Classification of anti-malarial drugs

- Attack the parasite in the RBC, preventing/ terminating the clinical attack

Classification of of anti-malarial drugs

- Act on pre-erythrocytic forms in the liver

Classification of anti-malarial drugs

- Destroy the sexual forms of the parasite in the blood

Classification of anti-malarial drugs

- Kill the dormant forms in the liver

Classification of anti-malarial drugs

- Inhibit the development of oocysts on the gut wall of the mosquito which has fed on the gametocyte carrier so that the mosquito cannot transmit the infection

Use of antimalarial drugs

- Used before infection occurs or becomes evident

- Example: a blood schizonticidal drug may have minimal effects on parasite growing on liver, but if it is still present in the blood when the merozoites leave the liver and invade the blood cells for the first time, it will effectively prevent symptomatic malaria

Use of antimalarial drugs

- Action on the established infection

- Example: use of blood schizonticidal drug for the treatment of the acute attack and in the case of relapsing malaria, radical treatment of the dormant liver forms

Use of antimalarial drugs

- Deterrence of infection of mosquitos with the use of gametocytocidal drugs to attack the gametocytes in the blood of the human host

- Interruption of the development of the sporogenic phase in the mosquito when it feeds on the blood of an infected person who has been given the appropriate sporonticidal compound

Defined as the absence of parasitemia on Day 14 (Day 28 for low to moderate transmission areas) irrespective of axillary temperature without previously meeting any criteria of EFT, late clinical failure, or late parasitological failure

Common antimalarial drugs

- Drug of choice

Common antimalarial drugs

- DOC for pregnancy

Common antimalarial drugs

- DOC for severe malaria (3)

Common antimalarial drugs

- Therapy for severe malaria

Common antimalarial drugs

- Newly registered against severe malaria

Common antimalarial drugs

- Chloroquine-resistant vivax malaria

Common antimalarial drugs

- DOC for gametocytes & hypnozoites

Common antimalarial drugs

- Most common drug combination used in uncomplicated falciparum malaria

Drug resistance

- Mildest form of resistance

- Characterized by initial clearance of parasites but recrudescence occurs within a month after the start of treatment

Drug resistance

- Initial reduction in parasitemia after treatment

- Failure to clear the blood of asexual parasites and soon after an increase of parasitemia follows

Drug resistance

- Severe form of resistance in which parasitemia will either show no significant change with treatment or will eventually increase

Drug resistance

- Considered when treatment failure occurs with 3 or more antimalarial agents

- Artesunate + mefloquine: first line regimen

Other treatment

- Given in cases of renal failure in severe malaria

Other treatment

- For control of seizures

Other treatment

- Given in cases of status epilepticus

Malaria prophylaxis be should taken with good compliance for the duration of the stay and should be continued for ________ after the last possible exposure to infection (parasites may still emerge from liver).

Prophylactic drugs for malaria