Term
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Definition
disease characterized by:
- severe intermittent hemolysis, fever, chills, & sweating that recur every 3rd or 4th day;
Severe forms:
- coma, renal failure, diarrhea, pulmonary edema, death may result;
- relapses may occur months or even years after initial attack; |
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Term
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Definition
malignant tertian malaria;
most lethal form;
fever recurs every 3rd day;
no 2ndary tissue forms;
drug resistant forms are serious problem; |
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Term
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Definition
benign tertian malaria;
most common form;
fever every 3rd day;
2ndary tissue forms;
relapses;
resistant strains becoming widespread; |
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Term
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Definition
quartan malaria;
fairly rare;
fever every fourth day;
no secondary tissue forms; |
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Term
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Definition
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Term
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Definition
| infected female anopheles mosquito (definitive host) injects plasmodial sporozites into human (intermediate host) --> sporozites enter hepatic parenchymal cells --> asexual replication to merozites --> invade RBCs --> merozites enlarge & multiply to form schizonts --> RBCs burst, releasing merozoites & metabolites --> fever & chills --> free merozoites infect more RBCs of differentiate into gametocyte (sexual form) --> ingested by another mosquito |
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Term
| Blood schizonticides - chloroquine, hydroxychloroquine, quinine, quinidine gluconate, mefloquine, pyrimetahamine + proguanil, atovaquone + proquanil, tetracyclines |
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Definition
act on erythrocytic forms of parasite;
used to suppress symptoms & provide a "clinical cure"; |
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Term
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Definition
act on hepatic stages of parasite;
DO NOT suppress symptoms once erythrocytic stages have been established;
DO knock out 2ndary tissue forms of P. vivax & P. ovale;
useful in preventing relapses; |
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Term
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Definition
act on gametocytes;
do NOT help individual suffering from malaria but MAY slow spread of dx; |
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Term
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Definition
| erythrocytic forms of parasite have been eradicated & pt is symptom free; |
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Term
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Definition
| all forms of parasite, including any 2ndary tissue forms have been eradicated; |
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Term
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Definition
prevent initial development of primary hepatic forms of parasite;
not practical with most presently available drugs;
primaquine, pyremethamine, & proguanil seem to have some of this activity |
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Term
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Definition
commonly used as prophylactic agents;
act on erythrocytic forms to suppress symptoms;
if individual is exposed to P. vivax or P. ovale, these agents do not affect 2ndary tissue forms of parasite & do not prevent relapses; |
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Term
| chloroquine (Aralen), hydroxychloroquine (Plaquenil) |
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Definition
blood shizonticides;
acts on erythrocytic forms, no effect on 2ndary tissue forms of P. vivax, P. ovale;
interferes w/ parasite's feeding mechanism;
suppressive agent - clinical cure for all forms, radical cure for P. falciparum, P. malariae;
prophylactic uses;
Orally administered - well absorbed via GI tract;
Accumulates in skin & retina;
metabolized by liver - caution in pts w/ liver dx;
T1/2 = 6-7 days;
Toxicity (less than quinine):
- CNS - dizziness, HA, tinnitus;
- GI upset - take w/ food;
- retinal & corneal toxicity - monitor visual fcn;
- immunologic - skin rashes, blood dyscrasias, lupus-like sx - C/I'd in pts w/ psoriasis & porphyria;
Anti-inflammatory action at HIGH DOSES - used for RA, SLE |
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Term
| quinine, quinidine gluconate |
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Definition
Action:
- old drug mainly supplanted by chloroquine;
- acts on erythrocitic forms;
- gametocytocidal;
- inteferes w/ plasmodial digestion of Hb;
- used in tx of chloroquine-resistant P. falciparum;
PKs: orally effective, T1/2 = 5-16 hrs;
Actions:
- analgesia & antipyretic;
- GI irritaion, N/V;
- blurred vision & auditory disturbances;
- depressant effect on heart;
- birth defects & abortion;
- skeletal muscle relaxation;
- "Cinchonism" - syndrome of toxicity - resembles salicylism (HA, nausea, dizziness, blurred vision, tinnitus) |
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Term
| mefloquine (Lariam, Fansimet) |
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Definition
effective against chloroquine-resistant strains of P. falciparum;
acts on erythrocytic forms of parasites;
some strains rapidly develop resistance;
DRUG OF CHOICE for treatment & prophylaxis of chloroquine-resistant P. falciparum;
Only used orally;
Less toxic than chloroquine but DOES cause GI upset & depression of myocardium;
Can cause seizures, aggravates latent psychoses;
Should NOT be used in pts w/ a history of mental illness or epilepsy;
CAN be used during pregnancy;
Use w/ extreme caution in pts w/ cardiovascular disorders, psychiatric problems, or epilepsy |
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Term
| pyrimethamine (Daraprim), proguanil (aka chloroguanid, Paludrine) |
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Definition
inhibits parasite's dihydrofolate reductase, main effect on erythrocytic forms;
Prophylactic use for chloroquine-resistant strains of P. falciparum;
Used in combo with sulfonamides (sulfadoxine) for synergistic effect against parasites; |
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Term
| pyrimethamine + sulfadoxine (Fandisar) |
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Definition
| used for presumptive treatment of malaria (if a person begins to show symptoms, he/she takes drug) |
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Term
| atovaquone + proquanil (Malarone) |
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Definition
new antimalarial drug;
one drug is a dihydrofolate reductase inhibitor;
2nd drug acts by depolarizing parasite's mitochondria & inhibiting electron transport;
Side Effects - rare (HA, abdominal pain);
Alternative to mefloquine or doxycycline for prophylaxis against chloroquine-resistant P. falciparum; |
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Term
| tetracyline antibiotics (doxycycline) |
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Definition
| antimalarial activity & used as alternate or adjunctive drugs for tx & prophylaxis of malaria; |
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Term
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Definition
tissue schizonticide;
active against tissue forms of all species of plasmodia;
gametocytocidal;
Will not suppress dx once it has developed;
Main ADV: kills 2ndary forms of P. vivax & P. ovale;
NOT used for routine prophylaxis becaues of toxicity;
GIVEN as follow-up therapy;
Toxicities:
- GI upset, HA, dizziness, hemolytic anemia (esp. in pts w/ G6PDH deficiency);
- teratogenicity; |
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Term
| Acute Uncomplicated Attack |
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Definition
chlorquine - clinical cure for most forms;
quinidine gluconate, mefloquine (Lariam), pyrimethamine + sulfadoxine (Fansidar), atovaquone + proquanil (Malarone) - used for chloroquine-resistant P. falciparum & other drug resistant forms of P. falciparum;
doxycycline - adjunct drug; |
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Term
| Prevention of Relapse (radical cure) for P. vivax & P. ovale |
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Definition
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Term
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Definition
chloroquine - for most non-resistant forms;
mefloquine (Lariam) - chloroquine-resistant P. falciparum;
doxycycline;
atovaquone + proquanil (Malarone);
proquanil/chloroguanide (Paludrine);
pyrimethamine + sulfadoxine (Fansidar) - presumptive therapy;
primaquine |
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