depends what species your treating.
IP's usually are indicated by a few thing ime...
-always hungry yet the fish never seems to bulk -up ( in spiney eels and rays I've seen, the stomach seems full/bloated yet the head is "boney" and the rest of the fish appears emaciated)
- white stringy poop ( It's not always IPs sometimes foods will cause this, imo its a sign of intestinal unrest if you will.)
- gastro unrest ( undilations of the body, "odd behaviors", either lethargic or can't seem to "rest" )
Any of those 2 symptoms and I usually treat w/ prazi... pre-soaking their usual pellets works ime, or if nightcrawlers are a favored food injecting them seems by general concensus one of the best ways. I directly add it to my water every 4-6 monthes for my live eating fish for the past few years now as a precautionary measure and IPs aren't an issue any longer w/ them.
I also ere on the side of less is more... IN cases where a heavy parasite infestation or young fish is concerned killing all the IPs in one shot can be lethal to fish ( and ime other animals, I've owned my horse almost as long as I've been keeping fish and de-worming is an important part of their routine care as well. I've adapted much of what I learned to fishkeeping in this reguard.) The dead parasites will cause intenstinal bloackage, and rot causing secondary bacterial infections ect. It's not common.. but it's not rare either. I've used prazi to treat my young armatus spiney a few years back by dosing the tank itself once a week after each water change for 6 weeks straight of a particularly aggressive worm case ( the fish went on to live in my care for the next 2yrs before he was rehomed healthy and imo happy) By dosing this way he got very small amounts and never became bound up ( though you could literally see him "blow them")
I honestly do not know if they can/do build up a resistance to this type of treatment... I've never really had anyone say "Yes" or "no" diffinitively... But I've never had to resort to Metro, or Epsom salts ( both from my understanding as safe as prazi.. but prazi is easy to find and I have yet to find a species that reacts negatively out of the gate from it) So I've had no need to use them. ( but trth be told I really should understand them better incase the day comes prazi doesn't do it)
Even after the initial dose if all appears well I do a follow up treatment 4 weeks later as a general rule like anti-biotics... kill them dead 100% or they can and will recover and become "likely" more resistant to treatments in the future.