Malarial treatment

Question 0

What drug is most often given as prophylactic treatment (barring resistance)?

Answer 0

Chloroquine

Question 1

What do prophylactic drugs do for you?

Answer 1

Just prevent symptoms, do not kill protozoite stage

Question 2

How quickly do most deaths occur for malarial infection?

What does this say about treatment?

Answer 2

First 24-48 hours.

Treat QUICKLY. parenteral treatment

Question 3

Which is the only drug that might work to kill liver latent infection?

Answer 3

Primoquine

Question 4

How is chloroquine selective for plasmodium?

Answer 4

It accumulates 25x more in infected RBC’s than regular RBC’s

Question 5

What is the mechanism of action for chloroquine?

Answer 5

Binds ferriprotoporphyrin XI to prevent hemozoin formation, leading to toxicity

Question 6

What is the most important side effect of chloroquine?

Answer 6

Visual Sx. Blindness, severe eye damage

Question 7

How do quinine and quinidine work?

Answer 7

Same way as chloroquine

Question 8

What is used to treat chloroquine resistant P. falciparum?

Answer 8

quinine and quinidine

Question 9

What are the most important side effects of both quinine and quinidine?

Answer 9

Eyes.

Tinnitus, nausea, diarrhea

Question 10

What is the unique side effect of Quinidine?

Answer 10

Heart problems, so need cardiac monitering

Question 11

What do you usually give IV for severe malaria?

Answer 11

Quinidine

Question 12

How does mefloquine work?

Answer 12

Same as chloroquine

Question 13

What is a unique side effect of mefloquine?

Answer 13

Neuropsychological effects: Dreams, hallucinations

Question 14

What is the mechanism of Atovaquone?

Answer 14

depolarizes parasitic mitochondria leading to inhibition of ETC

Question 15

What is often given along with Atovaquone?

Answer 15

Proguanil

Question 16

What is the mechanism of proguanil?

Answer 16

Inhibits DHFR, increases mitochondrial toxicity

Question 17

Why are atovaqone and proguanil often given together?

Answer 17

Decrease resistance because they work well to kill together

Question 18

Why is atovaquone/proguanil not to be given alone with severe anemia?

Answer 18

SLOW onset

Question 19

How should atovaquone/proguanil be taken?

Answer 19

daily

Question 20

What is the mechanism of action of artemisinins?

Answer 20

Produces free radicals from heme in malarial pigment

Inhibits calcium ion ATPase in P. falciparum

Question 21

How quickly do Artemisinins work? Should they be given alone?

Answer 21

FAST.

NO. don’t want resistance to develop.

Question 22

What do you need to make sure a patient doesn’t have when giving primaquine?

Answer 22

G6PD deficiency