Malaria Flashcards
(21 cards)
What are the two types of antimalarial resistance?
-Chloroquine resistance
-Artemisinin resistance
Non-pharmacologic ways to prevent malaria
-Indoor residual spraying
-Mosquito nets
-Stay in enclosed ac rooms
-Mosquito coils
-Use effective mosquito repellant
Malaria risk factors
-Travel destination
-Altitude at destination
-Time of travel
-Type of accommodation
-Length of stay
What chemoprophylaxis should be given to someone traveling to any malaria-endemic region?
-Atovaquone/proguanil
-Doxycycline
-Tafenoquine
What chemoprophylaxis should be given to someone traveling to a chloroquine sensitive region?
-Chloroquine
-Hydroxychloroquine
What chemoprophylaxis should be given to someone traveling to a region primarily with P. vivax?
Primaquine
What chemoprophylaxis should be given to someone traveling to a region with mefloquine-sensitive malaria?
Mefloquine
Atovaquone/proguanil clinical pearls
-Take 1-2 days before departure and continue for 7 days
-Take with food or milk
-Can use in all regions
-Avoid use in CrCl less than 30, women who are pregnant, women who are breastfeeding, children under 5 kg
Chloroquine clinical pearls
-Begin 1-2 weeks before departure and continue for 4 weeks after leaving
-Can cause blurred vision, dizziness, GI disturbances
-Only taken weekly
Hydroxychloroquine clinical pearls
-Begin 1-2 weeks before departure and continue for 4 weeks after leaving
-Only taken weekly
Doxycycline clinical pearls
-Begin 1-2 days before departure and continue for 4 weeks after leaving
-Wear sunscreen
-Separate ingestion from positive cations
-Women are prone to getting vaginal yeast infections
Mefloquine clinical pearls
-Begin more than 2 weeks before departure and continue for 4 weeks
-Only taken weekly
-Can be used in all trimesters of pregnancy
-Avoid use in recent history of psychiatric disorders or seizures
Primaquine clinical pearls
-Begin 1-2 days before departure and continue for 7 days after leaving
-Must test for G6PD deficiency
-Avoid in women who are pregnant, women who are breastfeeding unless infant is tested for G6PD deficiency
Tafenoquine clinical pearls
-Begin 3 days before departure and continue 1 week after leaving
-Must get G6PD testing done
-Avoid in pregnant or breastfeeding women and people with psychotic disorders
Signs and symptoms of malaria
-Fever and traveled to a malaria endemic region before fever onset
-Headache
-Anemia
-Thrombocytopenia
-Hyponatremia
-Acidemia
-Increased creatinine
-Hypoglycemia
-Night sweats
How do you determine if a patient has severe malaria?
Has one of the following:
-Impaired consciousness/coma
-Hemoglobin less than 7
-Acute kidney injury
-Acute respiratory distress syndrome
-Circulatory collapse/shock
-Acidosis
-Disseminated intravascular coagulation
-Parasite density over 5%
What are the treatment options for uncomplicated malaria with chloroquine resistance?
-Artemether-lumefantrine
-Atovaquone-proguanil
-Quinine sulfate + doxycycline, tetracycline, or clindamycin
What are the treatment options for uncomplicated malaria with chloroquine resistance but no mefloquine resistance?
Mefloquine
What are the treatment options for uncomplicated malaria without chloroquine resistance?
-Chloroquine
-Hydroxychloroquine
Anti-relapse treatment
-Primaquine phosphate
-Tafenoquine
Treatment of severe malaria
-Perform blood smears every 12-24 hours until negative
-IV artesunate then transition to oral treatment after finishing
-Artemether-lumefantrine is the preferred oral treatment
