The recent trends of parasitic infections in Korea include remarkable decreases of soil-transmitted nematode infections and elimination of lymphatic filariasis. In comparison, enterobiasis (pinworm infection) continues to be prevalent among children and the cases of zoonotic tissue-invading nematode infection are slightly increasing or they are being increasingly diagnosed. In addition, imported parasitoses continue to be problems from the clinical and public health points of view. In this review, the advances in the management and anthelmintic treatment of these nematode infections are briefly reviewed. Albendazole, mebendazole, thiabendazole, flubendazole, pyrantel pamoate, pyrvinium pamoate, oxantel pamoate, levamisole, ivermectin, and diethylcarbamazine are the examples of anti-nematode anthelmintics that are currently being used. Although several of these drugs are known to be broad-spectrum anthelmintics, selection of each drug should be done specifically for each nematode infection, and with consideration of the specific conditions of each patient and the purposes, for example, when performing individual or mass treatment. It is hoped that the chemotherapy regimens reviewed here will help physicians to treat their patients infected with nematode parasites.
Albendazole ; Anthelmintics ; Child ; Diethylcarbamazine ; Elephantiasis, Filarial ; Enterobiasis ; Humans ; Ivermectin ; Korea ; Levamisole ; Mebendazole ; Nematode Infections ; Parasites ; Public Health ; Pyrantel Pamoate ; Pyrvinium Compounds ; Thiabendazole

Drug-induced hepatotoxicity is injury to the liver as a result of drug exposure. Due to their unpredictable nature, drug-induced liver injuries pose a serious problem for clinicians, health agencies, and pharmaceutical firms. Albendazole is a benzimidazole with wide spectrum coverage as an antiparasitic drug. Very few cases of high-dose albendazole-induced hepatotoxicity have been reported so far, and no case in response to a single dose. A 25-year-old man presented to our hospital with dark urine. Twenty days prior to presentation, he took a tablet of albendazole (400 mg) as a prophylactic treatment for lumbricosis. Upon laboratory analysis, aspartate aminotransferase (AST) was 748 IU/L, alanine transaminase (ALT) was 939 IU/L, and total/direct bilirubin was 9.3/7.3 mg/dL. The patient was negative for viral markers (HAV, HBV, and HCV) and autoantibodies. Abdominal ultrasonography revealed no evidence of chronic liver damage. The pathology was compatible with drug-induced hepatotoxicity. The patient improved with conservative management only.
Adult ; Alanine Transaminase ; Albendazole ; Aspartate Aminotransferases ; Autoantibodies ; Benzimidazoles ; Bilirubin ; Biomarkers ; Drug-Induced Liver Injury ; Humans ; Liver

No abstract available.
Benzimidazoles ; Diarrhea

No abstract available.
Benzimidazoles ; Diarrhea

INTRODUCTIONNovel oral anticoagulants (NOACs) have at least equivalent efficacy compared to standard anticoagulants with similar bleeding risk. Optimal management strategies for bleeding complications associated with NOACs are currently unestablished.

MATERIALS AND METHODSA working group comprising haematologists and vascular medicine specialists representing the major institutions in Singapore was convened to produce this consensus recommendation. A Medline and EMBASE search was conducted for articles related to the 3 available NOACs (dabigatran, rivaroxaban, apixaban), bleeding and its management. Additional information was obtained from the product monographs and bibliographic search of articles identified.

RESULTSThe NOACs still has substantial interactions with a number of drugs for which concomitant administration should best be avoided. As they are renally excreted, albeit to different degrees, NOACs should not be prescribed to patients with creatinine clearance of <30 mLs/min. Meticulous consideration of risk versus benefits should be exercised before starting a patient on a NOAC. In patients presenting with bleeding, risk stratification of the severity of bleeding as well as identification of the source of bleeding should be performed. In life-threatening bleeds, recombinant activated factor VIIa and prothrombin complex may be considered although their effectiveness is currently unsupported by firm clinical evidence. The NOACs have varying effect on the prothrombin time and activated partial thromboplastin time which has to be interpreted with caution. Routine monitoring of drug level is not usually required.

CONCLUSIONNOACs are an important advancement in antithrombotic management and careful patient selection and monitoring will permit optimisation of their potential and limit bleeding events.

