Ivermection Mechanism of action

mechanism of action of avermectin class drugs
broad spectrum anthelmintic

1. IVERMECTIN ABHIJITH SP CVAS POOKODE

2. INTRODUCTION Ivermectin  is a medication used to treat many types of parasitic infestations. Ivermectin was discovered in 1975 and came into medical use in 1981.  It is on the World Health Organization's List of Essential Medicines. This includes head lice, scabies, strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis. It can be taken by mouth or applied to the skin for external infestations. Use in the eyes should be avoided. 21-09-2020 ABHIJITH SP CVAS POOKODE 2

3. CLASS It belongs broad spectrum Anthelmintics group. Class is Avermectins. Brand name: Soolantra, Stromectol, Sklice 21-09-2020 ABHIJITH SP CVAS POOKODE 3

4. EXAMPLES Ivermectin Abamectin Doramectin Eprinomectin 21-09-2020 ABHIJITH SP CVAS POOKODE 4

5. MOA 1.Alters chloride ion permeability which leads to paralysis and death 2.GABA Agonist activity 3.Kills microfilariae and impairs filarial reproduction and leads to MAZZOTTI REACTION, severe inflammatory response with fever, chills, swollen lymph nodes, arthralgias and other symptoms. 21-09-2020 ABHIJITH SP CVAS POOKODE 5

6. Mazzotti Reaction The  Mazzotti reaction , first described in 1948, is a symptom complex seen in patients after undergoing treatment of nematode infestation, particularly with the medication diethylcarbamazine (DEC). Mazzotti reactions can be life-threatening, and are characterized by fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, edema, and abdominal pain that occur within seven days of treatment of microfilariasis. The Mazzotti reaction correlates with intensity of infection; however, there are probably multiple infection intensity-dependent mechanisms responsible for mediating this complex reaction. The phenomenon is so common when DEC is used for the treatment of onchocerciasis that this drug is the basis of a skin patch test used to confirm that diagnosis. The drug patch is placed on the skin, and if the patient is infected with the microfilaria of  O. volvulus , localized pruritus and urticaria are seen at the application site. Drug of choice-Ivermectin. 21-09-2020 ABHIJITH SP CVAS POOKODE 6

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8. CLINICAL USE Used in 1.Ascaris lumbricoides 2.Enterobius vermicularis 3.Onchocerca volvulus (First choice) 4.Strongyloides stercoralis 5.Trichuris trichura 6.Scabies and External parasites 7. Heartworm infestation. 21-09-2020 ABHIJITH SP CVAS POOKODE 8

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10. TIPS Coolie, Shelties, Australian Shepherds, and English and Old English Sheepdogs breed is sensitive to ivermectin. Ivermectin is one of the most commonly used heartworm prevention medications used for dogs. It is present in many different heartworm products, including Heartgard Plus®, Iverhart Plus®, Iverhart Max®, Tri-Heart® and others. 21-09-2020 ABHIJITH SP CVAS POOKODE 10

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