Mechanism of effect
Piperazine is a GABA receptor agonist . Piperzine binds directly and selectively to muscle membrane GABA receptors, presumably causing hyperpolarization of nerve endings, resulting in flaccid paralysis of the worm.
While the worm is paralyzed, it is dislodged from the intestinal lumen and expelled live from the body by normal intestinal peristalsis.
Pharmacodynamic
Piperazine is an anthelminthic especially useful in the treatment of partial intestinal obstruction caused by Ascaris worms , which is a condition primarily seen in children. Piperazine hydrate and piperazine citrate are the main anthelminthic piperazines.
Pharmacokinetics
Absorption : Readily absorbed from the GIT (oral) .
Distribution : Distributes into breast milk .
Elimination :Renal—Approximately 20% is excreted unchanged in the urine within 24 hours.
Dosage
For oral suspension dosage form:
For common roundworms or pinworms:
** Adults and teenagers—1.8 grams every four hours for a total of three doses in one day. Treatment may need to be repeated in two weeks.
**Children—Dose is based on age. Treatment may need to be repeated in two weeks.
- Up to 2 years of age: 600 milligrams (mg) every four hours for a total of three doses in one day.
- 2 to 8 years of age: 1.2 grams every six hours for a total of two doses in one day.
- 8 to 14 years of age: 1.2 grams every four hours for a total of three doses in one day.
Drug contraindications
in patients with history of convulsive disordersSide effects
nausea , Headache , vomiting , vertigo , Diarrhea , fever , Tremor , Visual abnormalitiesAlerts
The presence of other medical problems may affect the use of piperazine . Make sure you tell your doctor if you have any other medical problems, especially:
Kidney disease or Liver disease—Patients with kidney or liver disease may have an increased chance of side effects .
Seizure disorder, especially a history of epilepsy—Piperazine may make the condition worse
Points of recommendation
It is important that your doctor check your progress after treatment. This is to make sure that the infection is cleared up completely, and to allow your doctor to check for any unwanted effects.
If your symptoms do not improve after you have taken piperazine for the full course of treatment, or if they become worse, check with your doctor.
For patients taking piperazine for pinworms :In some patients, pinworms may return after treatment with piperazine. Washing (not shaking) all bedding and nightclothes (pajamas) after treatment may help to prevent this.
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