Malaria And Influenzaaa Flashcards
Malaria Symptoms
If you’ve been to a country where malaria was present, you need to look out for hese possible signs of malaria over the next 12 months
• High fever
• Cold chills
• Persistent headache
• Nausea or vomiting
•Diarrhoea
• Fatigue
• Muscle pain
• Sweats
• Chest pain
• Abdominal pain
• Persistent cough
Mefloquine (lariam)-POM
Mefloquine (Lariam)
• Used for malaria prophylaxis (now rarely due to resistance)
• Neuropsychiatric reactions
Accronym: lari is mental or Me = Mental
. Do not use in epilepsy
Malarone- POM is used as prophylaxis and treatment of…..
• Used for falciparum malaria prophylaxis, treatment of uncomplicated falciparum and treatment of non.
Talciparum malaria
• Used as alternative to mefloquine or dovcycline
• Suitable for short trips because only needs to be taken for 7 days after leaving endemic area
quinine examples and it can prolongggg
Quinine- eg sulfate and bisulphate = used in treatment of falciparum and falciparum malaria
- associated with QT PROLONGATION = Q= QUEEN
Malaria prophylaxis- physical
Protection against insect bites
• Prophylaxis not absolute & breakthrough infection can occur with any of the recommended drugs
• Protect against bites
• Mosquito nets impregnated with permethrin (most effective barrier against insects)
• Mats [repellents] & vapourised insecticides useful
DEEET- children how old can use??? Is it safe in pregnancy and breast feeding??
• Diethyltoluamide (DEET) 50% (available as sprays & mr formulations). Safe to apply on children over 2 months old
• DEET (Safe to use in pregnancy & breastfeeding)
• DEET should be applied after Sunscreen
• DEET reduces the SPF of sunscreen, so sunscreen of SPF 30-50 should be applied
• Wear long sleeves & trousers after dusk to protect from bites
MEFLOQUINE (1234)
- ONCE WEEKLY
- 2-3 WEEKS BEFORE
- 4 WEEKS AFTER
DOXYCYCLINE(11242)
ONCE DAILY
1-2 BEFORE TRAVEL
4 WEEKS AFTER
- CAN BE USED FOR UP TO 2 YEARS
ATOVA AND PROGUANIL (1121)
- 1 DAILY
- 1-2 DAYS BEFORE TRAVEL
- 1 WEEK AFTER TRAVEL
- AVA/PROGUANIL, MEFLOQUINE CAN BE USED FOR A YEAR
OTHERS
ONCE WEEKLY
1 BEFORE
4 AFTAAAAA
Return from malarial region - any illness occurring within how long needs to be reported???within how long of return
Any illness that occurs within 1 year especially within 3 months of return mav be malaria
• Advise travellers, to report any illness to their doctor immediately, particularly if it is within 3 months of return from malarial area
• Malaria is a Notifiable disease
Malaria prophylaxis (EPILEPSY)
•Doxycycline (may interact with some antiepileptic drugs, will need to adjust dose)
•Atovaquone with Proguanil (Malarone)
Avoid in epileptics
•Avoid chloroquine ‚mefloquine in epileptic patients
• Memory trick: avoid quines for epilepsy
Malaria prophylaxis
Pregnancy & Breastfeeding
Safe in pregnancy
• Avoid travelling to malarial areas if possible during pregnancy
Chloroquine can be given but not effective in most areas
• Mefloquine can be given in 2nd & 3rd trimesters, only give in 1* if benefits outweigh risks
Avoid in pregnancy (except it no alternatives)
•Doxycycline contraindicated (Unless no other choice and whole course canbe completed 15 weeks before gestation)
• Atovaguone/proguanil (avoid but can give in 2nd or 3rd trimester it no alternative) also need to give Folic acid with it
Malaria prophylaxis
Anticoagulants- how long should in be measured for??
Pts on warfarin should start chemoprophylaxis 2-3 weeks before travel
• IN should be stable before travel
• IN should be measured before starting prophylaxis, 7 days after starting and after completing course.
• Check IN at regular intervals for prolonged stays
• Limited experience with DOACS and chemoprophylaxis
Safety information of antimalarials- qulorquine can causeeeee MHRA too( what do quinine prolong? What does mefloquine cases, what does chloroquine cause )
Quinine: QT interval prolongation
• Mefloquine: Discontinue if neuropsychiatric symptoms (
e.g abnormal dreams, anxiety, depression, restlessness, confusion & insomnia)
• Chloroquine: Ocular toxicity in adults if dose exceeds
4mg/kg daily. Also MHRA( Increased risk fo
Cardiovascular events when used with macrolides antibiotics)
Influenza what is type A,B,C- How does transmission spread???
Influenza is a highly infectious respiratory infection caused by viruses: Types A, B, and C.
• Type A: More severe, frequent outbreaks.
• Type B: Milder but can cause outbreaks.
• Type C: Mild or asymptomatic.
• Transmission: Spread through droplets, aerosols, or direct contact with respiratory secretions.Incubation period: 1-3 days.
Symptoms & Complications of influenzae
Sudden onset symptoms:
• Common: Chills, fever, headache, extreme fatigue, muscle pain.
• Respiratory: Dry cough, sore throat, nasal congestion.
Complications:
• Respiratory: Bronchitis, bacterial pneumonia, ear infections in children.
• Non-respiratory: Rare, may include cardiac or neurological issues.
At Risk Groups
Higher risk of severe illness:
• Children under 6 months.
• Pregnant women (including postpartum).
• Elderly (over 65 years).
•Patients with chronic diseases (respiratory, cardiac, diabetes, etc.).
•Severely immunosuppressed individuals.
Management of Influenza
Aims:
• Reduce illness duration and severity.
• Prevent complications.
• Control infection spread.
Treatment Guidelines- uncomplicated influenza what are the 2 treatment options
Uncomplicated Influenza:
• Usually managed at home.
• Antivirals (oseltamivir) for at-risk groups or severe cases.
Complicated Influenza:
• Treated in hospitals.
• Oseltamivir or inhaled zanamivir for severely immunosuppressed patients.
Post Exposure Prophylaxis- influenza
• For those exposed in households, care homes, or other vulnerable settings.
• Oseltamivir for most; Zanamivir if oseltamivir resistance is suspected.
Antiretroviral in influenza oooooooooooo zzzzzzzz
• Oseltamivir (Tamiflu) and Zanamivir for treatment and prevention.
• Oseltamivir resistance may occur, particularly in certain influenza strains.
