Malaria Flashcards
What is proguanil?
When can proguanil be taken?
Duration?
Paludrine
a week before entering malarial region (urgent cases can start 2 days before)
- continue during stay
- carry on 4 weeks after
How many 100mg tablets should adults take?
2
Can tablets be crushed and mixed with foods for children?
Yes
How many tablets should the following take? - <1 year - 1-4 years - 5-8 years - 9-14 years >14 years
<1 year: 1/4 tablet (25mg) 1-4 years: 1/2 tablet (50mg) 5-8 years: 1 tablet (100mg) 9-14 years: 1 and 1/2 tablets (150mg) >14 years: adult dose
When can chloroquine 250mg tablet be taken? Duration?
weekly dose
Starting a week before
continue during stay
carry on for another 4 weeks after leaving region
what dose should a pt take
2 tablets
What should the following take? - 1-4 years - 5-8 years - 9-14 years >14years ?
1-4 years - 1/2 tablet
5-8 years - 1 tablet
9-14 years - 1 and 1/2 tablets
>14years - adult dose
What is Maloff Protect?
Atovaquone/Proguanil 250mg/100mg
Duration of Maloff?
1-2 days before, continue during stay carry on for 1 week
what dose should adults take?
1 tablet
What are the signs pts have and need to urgent medical urgency after taking antimalarials?
difficulty breathing
swelling of face, lips, tongue or throat
rash
Which pts should proguanil be used with caution?
renal impairment - reduce dose
check for resistance in the malarial zone
What is avlocor?
Chloroquine
In which pts should avloclor be used with caution?
check resistance to chloroquine in area
risk of hypoglycaemia - signs and symptoms regardless if diabetic
Renal disease
hx of epilepsy
psoriasis
those planning to conceive or pregant - refer
which pts should maloff be used with caution?
anyone who weighs <40 kg
planning to conceive, P and BF
licensed for max of 12 weeks
supply for travel for longer periods should be done via RX or PGD
which pts is avloclor contraindicated in?
not alongside amiodarone
What pts is maloff protect contraindicated in?
renal or hepatic impariment
children and adolescent cannot use maloff protect
What side effects are caused by proguanil?
megloblastic anaemia, skin rash, GI disturbancese
What side effects are caused by alvoclor?
blood disorders hypoglycaemia Depression anxiety headahce convulsions EPSEs blurred vision cardiomyopathy GI disturbances SJS
what side effects are caused by maloff protect?
headache
N/V
depression
dizzines, rash, fever, cough, SJS
What interactions are caused with proguanl?
- increase effects of warfarin - refer
- antiretrovirals for HIV
- antacids - Al, Ca, Mg decreases abosporption
What interacts with avloclor ?
QT drugs
antacids
incrased TSH levels with concomitant use of levothyroxin
What side effects are caused by maloff protect?
antiretrovirals for HIV
rifampcin
and same as proguanil
What are counselling points you’d give a pt on antimalarials?
- use DEET, with stronger formulation providing longer duration of protection
- use of mosquito bed nets
- long sleeves, trousers
- Areas with non-flowing stagnant water are likely have numbers of mosquitos
What are the time limits you should tell pts to look out for if they get ill and should seek medical attention?
if they fall illl within a year
esp 3 months after coming back from malarial region
What symptoms are these?
flu-like symptoms, mainly fever
What is malaria prophylaxis advice?
- keep hydrated
- sun protection
- avoid unknown food sources to prevent travellers diarrhoea
- during flights take steps to minimise DVT - leg exercises and wear compression stockings
