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Paper II — 2021 February (Supplementary) (2010 Scheme) — Q1

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Paper II
2021 February (Supplementary) (2010 Scheme)

Question

An 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)

Q16 marksEssays

Answer

Classification of antimalarial drugs

  • Tissue schizonticides (causal prophylactic/radical cure): Primaquine, Proguanil
  • Blood schizonticides: Chloroquine, Quinine, Artemisinin derivatives, Mefloquine, Sulfadoxine-pyrimethamine
  • Gametocytocides: Primaquine (all species), Chloroquine (except falciparum)
  • Sporontocides: Proguanil, Primaquine

Why chloroquine and primaquine are combined

  • Chloroquine is a blood schizonticide, clearing the erythrocytic (blood-stage) parasites and providing rapid clinical improvement, but does not affect the dormant hepatic hypnozoite forms of P. vivax/ovale
  • Primaquine is a tissue schizonticide that eradicates these dormant hepatic hypnozoites, preventing relapse (radical cure)
  • The combination thus achieves both rapid symptomatic cure (chloroquine) and prevention of relapse (primaquine)

Mechanism, uses, and adverse effects of chloroquine

  • Mechanism: Concentrates in the parasite’s food vacuole and inhibits haem polymerase, causing accumulation of toxic free haem that damages the parasite
  • Uses: Treatment of sensitive malaria, malaria chemoprophylaxis, extraintestinal amoebiasis, rheumatoid arthritis/SLE
  • Adverse effects: GI upset, pruritus, retinopathy/corneal deposits (prolonged use), cardiotoxicity with rapid IV use, haemolysis in G6PD deficiency

Four drugs for chloroquine-resistant P. falciparum malaria

  • Artesunate, Mefloquine, Quinine, Sulfadoxine-pyrimethamine (used as artemisinin-based combination therapy)
  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. 6Classify anti malarial drugs. Mention the adverse effects and therapeutic uses of chloroquine. (2+2+2=6)2013 September (Supplementary) (2010 Scheme)Essay · 6 marks
  7. 7How 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
  8. 8Treatment of Chloroquine resistant falciparum malaria2024 June (Supplementary) (2019 Scheme)Short Answer · 4 marks
  9. 9Artemisinin based combination therapy in Malaria2024 March (Supplementary) (2019 Scheme)Short Answer · 4 marks
  10. 10Artemisinin based combination therapy (ACT ) in malaria2016 October (Supplementary) (2010 Scheme)Short Note · 3 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

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