Malaria

Question 1

What is proguanil?
When can proguanil be taken?
Duration?

Answer 1

Paludrine
a week before entering malarial region (urgent cases can start 2 days before)
- continue during stay
- carry on 4 weeks after

Question 2

How many 100mg tablets should adults take?

Answer 2

2

Question 3

Can tablets be crushed and mixed with foods for children?

Answer 3

Yes

Question 4

How many tablets should the following take? 
- <1 year 
- 1-4 years 
- 5-8 years 
- 9-14 years 
>14 years

Answer 4

<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

Question 5

When can chloroquine 250mg tablet be taken? Duration?

Answer 5

weekly dose
Starting a week before
continue during stay
carry on for another 4 weeks after leaving region

Question 6

what dose should a pt take

Answer 6

2 tablets

Question 7

What should the following take? 
- 1-4 years 
- 5-8 years 
- 9-14 years 
>14years ?

Answer 7

1-4 years - 1/2 tablet
5-8 years - 1 tablet
9-14 years - 1 and 1/2 tablets
>14years - adult dose

Question 8

What is Maloff Protect?

Answer 8

Atovaquone/Proguanil 250mg/100mg

Question 9

Duration of Maloff?

Answer 9

1-2 days before, continue during stay carry on for 1 week

Question 10

what dose should adults take?

Answer 10

1 tablet

Question 11

What are the signs pts have and need to urgent medical urgency after taking antimalarials?

Answer 11

difficulty breathing
swelling of face, lips, tongue or throat
rash

Question 12

Which pts should proguanil be used with caution?

Answer 12

renal impairment - reduce dose

check for resistance in the malarial zone

Question 13

What is avlocor?

Answer 13

Chloroquine

Question 14

In which pts should avloclor be used with caution?

Answer 14

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

Question 15

which pts should maloff be used with caution?

Answer 15

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

Question 16

which pts is avloclor contraindicated in?

Answer 16

not alongside amiodarone

Question 17

What pts is maloff protect contraindicated in?

Answer 17

renal or hepatic impariment

children and adolescent cannot use maloff protect

Question 18

What side effects are caused by proguanil?

Answer 18

megloblastic anaemia, skin rash, GI disturbancese

Question 19

What side effects are caused by alvoclor?

Answer 19

blood disorders 
hypoglycaemia 
Depression 
anxiety
headahce 
convulsions 
EPSEs
blurred vision 
cardiomyopathy 
GI disturbances 
SJS

Question 20

what side effects are caused by maloff protect?

Answer 20

headache
N/V
depression
dizzines, rash, fever, cough, SJS

Question 21

What interactions are caused with proguanl?

Answer 21

• increase effects of warfarin - refer
• antiretrovirals for HIV
• antacids - Al, Ca, Mg decreases abosporption

Question 22

What interacts with avloclor ?

Answer 22

QT drugs
antacids
incrased TSH levels with concomitant use of levothyroxin

Question 23

What side effects are caused by maloff protect?

Answer 23

antiretrovirals for HIV
rifampcin
and same as proguanil

Question 24

What are counselling points you’d give a pt on antimalarials?

Answer 24

1. use DEET, with stronger formulation providing longer duration of protection
2. use of mosquito bed nets
3. long sleeves, trousers
4. Areas with non-flowing stagnant water are likely have numbers of mosquitos

Question 25

What are the time limits you should tell pts to look out for if they get ill and should seek medical attention?

Answer 25

if they fall illl within a year

esp 3 months after coming back from malarial region

Question 26

What symptoms are these?

Answer 26

flu-like symptoms, mainly fever

Question 27

What is malaria prophylaxis advice?

Answer 27

1. keep hydrated
2. sun protection
3. avoid unknown food sources to prevent travellers diarrhoea
4. during flights take steps to minimise DVT - leg exercises and wear compression stockings