malaria 2 Flashcards
what would you give in pregnancy now that proguanil is discontinued
chloroquine safe in pregnancy but not appropriate for most places bc effectiveness declined
alt if high risk area or resistance to other drugs, give mefloquine in 2nd and 3rd trimester
doxycycline CI in preg, but consider if other regimen unsuitable and if course can be completed before 15 weeks gestation
A+P should not be used in preg, but consider in 2nd and 3rd trimester if no suitable alt (needs folic 5mg during course)
which ones can be started 1-2 days before travel
doxy
A+P (malarone)
how often do you have to take malarone for prophylaxis
start 1-2 days before
finish 1 week after leaving
have to take tablets DAILY
how often do you need to take chloroquine for prophylaxis
Once weekly
start 1 week before
continue 4 weeks after leaving
how often do you need to take mefloquine for prophylaxis malaria
once weekly
start 2-3 weeks before and continue 4 weeks after
how often do you need to take doxycycline for prophylaxis malaria
once daily 1-2 days before and 4 weeks after
what can you use for long term prophylaxis
chloroquine
Which one is CI in EGFR <30
Avoid malarone for malaria prophylaxis (and if possible for malaria treatment) if creatinine clearance less than 30 mL/minute
When should you avoid malarone
Avoid for malaria prophylaxis (and if possible for malaria treatment) if creatinine clearance less than 30 mL/minute
Who needs a patient card and why
Mefloquine - neuropsychiatric reactions
What is recommended for anyone who has taken chloroquine for longer than 1 year
Annual monitoring for retinopathy is recommended in all patients who have taken chloroquine for longer than 1 year.
Which one can affect driving and skilled tasks
Mefloquine
Dizziness or a disturbed sense of balance may affect performance of skilled tasks (e.g. driving); effects may occur and persist up to several months after stopping mefloquine.
