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Anopheles culicifacies
MALARIA PARACYTES
PLASMODIUM VIVAX
PLASMODIUM FALCIPARUM
PLASMODIUM MALARIAE
PLASMODIUM OVALAE
Treatment
Radical Cure ( Tissue schizonticidal )
Primaquine
Prevent Transmission ( Primaquine )
Chemoprophylaxis ( Chloroquine,
Doxycycline)
Blood Schizonticidals Chlorquine
(Acute attacks)
Chloroquine
Schizonticidal drug against
erythrocytic forms
P.Falciparum resistence to CQ
SAFE in PREGNANCY
CQ contd:--
Mode of action
Accumulate in parasitized rbc
Forms complexes with plasmodial
DNA
CQ contd:--
Primaquine PQ
Is a hypnozidal drug (radical
cure)
&
a gametocidal drug (prevent
transmission)
Primaquine
C/I
Pregnancy
Children < 1yr
G6PD deficiency
PQ contd--
Side-effects
GIT disturbances
Methhaemoglobinaemia
Heamolytic anaemia in G6PD
deficiency (important to obtain H/O and family
history. Advice patients about recognizing the symptoms)
Quinine
Quinine contd--
Side-effects
Bitter taste
GIT disturbances
Hypersensitivity reactions
Hypotension, cardiac arrythmias
Quinine side-effects
contd--
Coartem
Artemether
+
Lumefantrine
A tablet contains 20mg Artemether
& 120 mg Lumefantrine
ACT contd--
Treatment regimes
Monoinfection with P vivax)
day 1
600mg CQ sulphate (4tabs) as a single
dose
day 2
600mg CQ sulphate(4tabs) as a single
dose
day 3
300mg CQ sulphate (2tabs) as a single
dose
Chemoprophylaxis
Only suppress clinical illness
Who needs chemoprophylaxis?
Pregnant mothers in endemic areas
Foreign travelers coming from nonmalarial areas
Non-immune local residents traveling
to endemic areas on temporary basis
Refugees deployed in endemic areas
Cerebral malaria
Specific treatment
Quinine dihydrchloride 20mg /Kg
in N saline iv infusion over 4hrs (loading
dose)
Cerebral malaria contd-Maintenance dose should be repeated 8hrly until patient can
swallow,
Cerebral malaria
Quinine dihydrchloride 20mg /Kg in
N saline iv infusion over 4hrs (loading
dose)
12hrs after the start of the dose
Quinine 10mg /kg infusion over 4hrs ,
8hrly(maintenance dose )
Complications
Hyperpyrexia, coma & convulsions
Dehydration
Hypoglycemia
Acute pulmonary oedema
Acute renal failure
Severe anaemia
bleeding