ANTHELMINTIC

any drug that acts against helminthic infections, i.e., those caused by parasitic worms. The term vermifuge is often applied to remedies used to remove intestinal worms; only rarely do the agents directly kill the parasites. No anthelmintic is completely effective, completely without toxic effect upon the host, or equally active against all worms. Most of the anthelmintics used in human medicine before World War II were replaced by more efficacious and less toxic drugs after the war. Anthelmintics have been developed to improve livestock production. Hygromycin is an antibiotic used as a feed additive to eliminate or reduce the large roundworms (Ascaris), nodular worms (Oesophagostomum), and whipworms (Trichuris) of swine, and the large roundworms (Ascaridia) and cecal worms (Heterakis) of poultry. Intestinal worm infections in general are more easily treated than those in other locations in the body. Because the worms need not be killed by the drug and the drug need not be absorbed when given by mouth, there is usually a wider margin of safety than with drugs for worm infections in other sites. Piperazine, introduced into human medicine about 1950 and shortly thereafter into veterinary medicine, relaxes the large intestinal roundworms (ascarids) and pinworms (oxyurids) of man and domesticated animals so that they are eliminated with the feces. Piperazine, still extensively used for infections of domesticated animals, including poultry, was superseded by the more active pyrvinium pamoate for the treatment of human pinworm infection. Other anthelmintics include dithiazanine, used for the treatment of the Strongyloides and whipworm of man and dog; thiabendazole, used primarily for the treatment of several nematodes of cattle, horses, and sheep but also used for treatment of whipworms and Strongyloides of man; tetramisole, used in some European countries, being, unlike most anthelmintics, apparently almost as effective against larval stages of intestinal nematodes as against adult worms in cattle, sheep, and poultry. Tetrachlorethylene, introduced in 1925 for the treatment of hookworms of man and dogs, is still used for the so-called American hookworm (Necator americanus) of man but was superseded by bephenium hydroxynaphthoate for the treatment of the European hookworm (Ancylostoma duodenale) of man and by disophenol for the treatment of canine hookworm (Ancylostoma caninum). Phenothiazine, introduced in the 1930s, is still used against the wireworm (Haemonchus contortus) of sheep and cattle. Quinacrine, an early synthetic World War II antimalarial later superseded, is now often used as an anthelmintic for the removal of the large tapeworms of man; it is also useful in the treatment of tapeworm infection of dogs. Other compounds used for intestinal worms of domesticated animals, but rarely of man, include arecoline hydrobromide, n-butyl chloride, carbon disulfide, copper sulfate, dichlorophen, lead arsenate, phthalofyne, and toluene. Dibutyltin dilaurate is used for tapeworm infections in poultry.