Академический Документы
Профессиональный Документы
Культура Документы
i. P. falciparum
ii. P. vivax
iii. P. malariae
iv. P. ovale
2. Erythrocytic stages
-parasite invade RBCs
-patient develops fever cycle
2. Quinoline-methanol Mefloquine
5. Diaminopyrimidine Pyrimethamine
6. 8-Aminoquinoline Primaquine
Tafenoquine
Antimalarial Drugs
CLASSES DRUGS
7. Sulfonamides and sulfone Sulfadoxine
Sulfamethopyrazine
Dapsone
8. Antibiotics Tetracycline
Doxycycline
Clindamycin
9. Sesquiterpine lactones Artesunate
Artemether
Arteether
Arterolane
10. Amino alcholos Halofantrine
Lumefantrine
11. Naphthyridine Pyronaridine
1. Causal prophylaxis
2. Suppressive prophylaxis
3. Clinical cure
4. Radical cure
5. Gametocidal
1. Causal prophylaxis
• Primaquine – for all species of malaria but not used due to its
toxic potential
• Rheumatoid arthritis
• Lepra reaction
• Photogenic reactions
• Infectious mononucleosis
Chloroquine
Contraindications
Contraindications
• In patients with anxiety, depression, psychosis, and in cardiac
conduction defects
Mefloquine
Drug interactions
Uses
• However its use is restricted due to its toxicity, cost and long
half life
QUININE
Pharmacokinetics
• Well absorbed from GI tract, even in patients with diarrhea
• Pregnancy:
o Causes abortion in early pregnancy by stimulating
myometrium and premature labor by stimulating uterus
o Hypoglycaemia
Clinical uses
• Malarial attacks
o Uncomplicated resistant falciparum
o Complicated and severe malaria including cerebral malaria
Adverse effects
• Mild abdominal upset, vomiting
• Occasional stomatitis
• Haematuria, rashes and transient loss of hair
• Nephrotoxicity
PRIMAQUINE
Mechanism of action
• Intermediate act as oxidant that are responsible for the
schizontocial action
Primaquine
Pharmacokinetics
• Hemolysis
• Methaemoglobinaemia
• Tachypnoea
• Cyanosis
Primaquine
Contraindications
Clinical uses
• radical cure of relapsing malaria (P.ovale and P.vivax)
• It includes:
1. Artesunate
2. Artemether
3. Arteether
4. Arterolane
Mechanism of action
1. ARTESUNATE
• Q-T prolongation
2. Artesunate/mefloquine(AS/MQ)
• Highly effective and well tolerated in uncomplicated
falciparum malaria
3.Artemether-lumefantrine(AS/LF)
• Clinical efficacy: 95-99%
Drug interaction
• Not to be given with drugs metabolized by CYP2D6( e.g.
metoprolol) as lumefantrine inhibits isoenzyme CYP2D6
Contraindication
• during first trimester of pregnancy and lactation period
4. Dihydroartemisinin(DHA)-
piperaquine
• Used in dose ratio of 8:1 for multidrug resistant Plasmodium
falciparum
7. Artesunate-pyronaridine
• Under clinical trial
CEREBRAL MALARIA
• Most severe neurological complication of infection
with Plasmodium falciparum