Malaria

Question 1

what are the counselling points you should give someone buying DEET products?

Answer 1

1. suitable for anyone over 2 months
2. avoid ingestion - wash hands before eating
3. suitable for pregnancyand breastfeeding but wash breast before feeding
4. apply DEET after sunscreen asreduces SPF of sunscreen

Question 2

what 2 drugs are in malarone?

Answer 2

arovaquone and proguanil

Question 3

what anti malarial has the longer build up time before travel?

Answer 3

mefloquine

Question 4

what are the 5 antimalarials?

Answer 4

malarone
chloroquine
proguanil
mefloquine
doxycycline

Question 5

what anti malarials are taken 1 weeks before travels?

what ones are taken 1 - 2 days before?

(malarone, chloroquine, proguanil, mefloquine, doxycycline)

Answer 5

1 week = chloroquine, proguanil

1 - 2 days = malarone, doxycycline

Question 6

what antimalarials are OD dosing and which ones are onces weekly?

(malarone, chloroquine, proguanil, mefloquine, doxycycline)

Answer 6

OD = malarone, proguanil, doxycycline

weekly = chloroquine and mefloquine

Question 7

how long to antimalarials need to be taken after travel?

Answer 7

4 weeks = chloroquine, doxycycline, mefloquine, proguanil

1 week = malarone

Question 8

what antimalarials have a maximum use of 1 year, 2 year, and long term?

Answer 8

1year max = malarone, mefloquine
2 year max = doxycycline
long term - praguanil, chloroquine

Question 9

how long after travelling could malaria still occur?

Answer 9

up to 1 year, especially first 3 months

Question 10

what antimalarial can be given in pregnancy?
what additional medicine should be given alongside?

Answer 10

chloroquine or proguanil
folic acid 5mg due to risk of neural tube defects

Question 11

what patient group is at risk of severe malaria?

Answer 11

asplenic patients (no spleen)

Question 12

what antimalarials need to be avoided in epilepsy?

Answer 12

chloroquine and mefloquine

Question 13

how should you manage a patient on warfarin needed antimalarials?

Answer 13

• begin treatment 2 - 3 weeks before departure
• INR should be stable before departutre
• measure INR before anti-malaria, 7 days after starting, and after completing course

Question 14

what patient groups should you caution mefloquine?

Answer 14

1. histroy of psychiatric disorders
2. history of convulsions

Question 15

what patients should you caution the use of chloroquine in?

Answer 15

1. history of convulsions
2. retinotoxic

Question 16

what antimalarial is cautioned in renal impairment and requires a dose reduction?

Answer 16

proguanil

Question 17

what antimalarial do you need to avoid exposure to sunlight?

Answer 17

doxycycline

Question 18

whats the written instructions patients should receive with standby treatment?

Answer 18

• seek urgent medical attention if fever (38oC +) develops 7+ days after arriving in a malaria area
• self treat if medical help isn’t availabile within 24hours of fever onset