixed invasions, since it has a therapeutic effect in lesions with round, flat (including pork tapeworm) worms and their larvae. Nemozole has an inhibitory effect on beta-tubulin polymerization in parasite cells. This leads to destruction of the cytoplasmic microtubules of the cells of the intestinal tract of helminths, a change in biochemical processes (suppression of glucose utilization), blockade of the movement of secretory granules and other organelles in the muscle cells of worms, which leads to their death. Unlike mebendazole preparations (vermox, vormin), which are practically not absorbed in the gastrointestinal tract, therefore do not have a sufficient effect in toxocariasis and trichinosis and are practically not effective in echinococcosis and cysticercosis, nemozole is absorbed in the gastrointestinal tract by 30%, and intake of fatty foods increases absorption the drug is 5 times what should be considered when appointing it.

Nemozole exists in the form of 400 mg tablets in one tablet for adults and adolescents and in the form of a suspension of 100 mg / 5 ml for children over 2 years of age. Pregnant women are not recommended.

Dosage and administration.
The drug is used orally during meals. Course and single doses are selected depending on the type of helminthiasis and body weight of the patient.

With toxocariasis and trichinosis, nemozole (albendazole) is prescribed for adults and patients over 14 years old with a body weight of more than 60 kg 400 mg 2 times a day, for patients with a body weight of less than 60 kg - 200 mg 2 times a day. For children, the drug is prescribed at a rate of 10 mg / kg / day in two divided doses. The course of treatment is from 7 to 14 days, depending on the duration and severity of the disease.

With echinococcosis and cysticercosis, nemozole (albendazole) is prescribed for adults and patients over 14 years of age with a body weight of more than 60 kg 400 mg 2 times a day, adults with a body weight of less than 60 kg and for children in a dose of 15 mg / kg / day . The course of therapy is 28 days. For the treatment of echinococcosis, it is recommended to carry out 3 courses of therapy with an interval of 2 weeks. In cases of uncomplicated liver echinococcosis, medication is possible. With a subarachnoid location of the cysticercus or its localization in the furrows of the brain, nemosol (albendazole) is used for at least 30 days, if necessary, the course of therapy can be repeated, after 2 to 3 weeks.

Of the other antiparasitic drugs, it is possible to use: with toks o akoz e - mebendazole (vermox, vormin) inside at the rate of adults at 100 mg twice a day, for children - 5 mg / kg / day in two divided doses 7-10 days; if necessary, repeated courses are possible;

with t and x inellez - mebendazole (vermox, vormin) inside, at the rate of adults, 100 mg three times a day, children - 5 mg / kg / day in two doses with a course of 5-7-12 days;

with cysticercosis - praziquantel 50-100 mg / kg / day in 3 divided doses, 30 days course (with neurocysticercosis in combination with prednisolone (usually in combination with prednisolone).

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Treatment of tissue helminthiases

  1. Antonov M.M .. Tissue helminthiases in adults and children (epidemiology, clinic, diagnosis, treatment, prevention), 2004

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