Question
Classify drugs used in treatment of malaria. Explain the mechanism of action, adverse effects
and dose of any one such drug. Which drug is used for radical cure of acute vivax malaria.
Q1 6 marks Essays ★ ✓
Answer
Classification of antimalarial drugs (by stage of action)
Tissue schizonticides (causal prophylactic/radical cure): Primaquine, Proguanil
Blood schizonticides: Chloroquine, Quinine, Artemisinin derivatives, Mefloquine, Sulfadoxine-pyrimethamine
Gametocytocides: Primaquine, Chloroquine (except falciparum)
Sporontocides: Proguanil, Primaquine
Mechanism, adverse effects and dose of Chloroquine
Mechanism: Concentrates in the parasite’s food vacuole, inhibits haem polymerase (which normally converts toxic free haem into inert haemozoin), leading to accumulation of toxic free haem that damages the parasite’s membranes and kills it
Adverse effects: GI upset, pruritus, headache, retinopathy/corneal deposits with prolonged use, cardiotoxicity with rapid IV administration, haemolysis in G6PD deficiency
Dose: 25 mg/kg base over 3 days (e.g., 10 mg/kg on day 1, 10 mg/kg on day 2, 5 mg/kg on day 3) for treatment of sensitive malaria
Radical cure of acute vivax malaria
Primaquine , given along with a blood schizonticide (chloroquine), to eradicate the dormant hepatic hypnozoites and prevent relapse (after excluding G6PD deficiency)
1 Antimalarial Drugs
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