Flukicidal drugs: pharmacotherapeutics and drug resistance

Abstract

The purpose of this chapter is to review our current understanding of the action of flukicidesagainst Fasciola hepatica and Fasciola gigantica,particularly the former given the greater body ofwork reported in the literature for this species. Weillustrate how the drugs work and how they areabsorbed, distributed, metabolized and excretedby the host, which in turn dictates exposure of theparasite to the active drug or drug metabolites. Toachieve optimal efficacy, it is vital that a givendrug can gain access and accumulate within theparasite, hence we report on what we know aboutthe main route of drug entry into F. hepatica. Finally, as we face the threat of drug resistance inFasciola spp., we consider how we can determinewhen a parasite population has become resistantto a given drug and how they have evolved andadapted to overcome its effects, especially to thehighly effective drug triclabendazole (TCBZ).