Clorsulon

**Clorsulon** is a highly effective, narrow-spectrum antiparasitic agent primarily used as a **flukicide**. - **Primary Indication**: FDA-approved for treating immature and adult liver flukes (*Fasciola hepatica*) in cattle. - **Off-label Uses**: Frequently utilized in sheep and camelids (llamas) for similar fluke infections. - **Limitations**: It is ineffective against flukes younger than 8 weeks, rumen flukes (*Paramphistomum* spp.), and lacks complete efficacy against *Fasciola magna* in sheep. > **Clinical Pearl**: Because of its narrow spectrum, clorsulon is often formulated in combination with macrocyclic lactones (like ivermectin) to provide broad-spectrum coverage against both internal/external nematodes and trematodes.

กลไกการออกฤทธิ์: Clorsulon exerts its flukicidal effect by disrupting the parasite's energy metabolism. - It competitively inhibits two key glycolytic enzymes in susceptible flukes: **3-phosphoglycerate kinase** and **phosphoglyceromutase**. - This blockade disrupts the **Emden-Myerhof glycolytic pathway** → depletes the fluke's primary metabolic energy source (ATP) → leads to paralysis and death of the parasite. - **Dose-dependent efficacy**: At 7 mg/kg, it kills migrating flukes (8 weeks post-infection); at 2 mg/kg, it only affects adult flukes (14 weeks post-infection).

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