Paper II — 2016 October (Supplementary) (2010 Scheme) — Q6

Paper II

2016 October (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Artemisinin based combination therapy (ACT ) in malaria

Q63 marksShort Notes★✓

Answer

Artemisinin-based combination therapy (ACT) is the WHO-recommended first-line treatment for uncomplicated P. falciparum malaria, including chloroquine-resistant/multidrug-resistant strains.

Rationale

• Artemisinin derivatives (Artesunate, Artemether) produce rapid parasite clearance by generating free radicals that damage the parasite’s proteins/membranes (via cleavage of the endoperoxide bridge, catalysed by intraparasitic haem/iron), but have a short plasma half-life
• Combining with a longer-acting partner drug (e.g., Lumefantrine, Sulfadoxine-pyrimethamine, Mefloquine) eliminates residual parasites and reduces the risk of recrudescence, while the rapid-acting artemisinin component reduces the parasite burden the partner drug has to handle — minimizing selection pressure for resistance to either drug

Examples

• Artemether-Lumefantrine
• Artesunate-Sulfadoxine-pyrimethamine
• Artesunate-Mefloquine

Adverse effects

• Generally well tolerated: GI upset, dizziness; rare neutropenia

Related Concepts

1. 1Antimalarial Drugs

Other Years Asked

1. 1(2022 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
2. 2Classify Antimalarial drugs. Write the mechanism of action, therapeutic uses and adverse effects of Chloroquine. (3+3)2024 March (Supplementary) (2010 Scheme)Essay · 6 marks
3. 3o fever with chills for the past two days and diagnosed as a case of plasmodium falciparum malaria.2017 February (2010 Scheme)Essay · 6 marks
4. 4Classify 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.2015 February (2010 Scheme)Essay · 6 marks
5. 5Read the case history and answer the following questions: An 18 years old boy was brought to the outpatient department with history of fever with chills and shivering for the past three days. Peripheral blood smear showed presence of intra erythrocytic P.vivax parasite. (2+2+2)  Prescribe drugs treatment for the patient with dosage schedules.  Explain the mechanism of action of chloroquine.  What are the adverse effects of chloroquine when used for prolonged period in large doses2021 December (Supplementary) (2010 Scheme)Essay · 6 marks
6. 6An immigrant labourer comes to the hospital with fever, chills and rigor. Peripheral smear showed malarial parasites. He was given chloroquine and primaquine.  Classify antimalarial drugs  Why are chloroquine and primaquine combined.  Explain the mechanism of action, uses and adverse effects of chloroquine.  List four drugs used for chloroquine resistant falciparum malaria. (2+1+2+1)2021 February (Supplementary) (2010 Scheme)Essay · 6 marks
7. 7Classify anti malarial drugs. Mention the adverse effects and therapeutic uses of chloroquine. (2+2+2=6)2013 September (Supplementary) (2010 Scheme)Essay · 6 marks
8. 8How will you treat a case of malaria. What is the treatment given for relapse. Mention the drugs which can be given to prevent malaria while visiting an endemic area. (2+2+2)2024 December (Supplementary) (2019 Scheme)Short Essay · 6 marks
9. 9Treatment of Chloroquine resistant falciparum malaria2024 June (Supplementary) (2019 Scheme)Short Answer · 4 marks
10. 10Artemisinin based combination therapy in Malaria2024 March (Supplementary) (2019 Scheme)Short Answer · 4 marks
11. 11Chloroquine2025 August (Supplementary) (2010 Scheme)Short Note · 3 marks
12. 12Chloroquine2020 February (Supplementary) (2010 Scheme)Short Note · 3 marks
13. 13Artemisinin derivatives2019 July (Supplementary) (2010 Scheme)Short Note · 3 marks
14. 14Chloroquine2023 March (Supplementary) (2010 Scheme)Short Note · 3 marks
15. 15Chloroquine2017 August (Supplementary) (2010 Scheme)Short Note · 3 marks
16. 16Acyclovir2021 February (Supplementary) (2010 Scheme)Short Answer · 1 mark
17. 17Used in chloroquine resistant malaria2018 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
18. 18Primaquine in plasmodium vivax malaria2022 May (Supplementary) (2010 Scheme)Short Answer · 1 mark
19. 19Primaquine in Vivax malaria2022 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
20. 20Treatment of rheumatoid arthritis.2016 February (2010 Scheme)Short Answer · 1 mark
21. 21Treatment of multi drug resistant falciparum malaria2013 April (2010 Scheme)Short Answer · 1 mark
22. 22Sulphadoxine and pyrimethamine in malaria2020 February (Supplementary) (2010 Scheme)Short Answer · 1 mark
23. 23Chloroquine resistant malaria.2014 September (Supplementary) (2010 Scheme)Short Answer · 1 mark