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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 49, Chemotherapy of Malaria in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, Chapter 49 in the 12th Edition contains:

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  • Tables 49-2, 49-3, and 49-4 which provide information about appropriate regimens, including adult and pediatric dosages, for the prevention, treatment, and presumptive self-treatment of malaria

  • Figure 49-4 which is an algorithm approach to the treatment of malaria

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LEARNING OBJECTIVES

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  • Know the stages of the malaria parasite in the human body.

  • Classify antimalarial drugs into those that are effective against only the blood stages of the parasite, those that are effective against both the blood and liver stages, and those that are effective against only the liver stages of the parasite.

  • Understand the use of antimalarial drugs in clinical context, particularly with regard to their mechanism of action, therapeutic uses, and toxicities.

  • Describe the principles and guidelines for the chemoprophylaxis and treatment of malaria.

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DRUGS INCLUDED IN THIS CHAPTER

Artemisinin and Artemisinin—combination therapies

Atovaquone/Proguanil (MALARONE)

Chloroquine (ARALEN)

Doxycycline—see Chapter 41

Hydroxychloroquine (PLAQUENIL)

Mefloquine (LARIUM)

Primaquine

Pyrimethamine (DARAPRIM)

Quinine/Quinidine

Sulfadoxine/Pyrimethamine (FANSIDAR)

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Table Graphic Jump Location
CRITERIA FOR DIAGNOSIS OF SEVERE MALARIA
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CRITERIA FOR THE DIAGNOSIS OF MALARIA

  • Signs and symptoms consistent with malaria, including fever, chills, malaise, myalgia, headache, ± severe malaria criteria (see Table CRITERIA FOR DIAGNOSIS OF SEVERE MALARIA), plus

  • Demonstration of the malaria parasite:

    • Light microscope examination of stained thin or thick smear

    • Rapid diagnostic test

    • Molecular or biophysical-based testing

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Table Graphic Jump Location
ANTIMALARIAL DRUG MECHANISMS OF ACTION AND RESISTANCE
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