Antiparasitic and antimalarial agents

Antiparasitic and antimalarial agents

Drug monograph · NCLEX study reference
Therapeutic class	Antiparasitic
Pharmacologic class	Antimalarials and anthelmintics by target
Onset / peak / duration	Varies; some single-dose (ivermectin, some anthelmintics), some multi-day.
Half-life / level	Hydroxychloroquine very long; no routine level.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Supportive care.
Pregnancy / lactation	Some used in pregnancy under specialist guidance (such as for malaria); albendazole avoided in the first trimester.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Antiparasitic and antimalarial agents — Antiparasitic; Antimalarials and anthelmintics by target.

Identification

• Therapeutic class: Antiparasitic.
• Pharmacologic class: Antimalarials and anthelmintics by target.

Pharmacology

• Mechanism of action: Disrupt parasite metabolism or neuromuscular function (ivermectin paralyzes parasites; benzimidazoles block glucose uptake; antimalarials interfere with parasite heme handling).
• Onset / peak / duration: Varies; some single-dose (ivermectin, some anthelmintics), some multi-day.
• Half-life / therapeutic level: Hydroxychloroquine very long; no routine level.

Clinical use

• Indications: Malaria prevention and treatment, lupus and rheumatoid arthritis (hydroxychloroquine), intestinal worms (albendazole, mebendazole), scabies and strongyloides (ivermectin), schistosomiasis (praziquantel).
• Usual dose, route, frequency: PO; malaria prophylaxis dosing per regimen and travel.
• Maximum dose / adjustments: Hydroxychloroquine dosed by ideal body weight to limit retinal toxicity.

Safety

• Contraindications: Retinal disease (hydroxychloroquine), hypersensitivity.
• Black box warning: None for these prototypes.
• Interactions: Hydroxychloroquine with QT-prolonging drugs and digoxin; antacids reduce its absorption; albendazole with dexamethasone (raises levels).
• Pregnancy / lactation: Some used in pregnancy under specialist guidance (such as for malaria); albendazole avoided in the first trimester.
• High-alert: No.

Adverse effects

• Common side effects: GI upset, headache; hydroxychloroquine can cause nausea and skin changes.
• Serious effects to report: Hydroxychloroquine retinopathy (vision changes), cardiomyopathy and QT prolongation, hemolysis in G6PD deficiency.
• Antidote / reversal: Supportive care.

Nursing process

• Assessment before administration: Baseline eye exam (hydroxychloroquine), G6PD status if relevant, cardiac history.
• Interventions during therapy: Take with food; periodic eye exams for long-term hydroxychloroquine.
• Monitor: Vision (hydroxychloroquine), parasite clearance, ECG if at risk.
• Evaluation / expected outcome: Eradication of the parasite or disease control.

Patient teaching

• Patient teaching: Complete the regimen; report vision changes (hydroxychloroquine); take with food.
• Notify provider if: Vision or color changes, palpitations, severe GI symptoms.
• Administration tips: With food; keep eye exam schedule for chronic hydroxychloroquine.