Overview Microtubule Assembly Inhibitors Name of Drug Mechanism of Action Indications Albendazole, mebendazole Inhibits tubulin polymerization resulting in inability to form microtubules and impaires glucose uptake Ascaris lumbricoides Necator americanus Trichinella spiralis Enterobius vermicularis Trichuris trichiuria Echinicoccus Strongyloides stercoralis Taenia solium Microsporidia Thiabendazole Unknown but may inhibit helminth-specific fumarate reductase Paralyzing Agents via Depolarization Pyrantel pamoate Acts at neuromuscular junction by stimulating nicotinic receptors resulting in paralysis via depolarization Ascaris lumbricoides Necator americanus Enterobius vermicularis Agents That Increase Susceptibility of Microfilariae to Phagocytosis Diethylcarbamazine Sensitizes microfilarie to phagocytosis which immobilizes them via an unknown mechanism Wucheria bancrofti Brugia malayi Loa loa Onchocerca volvulus Toxocariasis Hyperpolarizing Agents Via Chloride Channel Opening Ivermectin Binds to glutamate-gated chloride ion (Cl-) channels in microfilaria increasing Cl- permeability resulting in paralysis via hyperpolarization Intensifies GABA transmission Impairs intrauterine development of Onchocera volvulus microfilariae may also inhibit its release from pregnant worms Onchocerca volvulus Strongyloides stercolais Ascaris lumbricoides Trichuris trichiura Enterobius vermicularis Filariasis Paralyzing Agents Via Increasing Calcium Ion Permeability Praziquantel Causes ↑ Ca2+ permeability in the parasite leading muscle contraction and ultimately paralysis by sustained contraction Schistosomiasis Clonorchiasis Paragonimiasis Taenia solium Other trematodes and cestodes Oxidative Phosphorylation Inhibitors Niclosamide Impairs ATP production by uncoupling of oxidative phosphorylation in the electron transport chain Tapeworm infections Fasciolopsis buski Miscellaneous Piperazine Selectively binds to GABA receptors resulting in paralysis via hyperpolarization Parasite is expelled from intestinal lumen of host via peristalsis of host Ascariasis Oxamniquine Inhibits nucleic acid metabolism Paralyzes via unknown mechanism Schistosoma mansoni