Administration, Oral ; Anticoagulants ; therapeutic use ; Benzimidazoles ; Consensus ; Dabigatran ; Hemorrhage ; prevention & control ; Humans ; Singapore ; Thiophenes

Triclabendazole was used in treatment of 249 fascioliasis patients selected from 25 provinces including 19 Northern and 6 Southern ones. Two different doses were used for two groups: 10mg/kg/body for 226 patients, and 20mg/kg/body for 43 others, twice per day with the interval 6-8 hours from meals. Symptoms on these fascioliasis patients were found as positive ELISA test with Fasciola gigantica antigen (100%), prejudice in liver by ultrasound (87.9%), pain of liver (87.1 %), eosinophilia (63.5%), plodding (26.1 %), fever (39.8%), digestive disorder (20.1%) and positive stool examination with Fasciola egg (16.9%). Most of symptoms were decreased and disappeared within 1 month after treatment except for pain of liver in some patients that lasted longer and disappeared within 6 to 12 months after treatment. The cure rate was 92.9% for 1 month after treatment, 95.2% for 3 months after treatment and 100% for 6 months after treatment. Ultrasound prejudice in liver decreased and disappeared 80.9% for 1 month, 92.6% for 3 months, 96.3% for 6 months and 100% for 12 months after treatment. Eosinophilia rate returned to normal of 90.7% for 6 months and 100% for 12 months after treatment. ELISA test with F. gigantica antigen become negative of 89.4% for 6 months and 100% for 12 months. GOT, GPT, urea and creatinin tests had not pathological change by 1 month using triclabendazole. Side effect of triclabendazole was inconsiderable and disappeared without medical treatment. Triclabendazole may be recommended in treatment for fascioliasis in Vietnam with doses of 10 or 20 mg/kg of body weight.
Fasciolidae ; Therapeutics ; Benzimidazoles

Human fascioliasis has recently been widely found in many regions of Vietnam confirmed by clinical and laboratory examinations. Therapeutic efficacy of the specific treatment drug for this disease - triclabendazole (provided by WHO) - was investigated in a study conducted in the hospital for tropical diseases, Ho Chi Minh city from November 2004 to August 2005. A total number of 53 patients treated with single dose of triclabendazole 10 mg/kg of body weight were found to have good compliance. All clinical symptoms disappeared within 24 hours of drug administration and three days later the patients were allowed to discharge with the good health status: pinky face, no abdominal pain and fever, normal vital signs, and good general status. All the patients were requested to return to hospital for re-checking after three months. However, only 18 of them had followed the request due to the objective reasons. The returned ones were found to have good health state with no resurgent clinical features and normal laboratory findings except for a slow decrease of antibody titer. The remaining patients were followed up via telephone and mails showed good health status. Triclabendazole was found to be a good anti-fascioliasis drug with high safety and efficacy and low side effects, and is recommended to widely use in treatment for fascioliasis.
Fascioliasis ; Therapeutics ; Benzimidazoles

The most important and widely-prescribed drug for anticoagulation is a vitamin K antagonist such as warfarin although it has several limitations in clinical use. New oral anticoagulants (NOACs) have been developed to overcome these problems. The clinical efficacy and safety of dabigatran, rivaroxaban, and apixaban have been shown to be superior to warfarin through large-scale clinical trials. These NOACs can replace warfarin in significant proportions of patients with non-valvular atrial fibrillation to prevent stroke. Recent management guidelines for atrial fibrillation have already recommended NOACs for stroke prevention instead of warfarin. Future clinical studies should resolve the limitations of NOACs and try to extend their clinical indications.
Anticoagulants ; Atrial Fibrillation ; Benzimidazoles ; beta-Alanine ; Dabigatran ; Humans ; Morpholines ; Pyrazoles ; Pyridones ; Rivaroxaban ; Stroke ; Thiophenes ; Vitamin K ; Warfarin

No abstract available.
Benzimidazoles ; Quinuclidines ; Tetrahydroisoquinolines ; Solifenacin Succinate

No abstract available.
Benzimidazoles ; Quinuclidines ; Tetrahydroisoquinolines ; Solifenacin Succinate