Antimalarial Drugs
ANTIMALARIAL DRUGS
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Introduction
· Malaria is a
life-threatening disease caused by Plasmodium parasites, transmitted to humans
through the bites of infected Anopheles mosquitoes.
· Antimalarial drugs
are used to prevent and treat malaria.
Definition
· Antimalarial drugs
are medications used to prevent or cure malaria by inhibiting the growth and
reproduction of Plasmodium parasites within the human body.
Classification
1.
Aminoquinolines
o
Chloroquine: Used for the treatment of
non-resistant malaria.
o
Hydroxychloroquine: Similar to
chloroquine, also used in autoimmune diseases.
2.
Artemisinin Derivatives
o
Artemether: Often combined with lumefantrine.
o
Artesunate: Used for severe malaria.
3.
Quinoline Methanols
o
Quinine: Used for chloroquine-resistant
strains.
o
Mefloquine: Used for prophylaxis and treatment of
drug-resistant malaria.
4.
Antifolates
o
Pyrimethamine: Often combined with sulfadoxine.
o
Proguanil: Often combined with atovaquone.
5.
Naphthoquinones
o
Atovaquone: Usually combined with proguanil.
6.
Antibiotics
o
Doxycycline: Used in combination therapy.
o
Clindamycin: Used as an alternative in certain
cases.
Pharmacokinetics
Chloroquine
·
Absorption: Rapidly absorbed from the
gastrointestinal tract.
·
Distribution: Widely distributed, especially in the
liver, spleen, kidneys, and lungs.
·
Metabolism: Metabolized in the liver.
·
Excretion: Primarily excreted in the urine.
Artemether
·
Absorption: Rapidly absorbed after oral
administration.
·
Distribution: Distributed to tissues and cross the
blood-brain barrier.
·
Metabolism: Metabolized in the liver.
·
Excretion: Excreted in the bile and urine.
Mechanism of Action
Chloroquine
Chloroquine interferes with the
parasite’s ability to detoxify heme, leading to the accumulation of toxic heme
within the parasite, causing its death.
Artemether
Artemether produces free radicals that
damage parasite proteins and membranes, leading to parasite death.
Uses
·
Prevention: Medications like chloroquine and
doxycycline are used for prophylaxis in malaria-endemic areas.
·
Treatment: Drugs like artemether-lumefantrine
and quinine are used for treating active malaria infections.
·
Severe Cases: Intravenous artesunate is used for
severe malaria.
Adverse Effects
Chloroquine
·
Nausea and vomiting
·
Headache
·
Dizziness
·
Visual disturbances
Artemether
·
Gastrointestinal disturbances
·
Headache
·
Dizziness
·
Rash
Contraindications
Chloroquine
·
Known hypersensitivity to chloroquine
·
Retinal or visual field changes
·
Psoriasis
Artemether
·
Hypersensitivity to artemether or other artemisinin derivatives
Role of Nurse
1.
Assessment
o
Obtain a thorough medical history including drug allergies and current
medications.
o
Assess for signs and symptoms of malaria.
2.
Administration
o
Administer antimalarial drugs as prescribed.
o
Monitor for adverse effects during and after administration.
3.
Patient Education
o
Educate patients on the importance of medication adherence.
o
Inform about potential side effects and when to seek medical attention.
o
Advise on preventive measures such as mosquito nets and repellents.
4.
Monitoring
o
Monitor vital signs and symptoms to assess the effectiveness of the
medication.
o
Conduct regular blood tests to monitor for potential side effects, such
as liver function tests and complete blood counts.
5.
Documentation
o
Document the patient’s response to the medication.
o
Record any adverse effects and actions taken.
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