Drug Guide
Pyrvinium Pamoate
Classification
Therapeutic: Anthelminthic
Pharmacological: Pyrvinium Pamoate acts by disrupting energy production in helminths, leading to their paralysis and death.
FDA Approved Indications
- Treatment of intestinal pinworm (Enterobius vermicularis) infections.
Mechanism of Action
Pyrvinium Pamoate interferes with mitochondrial function in parasites, inhibiting electron transport and ATP synthesis, leading to paralysis and death of the worms.
Dosage and Administration
Adult: The typical dose for adults is 25-50 mg taken orally once or as directed by a healthcare provider.
Pediatric: Pediatric dosing varies; usually 25 mg orally once, may be repeated after a week if needed, under healthcare supervision.
Geriatric: Dosing is similar to adults; caution advised in elderly patients due to potential comorbidities.
Renal Impairment: No specific dose adjustment indicated, but use with caution.
Hepatic Impairment: No specific data available; use with caution.
Pharmacokinetics
Absorption: Poorly absorbed from the gastrointestinal tract, which is desirable for its intestinal effect.
Distribution: Minimal systemic absorption, remains mainly within the GI tract.
Metabolism: Metabolism details are limited; mainly unabsorbed drug acts locally.
Excretion: Excreted largely unchanged in feces; minimal systemic absorption reduces concern for renal excretion.
Half Life: Not well established due to minimal absorption.
Contraindications
- Hypersensitivity to Pyrvinium Pamoate or related compounds.
Precautions
- Use with caution in patients with pre-existing bowel disorders, or in pregnant or breastfeeding women, as safety data are limited.
Adverse Reactions - Common
- Mild gastrointestinal upset, nausea, or vomiting. (Uncommon)
Adverse Reactions - Serious
- Hypersensitivity reactions, including rash or angioedema. (Rare)
Drug-Drug Interactions
- None well-documented; however, caution with other medications affecting gastrointestinal motility.
Drug-Food Interactions
- No significant food interactions.
Drug-Herb Interactions
- No well-known interactions.
Nursing Implications
Assessment: Assess for signs of helminth infection, allergies, and prior hypersensitivity.
Diagnoses:
- Risk for allergic reaction.
- Impaired comfort related to gastrointestinal side effects.
Implementation: Administer as prescribed, usually as a single dose.
Evaluation: Monitor for resolution of parasitic infection symptoms, and any adverse reactions.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Maintain good hygiene to prevent reinfection.
- Seek medical advice if side effects occur or if symptoms persist.
Special Considerations
Black Box Warnings:
- None.
Genetic Factors: No known genetic considerations.
Lab Test Interference: No significant interference with laboratory tests reported.
Overdose Management
Signs/Symptoms: Gastrointestinal distress, possible toxicity in case of overdose.
Treatment: Supportive care; no specific antidote. Consult poison control if overdose is suspected.
Storage and Handling
Storage: Store at room temperature, away from moisture and heat.
Stability: Stable when stored properly.