(3) Since the gastrointestinal tract of adults does not appreciably increase in
size with increased weight gain, the dosage for adults need not exceed that
recommended for a patient weighting 154 pounds. A single dose of 7 teaspoonfuls of
the oral suspension should be adequate for patients who weigh more than 154 pounds.
(4) Adverse reactions associated with this drug include nausea, vomiting,
cramping, and diarrhea.
f. Paromomycin (Humatin). Paromycin is used as an alternative drug of
choice (not an approved Food and Drug Administration indication) for tapeworm
(cestodes) infestation. This drug is also used in the treatment of amebiasis. Paromycin
is a broad-spectrum antibiotic that is poorly absorbed from the gastrointestinal tract.
Adverse effects associated with this agent include abdominal pain, diarrhea, nausea,
and vomiting. This agent has the potential for causing nephrotoxicity, ototoxicity, and
central nervous system toxicity. It should be used with caution by patients who have
ulcerative lesions of the bowel to avoid renal toxicity through inadvertent absorption.
Paromycin should not be used by persons who have intestinal obstructions.
g. Niclosamide (Niclocide). Niclosamide is the drug of choice in the
treatment of tapeworms. The scoleces and proximal segments of the cestode are
rapidly killed on contact with this agent. Concomitant use of a laxative is not necessary
except in the treatment of Taenia saginata (beef tapeworm) infections. It should be
used with extreme caution in children under the age of 2 years due to lack of experience
with the drug in this age group. The tablets should be crushed or chewed before being
swallowed. Some patients may experience mild nausea and vomiting.
h. Emetine hydrochloride. Emetine hydrochloride is the drug used in the
treatment of intestinal and extraintestinal amebiasis. Because of its toxicity, patients
should be hospitalized during treatment with emetine. Adverse effects with the use of
this drug include precordial pain, tachycardia and other arrhythmias, congestive heart
failure, dyspnea, and hypotension. Nausea, vomiting, dizziness, headache, and
skeletal muscle weakness may also occur. This drug should not be used in patients
with a history of cardiac or renal disease or in pregnant women. It should not be used
by young children unless alternative drugs have not been effective.