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18 Cards in this Set
- Front
- Back
Areas with chloroquine resistance
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Malarone
Mefloquine |
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Areas with multiple drug resistance
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Doxycycline
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Areas with P. vivax and/or P. ovale
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Primaquine
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P. vivax & ovale
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Chloroquine then primaquine
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Chloroquine sensitvie P. falciparum & malariea
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Chloroquine
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Uncomplicated infection with resistance P. falciparum
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1st: quinidine + doxy or tetracycline or clindamycin
2nd: Malarone or Mefloquine or coartem |
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Severe or complicated infection with P. falciparum
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1st: Artesunate then doxy or clindamycin or malarone or mefloquine
1st: Quinine plus doxy or tetraccline or clindamycin 2nd: Artemether then doxy or clindamycin or malarone or mefloquine |
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Chloroquine
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Prop: Rapid onset, long half life, antacids decrease absorption
MOA: Inhibit hemozoin metabolism Resistance: Altered chloroquine- transporter protein CG2 Action: Sensitive to all blood schizont, all gametes- falciparum; not useful for tissue forms of P. ovale or vivax Uses: acute attacks (P. v, o, m & f), prophylaxis, hepatic amebiasis Contra: epilepsy, myasthenia gravis, mefloquine SE: Heart, confusion, convulsion, coma, pruritus, treat OD with epi, diazepam, ventilation Precautions: G6PD, QRS- interval, pregnancy |
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Quinine and quinidine
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Anti malarial: against asexual plasmodia, gametocidal for P. v, m NOT P. f
Uses: DOC for drug resistant P. falciparum, used in combo with doxy or clindamycin, safe in pregnancy SE: QT elongation, cinchonism, hygoglycemia Precaution: G6PD def Contra: tinnitus, dizziness, optical neuritis |
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Mefloquine
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Prop: oral only
Actions: all blood schizonts, no activity on gametes Uses: Prof/ treatment of P. v & f, prophylaxis for travelers, in combo with artesunate (SE Asia & S. Am) SE: GI, seizures, psychiatric, bradycardia, QT prolongation, arrhythmia Contraa: cause still birth, DOC for prophylaxis in pregnancy |
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Primaquine
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Prop: oral, DOC for treating hyponozoites
MOA: electron transport--> ROS Malarial: All P. v & o, gametocytes of all P Uses: terminal prophylaxis, radical cure of P. o & v SE: GI, pruritus, methemoglobinemia, headaches Contra: G6PD and pregnancy |
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Atovaquone, atovquone + proguanil
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Prop: oral absorption inc with fatty foods
MOA: Inhibits electron transport, collapse mitochondrial membrane potential Resistance: Mutations in mitochondrial b- gene Malarial: all blood schizonts, liver stages of P. f but not against P. v hypnozoites Uses: Proph & treatment of malaria, pneumonia, brain & eye infections SE: abd. pain, nausea, vomiting, headache, diarrhea Precaustions: rifampin--> inc P450--> decrease atovaquone, co- admin with tetracycline--> decr plasma atovaquone Contra: pregnancy & lactating mothers |
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Tetracycline, doxy, clindamycin
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Prop: useful in SE Asia, slow acting schizontocides
MOA: Inhibits protein elongation Malarial: tissue schizonts of P. f Uses: alone (prophylaxis in chloroquine & mefloquine resistant), w/ quinine/ quinidine- clindamycin SE: bones & teeth Contra: pregnancy, infancy <8 |
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pyrimetamine + sulfadoxine and dapsone
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MOA: anti folate synthesis
Malarial: all blood schizonts Uses: Quinine--> drug res. P. f SE: bone marrow depression, erythema multiform, epidermal necrolysis Contra: lactating mothers, infants < 2 months Precautions: IC |
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Artemisinins
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MOA: Free radical disrupts protein, heme function
Malarial: Blood schizonts of P. v & f Uses: W/ lumefantrine, mefloquine--> severe P. f, schistosomiasis Precautions: Kids, pregnancy |
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Amodiaquine
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Use: Chloroquine- rest P. f
SE: Hepatotoxicity, agranulocytosis |
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Halofantrine
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Prop: cardiotoxity, erratic bioavail
X- res to mefloquine and lumefantrine (/artemisinin--> multidrug rest P.f) |
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Lumefantrine
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Used in combo with arteminsins--> multidrug rest P. f
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